"to Have No Yesterday": the Rise of Suicide Rates in the Military and Among Veterans

• Publication year: 2022

46 Creighton L. Rev. 393. "TO HAVE NO YESTERDAY": THE RISE OF SUICIDE RATES IN THE MILITARY AND AMONG VETERANS

"TO HAVE NO YESTERDAY": THE RISE OF SUICIDE RATES IN THE MILITARY AND AMONG VETERANS

LINDSAY I. MCCARL(fn*)

ABSTRACT................................................394

I. INTRODUCTION...................................395

II. COMPARATIVE ANALYSIS OF SUICIDE RATES OF PAST AND CURRENT WARS...................399

A. WORLD WAR I AND WORLD WAR II ...............399

B. VIETNAM WAR...................................400

C. PERSIAN GULF WAR (OPERATION DESERT STORM)..402

D. IRAQ AND AFGHANISTAN WARS (OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM)...403

III. WHY IRAQ AND AFGHANISTAN SUICIDE RATES ARE DIFFERENT.......................... 405

A. IS THE PERCEPTION A REALITY? EXPLANATIONS FOR THE DIFFERENCES ........................... 406

1. Differences in the Wars and Conflicts Themselves..................................406

2. Medical and Technological Advancements.........408

B. REPORTING ACCURACY AND ITS IMPORTANCE IN PREVENTING SUICIDES............................411

1. Suicide Risk and Protective Factors..........412

2. Targeted Suicide Prevention Programs .......413

3. Validation of Suicide Prevention Programs ...414

C. RECENT EFFORTS TO INCREASE AND EFFECTIVELY USE METRICS....................... 415

IV. IMPLEMENTED PROGRAMS ...................... 416

A. GOVERNMENT SPONSORED PROGRAMS ............. 416

1. Transitional Training-From Combat back to Non-Combat and Civilian Life............. 416

2. Programs and Initiatives Within the VA...... 420

B. COMMUNITY AND VSO SPONSORED EFFORTS: HELPING VETERANS AT A LOCAL LEVEL ........... 423

V. PROPOSED LEGAL CHANGES IN THE MILITARY, CONGRESS AND IN COURTS......... 425

A. BEFORE THEY LEAVE: LEGAL SOLUTIONS FROM WITHIN.......................................... 426

B. THE ROLE OF OTHER THAN HONORABLE DISCHARGES FOR VETERANS INFLICTED WITH MENTAL HEALTH DISORDERS..................... 428

C. AFTER SERVICE: THE LEGAL RAMIFICATIONS FROM CALLING THE VETERANS CRISIS LINE AND RELATED STIGMA................................ 430

VI. CONCLUSION ..................................... 431

ABSTRACT

Suicide rates in the military and among veterans have increased significantly since the beginning of the Iraq and Afghanistan wars, despite the implementation of VA-sponsored programs to help stave off deaths of our war-beaten warriors. But the VA-in addition to a number of other relevant societal and governmental actors-has simply not done enough to prevent suicides among our veterans and military personnel. The first step in resolving this tragedy is to create an accurate and thoroughly detailed data system that can track the suicides of all military personnel and veterans. Such a database and related studies will provide government agencies the ability to accurately measure whether currently implemented or new suicide prevention programs are effective at reducing suicides, and the system will allow the government to determine which groups of military personnel or veterans have a higher risk of suicide. Additionally, laws and policies within the military justice system must be updated to address the increased suicides so as not to prevent servicemembers from getting the mental health care they desperately need.

"Death must be so beautiful. To lie in the soft brown earth, with the grasses waving above one's head, and listen to silence. To have no yesterday, and no to-morrow. To forget time, to forgive life, to be at peace."(fn1)

I. INTRODUCTION

In March 2010, the United States Department of Veterans Affairs ("VA") released a sobering statistic: every eighty minutes, a military veteran commits suicide.(fn2) The number of suicides has increased significantly since the beginning of the Iraq and Afghanistan wars, despite the implementation of VA-sponsored programs to help stave off deaths of our war-beaten warriors.(fn3) One such program, the Veterans Crisis Line, took more than 650,000 calls and claims to have saved more than 23,000 lives in the five years since its inception in 2007.(fn4)Yet still, twenty-two veterans take their lives everyday, and a currently serving sailor, Marine, soldier, or airman takes his or her life every thirty-six hours.(fn5) The VA-in addition to a number of other relevant societal and governmental actors-has simply not done enough to prevent suicides among our veterans and military personnel.(fn6)

"You have two minutes to convince me not to kill myself . . . starting now!" said the voice of an Army veteran who called the Veterans Crisis Line.(fn7) Chuck(fn8) had deployed during Operation Iraqi Freedom ("OIF") to Iraq, where he received a "mild" traumatic brain injury from a detonated improvised explosive device while in combat with the enemy.(fn9) He witnessed a close friend get seriously injured and watched several others die as a result of the combat in Iraq.(fn10) After Chuck's deployment, he was diagnosed with post-traumatic stress dis- order ("PTSD") and lost his faith in religion.(fn11) Like many veterans returning from war, Chuck did not want to seek help from the VA or other medical professionals for fear others might view him as weak and helpless.(fn12) He took to the streets instead and lived under a bridge with fifteen other homeless Iraq and Afghanistan war veterans.(fn13)

When Chuck called the Veterans Crisis Line, he challenged the answering therapist to convince him to not commit suicide with the untwisted end of a metal coat hanger he had pointed at his jugular vein as he lay sitting on his motel bed.(fn14) After a two-hour conversation with the therapist, an ambulance took Chuck to the nearest medical center.(fn15) Three months later, Chuck was at a PTSD recovery center.(fn16) He found his way back to his faith, and he even began a bible study with the homeless veterans under the bridge where he had lived just a few months prior.(fn17) Chuck was saved-both literally and religiously-thanks to the availability of the Veterans Crisis Line and the suicide intervention therapist on the other end of the line. But not all veterans meet the same fate.

During the initial upswing of combat operations in OIF, Randen Harvey served two back-to-back deployments in Iraq from 2003 to 2005.(fn18) While there, he was detailed to "clean up" duty: he was responsible for retrieving the dead bodies of fellow soldiers and Marines-as well as civilian women and children-and ensuring the dead received proper disposal or shipment back to the United States.(fn19) This experience changed Randen for the rest of his life, and when the Marine Corps discharged him in November 2005 his family could see as much.(fn20) Upon returning home his mother even commented, "[h]e looked so haunted."(fn21) Randen was unable to sleep, could not stay long in any job (though not for lack of trying), and eventually moved out of his room in his mother's house to the porch, where he slept with a handmade machete.(fn22)

Within four months of leaving the Marine Corps, Randen went to a VA urgent care facility claiming he could only sleep four hours a night and had cut himself on his arms.(fn23) Two weeks later, he swallowed all the pills that the doctor prescribed to him and wound up back at a VA hospital.(fn24) Yet another two weeks later, Randen was finally evaluated for and diagnosed with PTSD, agoraphobia,(fn25) alcohol abuse, and panic anxiety disorder.(fn26) Merely being diagnosed with these health problems, however, did not afford Randen the mental health care he desperately needed.

On June 11, 2006, Randen walked into the same VA medical center and warned that he "might jump off the roof or put a hose in his car exhaust."(fn27) Hospital staff did not heed his threats, and just four hours later he was found on the roof of the VA facility where he had to be coaxed down by hospital security.(fn28) He told a VA psychiatrist, "Things would be much easier if I weren't here," yet Randen was discharged later that night.(fn29) Randen returned the next day and continued to express his concerns of feeling helpless and ashamed.(fn30)

Despite the obvious and apparent warning signs that Randen was severely depressed and suicidal-indeed, he was admitted to the Detroit VA Medical Center for an attempted suicide-the VA did nothing to address his symptoms or suicidal ideation. Randen's suicide came just three days later in his father's home,(fn31) a suicide that the VA could have prevented if its staff adequately performed their duties.

What is most disturbing about these two stories is that they are not unique. Quite to the contrary, they are representative of the thousands of veterans and military servicemembers that struggle with suicidal ideation on a daily basis.(fn32)

For these servicemembers to survive the battlefield only to return home and commit suicide is a notion that reeks of depressing irony. So how can the relevant actors-federal, state, and local agencies; Veteran Service Organizations ("VSOs") and other non-governmental actors; and society in general-reverse the trend of rising suicide rates among military personnel and veterans? The first thing that must be done is to create an accurate and thoroughly detailed data system that can track the suicides of all military personnel and veterans-regardless of which war. Such a system would need to track a great deal of information about each...