The House Armed Services Committee is holding a hearing on military suicide prevention today. Suicide has been the leading cause of death in the Armed Forces since 2012. Therefore, this is an exceptionally important topic. I have to wonder, however, if the Pentagon is conducting an “all hands on deck” response to the ongoing crisis.
In 2009, the House Armed Services Committee held a hearing on suicide prevention. The Army vice chief of staff, vice chief of Naval Operations, assistant commandant of the Marine Corps, and vice chief of Staff of the Air Force were all witnesses. These positions are among the military’s most senior leaders, all four-star generals or admiral. They discussed their services’ approach to addressing the suicide preventions problem across multiple initiatives; to include healthcare, law enforcement, and leadership training.
At this year’s hearing, there is one rear admiral, one major general, two lieutenant generals, and the civilian director of the Defense Suicide Prevention program. This is a significant difference; the rank of the individual indicates the importance of the issue to the Pentagon. Does this change in seniority for the witnesses reflect a decreased emphasis for suicide prevention in the Pentagon? Why isn’t the assistant secretary of Defense for Health Affairs or the director of the Defense Health Agency testifying when mental health care is an important aspect of suicide prevention?
The Defense Suicide Prevention Office is trying to promote help-seeking behavior towards mental healthcare in the military. Last year they published their “Campaign Plan for Promoting Awareness of the Benefits of Help-Seeking and Understanding.” However, years of marketing efforts by the military to reduce the stigma towards mental health treatment have not produced measurable results. For example, the 2013 Mental Health Advisory Team’s (MHAT) assessment in Afghanistan found the percentage of soldiers who would feel embarrassed to seek mental healthcare, that believe that seeking mental healthcare would harm their career, or believe that they would be seen as weak for seeking mental healthcare has “remained fairly stable across the four MHATs” since 2009. Since the current stigma reduction marketing campaign has not decreased the stigma towards seeking mental healthcare, what does the Pentagon plan to do differently in the future?
Finally, the Pentagon’s inspector general (IG) has released two suicide prevention reports in the last twelve months. Both of these reports were hard-hitting, evidence-based, and honest evaluations of military suicide prevention. The first report was on the DoD Suicide Event Report (DoDSER). DoDSER is the method in DoD for tracking and understanding the circumstances surrounding suicide attempts and deaths. This IG report had seven observations and 16 recommendations. The second report was an assessment of the Defense Suicide Prevention Office. Military Times reported that the IG determined the office was in “disarray.” This second report had three observations and eight recommendations. In spite of the work the Pentagon’s IG has done, they are not participating the House Armed Services Committee’s hearing.
Much of the money that Congress has provided to the Pentagon for suicide prevention has gone to building the Defense Suicide Prevention Office, not providing additional services to service members or their families. Some programs have been cancelled during this time – such as the TRICARE Assistance Program that provided web-based counseling services to Service members and their families. Few of the DoDSER recommendations by the Pentagon’s inspector general have been implemented. Senior Pentagon leadership is not present at hearings or other suicide prevention events. So, I have to ask, is this an “all hands on deck” effort for the Pentagon or is it business as usual? Where is the leadership?
Madigan is vice president of Public Policy at the American Foundation for Suicide Prevention. Credit: John Madigan, The Hill
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