How the US can address the tragedy of veteran suicide

Veterans in the United States take their own lives at an alarming rate. Suggesting new ways to prioritize mental health in the military, veterans advocate Charles P. Smith offers a data-driven plan to help prevent suicide and ensure service members get proper care before, during and after active duty.

So on May 6 of 2019,

the sun was shining, the sky was blue,

clouds were that puffy white.

It was a perfect spring day.

I was walking back to my office,

and my phone rang.

And it was one of my lieutenants.

I said, "Hey, John.

How are you?"

He said, "Sir, I'm good.

But I've got some bad news."

He said our executive officer
died that weekend.

We went back and forth,

"What do you mean,
what are you talking about?"

I asked him what happened.

He said, "Sir, he killed himself."

I walked around my office
for a couple of hours in a complete fog,

trying to understand
what had happened, why.

I had just communicated with him
a few months earlier.

And I had no idea
that this officer was in trouble.

And I fault myself as a leader
for not having known that.

I went on this process
of trying to figure out

why, what's happening
in the veteran community,

why are these things going on.

I read reports from
the Department of Veteran Affairs,

Department of Defense,

I've read national studies
on mental health

and the issues associated with it.

I'm going to share with you
some of the things I found out.

Department of Veteran Affairs
has taken the lead on veteran suicide,

and it's actually
their number one priority.

Based on the reports they have
and the numbers that I've calculated,

between 2001 and 2019,

during the time
of the Global War on Terror,

my approximation is
there's 115,000 veterans

who have died by their own hands.

I also looked at the Department
of Defense report

that lists casualties.

This particular report

lists the casualties from October of 2001

specifically to November 18 of last year.

During that time frame
and the Global War on Terror,

there have been 5,440
active duty members killed in action.

So by my numbers,
115,000 approximate suicides,

5,440 killed in action.

What does that mean to me?

We have approximately 21 veterans
ending their lives by their own hand

for every one that is killed
by an enemy combatant.

It's a staggering, staggering number.

These national studies

that deal with mental health tell us

that if you have any type of genetic
mental health issue within your family

that can be passed on,

or if something has happened to you
in your childhood that was traumatic,

your ability to deal with post-traumatic
stress disorder, or PTSD,

significantly decreases.

They also tell us

that if you want
to have a full evaluation,

determine if somebody has PTSD,

you need to have a minimum
of one hour interview

with a mental health expert

that's trained to detect what PTSD is

to determine if you suffer from it.

Now let me talk about what happens
when you enter into the military.

When you join the armed forces,

you're going to go through a medical exam,

you're going to take
a physical fitness test,

you're going to take a drug test,

you're going to take a vocational test

so they can figure out what you're good at

and hopefully place you
in that type of job category.

But would you believe

that with approximately 115,000 suicides
over the last 20 years,

and the data that we know
from the national studies

on how to determine if somebody
is going to be able to cope

with post-traumatic stress disorder,

we still don't have a standardized
mental health evaluation

for our recruits
entering into the service.

That's something I think
that needs to change.

Number two,

when you leave the service --

When I left the service in 2003,

I had to attend some mandatory classes,

about two days' worth of classes,

and then I was on my way.

Today, it's a little different.

Today you'll actually get a call

if you're on what we call terminal leave

or paid time off
that you're trying to use up

before you actually are fully discharged.

I talked to one veteran who got a call.

He was on his way home from work,

and the only thing he could think of

was, "How quick can I get off this?"

And I think the call lasted
maybe 10 or 15 minutes.

But yet the national studies tell us

it needs to be an in-person,
one-hour interview.

I think that's something
that we can improve upon.

There's another thing
that the Department of Veteran Affairs

talked about in the reports.

They said that our service members
that are self-medicating

tend to be at a significantly
higher risk of suicide.

So those veterans that are
self-medicating with alcohol,

or drug abuse --

and in fact, the Department
of Veteran Affairs has classified

opioid use disorder, OUD,

as one of the epidemics.

So as I talked to marines from my unit

and tried to learn more about it,

I started to find out
some really, really alarming things.

I had a marine who came back from Iraq

and he went to the hospital
for a "back pain"

and he was prescribed some opioids.

He also suffered from
post-traumatic stress disorder.

He became addicted to these painkillers,

because not only did it mask
the pain in his back,

but it helped him to cope

with some of the horrific things
that he had to see, experience and do

over in the Middle East.

And he eventually overdosed.

Another challenge we have

is that when you're on active duty,

you are under the Department of Defense.

And so all of your doctors,
all your health care

is in that category.

When you leave the service,

you are now part of the Department
of Veteran Affairs.

So these active duty members

that seek help for their
mental health issues

and are diagnosed with PTSD
or other mental health issues,

when they leave the service,

there's no transition to a doctor

that's in the Department
of Veteran Affairs

or perhaps out in the civilian world

because of privacy acts.

Now there's some good news in this.

Just recently, it was legislated

that a database will be built

that will house both Department
of Defense health records

and Department of Veteran
Affairs health records.

But I want to take
that thought a step further.

My company was 204
marines and sailors strong.

As I looked at and I talked
to my marines from my unit,

what we came up with
is we are well in excess of a dozen

of our members that committed suicide.

When I talk to senior
leadership in the battalion,

and battalion is about
six to seven hundred marines,

they estimate that we're in the hundreds
who have committed suicide.

So let's take this database
that we're building,

and let's go a little bit further with it.

What if when a veteran passes away,

whether it's natural causes,

overdose or suicide,

we're able to feed that
into the Veteran Affairs

who is then able to access
Department of Defense records,

identify what type of units they were in,

what contingencies and operations
did they participate in,

and let's build the data points
to try to figure out

are there units that are more susceptible
to develop post-traumatic stress disorder

so that we can get them the mental health

prior to going on deployment,

prior to being in theater.

If they're in theater,

get them the mental health
while they're in theater,

and get them mental health
counseling and help

before they even come home out of theater.

(Applause)

And by the way,

if we can build those sets of data points
to be able to do that,

we don't just apply them to the military,

we can also use that
for the general population.

If we put our minds together

and our resources together,

and we openly talk about this,

and try to find solutions

for this epidemic
that's going on in America,

hopefully we can save a life.

Those are my thoughts, my ideas,

I hope that this talk
is not the end of this discussion

but rather the beginning of it.

And I want to thank you
for your time today.

(Applause)