Military Goes Online To Stem Troop Suicide

Military Goes Online To Stem Troop Suicide
March 16th, 2007  
Team Infidel

Topic: Military Goes Online To Stem Troop Suicide

Military Goes Online To Stem Troop Suicide
San Francisco Chronicle
March 16, 2007
Pg. 1

Web site helps soldiers cope with trauma and stress of Iraq
By Justin Berton, Chronicle Staff Writer
Here's a future scene from the Iraq battlefield, circa July 2007: A U.S. soldier battles against the enemy all day long. At night, after returning to base, he's troubled by what he's seen. But he knows better than to speak up.
Just outside the view of his fellow soldiers, he logs on to a virtual therapy Web site provided by the military called He knows that if his comrades see him talking with one of the shrinks on base, they would lose trust in him, label him a head case. A medical file soon would contain records of the visit. If he ever wanted a promotion, he'd have to explain the weakness of his mind.
Or that's the thinking among the male-dominated, therapy-averse troops, according to researchers, therapists and military psychologists who met at the fifth annual Military Suicide Prevention Conference in Hollywood, Fla., last week. Attendees discussed how to stem military suicides -- in 2005 alone, the last year for which there are confirmed figures, 22 service members killed themselves in Iraq, Kuwait and Afghanistan.
Although the suicide rate among soldiers in combat is comparable to that of the general male population of the same age group, concern is growing in the military that, due to the traumatic events of recent U.S. wars, both active soldiers and veterans are psychologically vulnerable. A study of troops returning from the Iraq war, published in the January issue of the American Journal of Psychiatry, showed that 16 percent of them met the criteria for post-traumatic stress disorder within one year of returning home. The disorder has been defined as a lingering anxiety or depression triggered by past extreme traumatic events, such as serving in combat.
Since the military is 85 percent male and the majority of its members are ages 17 to 24, conference attendees hailed the planned July 1 launch of afterdeploy as the best way to reach a group skeptical about counseling and most prone to suicide.
"If you told me to try therapy when I was 22, I would have told you you were the crazy one," said Keith Armstrong, a family therapist at UC San Francisco who spoke at the conference. He is one of the authors of the recently published "Courage After Fire," a book that helps families and soldiers cope with post-traumatic stress disorder.
Armstrong said the military's Web site, which will include an on-screen therapist who can appear in video workshops, will not have the nuance and feel of face-to-face meetings between client and therapist. But, he added, "If a large portion of your population won't step foot into a therapist's office in the first place, maybe this is the precursor to therapy that's necessary."
The Web site has been under construction for two years as part of a Congressional mandate to address post-traumatic stress disorder and after studies showed that soldiers in Iraq and Afghanistan were reluctant to visit field counselors for fear of being stigmatized by their peers, said Air Force Col. Dr. Robert Ireland, program director for mental health policy in the Office of the Assistant Secretary for Health at the U.S. Department of Defense.
In 2003, the Office of the U.S. Army Surgeon General conducted a study of military suicides after five soldiers in Iraq killed themselves within a month. The new Web site would allow soldiers in the field and veterans at home to log on anonymously. Since the Web site is considered self-help rather than professional therapy, soldiers won't receive medical advice or prescriptions for anxiety-relief drugs. Ireland said traffic on the site would not be tracked, nor would the Department of Defense monitor it.
"We won't know what's going on unless they contact a provider and say they used the site," Ireland said.
Army Col. Dr. Gregory Gahm said the site's design, including the URL -- .org instead of .mil -- is geared toward the young male who is unlikely to seek official military help for mental health needs. The test site, which Gahm presented at the conference, showed a home page with a decidedly hip look: images of young soldiers, surrounded by links that are spelled out in a style normally found on hip-hop CD covers: "KnOW your stUff." Another asks, "How am I doing?" and leads the user to a self-assessment survey.
In focus groups, Gahm said viewers complained that the initial site included photographs of men who looked "too depressed." The military hired a screenwriter and teamed with a psychiatrist to write dialogue for typical sessions.
After users progress through a series of self-analysis surveys and listen to video testimonials from fellow soldiers, they enter a workshop led by an on-screen therapist, to whom they e-mail their thoughts and questions. In response, the therapist offers prerecorded video answers about anxiety and depression as well as tips to address those emotions.
Gahm said the ideal therapist, who has yet to record the workshops, would be a multicultural female young enough to draw trust from her viewers yet old enough to be viewed as credible. She would also be a psychologist who works for the military.
"It's a small window we're working with to find this person," Gahm said, adding that the military would not turn to an actress. "But we're really trying to reach a young crowd who wouldn't ordinarily turn to therapy."
The video sessions are designed to increase in intensity and to allow users to save their workshops on private computer files. Eventually, Ireland said, he hoped users who logged on over several weeks or months would seek out a traditional therapist and share the work they've done.
"That way they've got a huge jump-start for themselves and the providers," Ireland said. "They've done the groundwork, and they don't feel like they're starting from scratch."
Army Reserve Sgt. Mike Durant, 33, who fought in Al Doha, Iraq, about 20 miles south of Baghdad from February 2005 to January 2006, said the view toward therapy among the ranks was "comparable to what it was in the 1940s."
During his tour, Durant, who now lives in Sacramento, saw a friend blown up by an improvised explosive device. At the time, his wife at home was in the process of divorcing him.
Researchers at the conference said that psychological autopsies of suicides showed failed relationships at home were among the leading causes. That, coupled with sleep deprivation and traumatic episodes of combat plus the proximity of loaded weapons, makes those on the battlefield particularly vulnerable to suicide.
Durant admitted he had thought of killing himself. "I wanted the waiting to be over," he said. "We'd do IED sweeps along the same roads, some days all day. You were just waiting for it to happen to you. You were waiting to get blown up."
After the death of his friend and with the divorce pending, Durant said his officers ordered him to visit a field Combat Stress Center for a mandatory 72-hour evaluation. Even before he returned to his battalion, he knew his commanders had lost faith in him. Anyone who was shipped to the shrinks, or sought treatment, was a liability.
"In their eyes, I was no longer reliable," Durant said. "I couldn't be trusted. I was unstable to them."
Even though he had been a member of the unit for 10 years and had served as an infantry team leader who was responsible for three men, Durant said that, while he was not officially demoted on paper, his duties dropped from one of leadership to that of a rifleman.
"Before I was sent there, I was fairly respected and highly regarded," he said. After his time at the Combat Stress Center, Durant said, "Peers and friends didn't want anything to do with me; it was like I had some sort of disease."
Durant, who now receives treatment at a Veterans' Affairs hospital in Sacramento, said the virtual therapy experiment might work for the soldiers who have already returned home. "In combat, there's just not a lot of time to cry about things. You try not to think about them; you push it out of your head. If you didn't, you wind up going crazy.
"But once you get back to the States, that's when you unwind. You start processing. You realize what you did, what you felt. That's when it becomes overwhelming."
In light of studies that estimate 16 percent of soldiers returning from Iraq have post-traumatic stress disorder, practitioners like Armstrong are bracing for a sharp increase of mental health patients into VA hospitals and the public health system. Even though there is no evidence that the disorder alone can lead to suicide, left undiagnosed and untreated, it can play a role in a soldier taking his life, Armstrong said.
Ireland said comparing the disorder and suicide rates in the Iraq and Afghanistan wars with past conflicts is difficult since reporting methods have varied. Just last year, the Department of Defense standardized the definition of suicide for all branches.
At the conference, a report from the Army Reserves showed that of the 20 confirmed suicides from its military branch in 2006, all occurred in the United States. Ten of the dead had served in Operation Iraqi Freedom or Operation Enduring Freedom in Afghanistan. Nineteen of the 20 suicides were male.
Lt. Col. Dr. Steven Pflanz, who manages the suicide prevention program for the Air Force, said, "We'll have to see how it plays out. If we did nothing, it would be a mental health care crisis. But if we can manage care now, it can possibly offset any problems down the line."
U.S. military fatalities in Iraq
Information available from March 19, 2003, to Feb. 3, 2007
Total deaths
All hostile deaths: 2,485
Total non-hostile deaths: 606 (Accidents: 390, Suicide: 99, Illness: 57, Pending: 42 [final category to be determined at a later date], Homicide: 12, Undetermined: 6)
Source: U.S. Department of Defense

Similar Topics
The Elite Largely Absent From Volunteer Military
Military Planners In Iraq May Soon Be Seeing 'Red'
Military Considers Sending As Many As 35,000 More U.S. Troops To Iraq, McCain Says
John Kerrys Military Record online
Kerry Unveils Plan To Overhaul Military