Sunday, May 24, 2009

Suicide in the US army

From the Washington Post:

Generals Find Suicide a Frustrating Enemy
As Numbers Continue to Climb, Top Officers Meet Monthly to Look for Answers
May 23

... Such meetings are one piece of a broader effort to arrest the Army's rising suicide rate, which has surged to record levels in the past year. In 2008, 140 soldiers on active duty took their own lives, continuing a trend in which the number of suicides has increased more than 60 percent since 2003, surpassing the rate for the general U.S. population...

The Army's biggest challenge is that its volunteer force is in uncharted territory. Many soldiers are now in the midst of their third or fourth combat tour, and Army surveys show that mental health deteriorates with each one... (link)
And the Daily Beast reveals the US military's backward treatment of mental illness:
... The surviving recruit's superiors were concerned about him. For two weeks, he was put on suicide watch, a common but not entirely standard procedure for at-risk soldiers. "Two battle buddies watch you 24/7," the recruit, who is still in training to become a radio operator, says. "You have to wear a road guard vest—there's no shoelaces, no bedsheets, no belt." On an Army base, where everybody is wearing the same digitized camouflaged uniform—and everybody is trained to spot small differences, like rank and unit, from a distance—just wearing boots held together by rubber bands instead of laces would draw attention. But a road guard vest is bright, construction-zone orange. In a sea of green, you can't miss it.

"You're in an isolated state," the recruit says. The orange vest makes you a pariah...

Suicide watch (also called unit watch, buddy watch, or command interest profile) is how the Army deals with soldiers in garrison who express suicidal thoughts but don't appear to be in immediate danger of harming themselves. It's been around in some form since the 1980s, and generally involves a suicidal soldier being watched by one or two fellow soldiers around the clock, and having his gun, shoelaces, and belt taken away, so he can't kill himself.

It’s unclear how widespread exactly the use of the road guard vest is. Not every base uses it, though it is used at Fort Benning, where infantry soldiers, who are more at-risk for killing themselves when they come back, are trained. One soldier-blogger at an unspecified base wrote in the summer of 2008 that “there are around five kids that have to wear big red vests for suicide watch because they tried to.”

The purpose of the vest is, ostensibly, to make it easy for others to keep an eye on a suicidal soldier, but forcing a soldier to advertise his own depression creates a powerful stigma. "When you see what happens to someone on suicide watch—the orange vest, the trips to the chaplain, the drill sergeant talking about them when they're not there, saying they can't handle the military. … When you see that, you're going to think twice about speaking up and saying you need some help. It makes you not want to talk to someone. You don't want to be like that guy," the recruit from Benning says.

One soldier describes suicide watch on his blog like this: “[E]veryone can see you because you're wearing a bright orange vest in a yard of green uniforms. Your baggy camouflage pants are always falling down and you can't walk any way but awkwardly without loosing [sic] your boots. Two guys who don't like you are constantly at your side and you'd damned well better do whatever they say. Drill Sargeants [sic] go out of their way to make fun of you for the captive audience. You are fodder. You are an example.”

"I can't think of anything worse in the ethos of the military," says Polly Coe, a therapist who treats soldiers stationed at Fort Campbell, in Kentucky. Singling out suicidal soldiers, she says, "makes them more suicidal." ...

I talked to many soldiers who remember seeing guys in orange vests at Fort Benning, though few of them have much sympathy for those recruits, who are often seen as wimps trying to get out of their contract... (link)

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