Soldier suicide rate continues to climb

soldierI’ve been wanting to devote some time to blogging about this but I fear that I can’t. But I just read on CBS News that soldier suicides are still rising at an alarming rate. An estimated 128 troops killed themselves in 2008 and apparently February has seen 18 soldier suicides. (That figure may increase because some suicides are suspected but not immediately confirmed.) The Army released announced in February that at least 24 soldier deaths had been ruled as suicides.

The Army normally releases figures on self-inflicted deaths only once a year. But due to the large number of 24 suspected in January, officials decided to announce monthly figures to focus attention on the problem and on prevention programs available.

–snip–

Speaking by telephone to a group of bloggers, Chiarelli noted that officials already have bolstered suicide prevention programs and are having special training sessions this month and next, but he said no one thing can solve the problem.

The military has added mental health staff, operates hotlines for troops to call, and has programs to counter stress on the battlefields in Iraq and Afghanistan. There was no breakdown on how many of the suicides happened at the warfront.

It’s a shame that so many troops had to lose their lives for the Army to get a wake up call on bolstering suicide prevention and mental health programs. My guess is suffering from PTSD also plays a part in pushing soldiers over the edge.

Loose Screws Mental Health News

Call me old-fashioned (I am 26 after all; that's 62 in technology years) but I don't like the idea of putting my personal health records online. Google Health has just launched in an attempt to rival Microsoft's Revolution Health. GH's site appears way more personalized than RH and the idea of uploading medical records doesn't thrill me. GH has features where you can put in the "general" information people don't mind giving out (ie, height, weight) and personalize the diseases, disorders, or conditions you might suffer from (somewhat like WebMD). This is about as far as I would go in using the site. No way would I upload a PDF from my doctor with my name, address, social security number, and health insurance information on the a site — I don't care HOW secure. Medical identity theft is a reality now and the last thing I need to worry about is some idiot hacker stealing people's medical records online. We already have enough problems with people stealing VA SSNs.

On the topic of health, the AP is reporting that an estimated 300 to 400 doctors commit suicide every year — a rate that rivals that of the general population. (Hat tip: GP Essentials)

As for the VA, the news keeps on getting better and better. The Washington Post reports that psychologists at VA facilities are being told to keep their PTSD diagnoses to a minimum so the VA can stem the tide of veterans seeking disability payments for the condition. Depending on the severity of the disorder, veterans can receive up to a little more than $2500 per month. Norma Perez, PTSD coordinator for a Texas VA facility, sent an internal e-mail to mental health and social workers saying:

Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out."

Instead, she recommended that they "consider a diagnosis of Adjustment Disorder."

VA staff members "really don't . . . have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

The Post quotes psychiatrist Dr. Anthony T. Ng who says that "adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months." This means less payout for the VA.

After the e-mail went public, VA Secretary Jim Peake issued a statement saying that Perez "has been counseled" and "is extremely apologetic." Of course. She has to be. She still has a job. (Credit to Kevin M.D.)

Calls for VA's top official to resign

I’d been meaning to talk about this story but it’s progressed faster than my typing hands can keep up.

An e-mail sent around at the Veterans Health Administration among Dr. Ira Katz, the VA mental health director, and other officials, discussed the issue of hiding the number of suicides committed by veterans from the public—an estimated five out 18 of them being under VA care. Now, a number of senators (and bloggers) are calling for Katz’s resignation.

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Mental Health Problems Among Soldiers and Veterans

I stumbled upon rawstory.com where I read about a report that CBS released detailing that suicide among veterans is double that of non-veterans. The Department of Veteran Affairs (VA) estimates that 5,000 veterans will commit suicide this year. Actually, the wording verbatim is "5000 suicides among veterans can be expected this year. It's sad that we've come to the point where we expect veterans to just kill themselves.

The Red State blog highlighted a notable quote from the story:

It found that veterans were more than twice as likely to commit suicide in 2005 than non-vets. (Veterans committed suicide at the rate of between 18.7 to 20.8 per 100,000, compared to other Americans, who did so at the rate of 8.9 per 100,000.)

One age group stood out. Veterans aged 20 through 24, those who have served during the war on terror. They had the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age. (The suicide rate for non-veterans is 8.3 per 100,000, while the rate for veterans was found to be between 22.9 and 31.9 per 100,000.)
I'll reiterate the obvious that everyone's been stating: Something needs to be done.
In general, the rate for veterans needs to significantly decrease, but I find the rate of suicide in the 20-24 age group alarming.
What's the disconnect between that age range as opposed to the other age ranges?
The issue here that needs to be addressed is psychological effects from the war resulting in post-traumatic stress disorder (PTSD).
While I'm sure that psychiatric assistance may come into play for some veterans, all veterans should receive counseling and therapy.
We'll see how the VA handles this information going forward.

In a related matter, USA Today published an article, based on an Army study in the Journal of the American Medical Association, detailing how duty in Iraq affects Army and National Guard soldiers.

The mental toll of fighting in Iraq affects 20% of active-duty soldiers and 42% of National Guard troops and reservists, according to an Army study, which also found that most mental health problems didn't surface until months after troops returned home.

Army psychiatrists examined the results of routine health screenings administered to nearly 90,000 soldiers – active-duty, National Guard and reservists – returning from Iraq in 2005 and 2006. They found about 25,000 suffering mental health problems, ranging from post-traumatic stress disorder (PTSD) and depression to substance abuse and family conflict, according to the study published Wednesday in the Journal of the American Medical Association.

The study also found that mental health problems did not surface as the soldiers left Iraq, but rather, that they appeared about three to six months after a tour of duty. Considering that soldiers are no longer in an unfamiliar area where their top concern is their safety, the appearance of mental health issues upon returning to the U.S. should be of no surprise.

One problem uncovered by the study was the Army's difficulty in treating alcohol abuse. Out of nearly 7,000 soldiers who admitted a drinking problem, 29 signed up for rehabilitation services. The authors blamed this on a policy that requires commanders be notified when a soldier enrolls in alcohol-abuse treatment programs.

I cannot provide any suggestions on how to change a tradition of pretentiousness in the Army: A solider pretending that nothing is wrong while turmoil rages inside his mind. Soldiers are expected and trained to be strong, to not be afraid, and to face their fears. Many of them when on active duty exemplify that attitude. However, working as a soldier is just that – it's work. Just like accountants or editors who are trained in their field, soldiers are trained in their jobs. When a soldier returns from duty, he is a normal human being like the accountant that clocks out at 5 in the evening. Perhaps that analogy might explain how a  soldier struggles with these problems when he is "off the clock," so to speak.

The emergence of mental health issues among soldiers – not just PTSD but also forms of abuse: drug, alcohol, violent – shows that the military needs to engage in preemptive action to combat these problems before they arise. (The puns were not intended, but I thought they were somewhat clever.)

Loose Screws Mental Health News

According to a press release (I’m well aware what I’m saying), a recent study possibly shows that schizophrenia’s physical effects are more widespread in the body; researchers previously theorized that schizophrenia was limited to the central nervous system.

“The findings could lead to better diagnostic testing for the disease and could help explain why those afflicted with it are more prone to type II diabetes, cardiovascular diseases, and other chronic health problems.”

Apparently, those who suffer from schizophrenia have abnormal proteins in the liver and red blood cells. While schizophrenia’s most visible effects are psychological, researchers have noted that schizophrenics are at a higher risk for “chronic diseases.” The genetic and physical implications of such a study could prove interesting, especially for those suffering from and at risk for schizophrenia. Also in schizophrenia news, researchers have noticed an “excessive startle response.” The startle response, known as prepulse inhibition (PPI), is being considered as a biomarker for the illness.

Something Furious Seasons might like to argue if he hasn’t taken the following on:

“Lastly, but quite importantly, atypical antipsychotic were found to be more effective than typical antipsychotics in improving PPI, thus ‘normalizing’ the startle response. This led the authors to note:

‘Because an overwhelming number of patients with schizophrenia are currently treated with atypical APs, it is possible that PPI deficits in this population are a vanishing biomarker.”

What’s the advantage with atypicals vs. typicals? How do they work differently? *sigh* I need a pharmaceutical-specific wikipedia.

Schizophrenia News previously wrote about how proof is lacking in schizophrenia developing in those who have suffered from child abuse. (Excuse me for the awful construction of that sentence.) However, a new study shows that those at a high risk for schizophrenia benefit from having a good relationship with their parents during childhood. Read more.

Editor and Publisher has noted that suicides among Army soldiers doubled in 2005 compared to 2004.

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