I am an Air Force wife. My husband has struggled with suicidal ideation and depression. So when I read Brown University’s recent Costs of War report on post-9/11 suicide rates among the military, I found the data tragic -- but not unsurprising.
More military-affiliated individuals have died by suicide than have been killed in post-9/11 operations. Military members have largely shouldered the burden of this war, and the cost of that trauma has been great. The suicide rate among this demographic is now higher than the civilian rate, and this is especially concerning because the rate for military members has been lower historically than civilian counterparts, as noted by the study.
According to Brown University, more post-9/11 service members and war veterans have died by suicide than in combat. “An estimated 30,177 have died by suicide as compared with the 7,057 killed in post 9/11 war operations.” The ripple effect of those who have been impacted by these horrible deaths number many times more.
While the Department of Defense, Veterans’ Administration, and other organizations are trying to address this alarming trend, one component that must be further integrated and supported is the family. Depression and suicide do not happen in a vacuum, and these events have a profound impact on those in the service member or veteran’s life.
Military service members, war veterans, and their families carry the costs of war daily. Most civilians in our country have been fortunate to not have experienced, at least directly, the horror of the Global War on Terror. But many U.S. servicemembers — especially those who have done multiple tours of duty — have. Traumatic events like IED blasts (with accompanying traumatic brain injury) carry significant impact even after a deployment ends and service members return to American soil. This can lead to Post Traumatic Stress Disorder. The Rand Corporation, in a 2019 report entitled Improving the Quality of Mental Health Care for Veterans, identified that up to 20 percent of deployed individuals experience PTSD, up to 44 percent have a dependency on alcohol, and 48 percent of those who deployed experienced strains in family life.
All of these are factors for suicide. War leaves those involved forever changed, and in some ways it feels like those of us who had a front row seat will forever be picking up the pieces of what used to be.
Even knowing that my husband struggled with suicidality left me with significant trauma. The what-ifs and what-could-have-beens still haunt me, and I am well aware that my family remains in a high risk category. There were, and sometimes still are, days where I did not know what I would or would not come home to. The helplessness of knowing that someone I love wanted to die as badly as he did could be overwhelming. It took a toll on me, and some days it still does.
I was fortunate in that my husband sought significant and intensive treatment. Even with that treatment, though, my family did not receive support from healthcare providers or the military. I believe that it is essential for all parties to be directly connected with the treatment team for the healing process of the wounded individual. It is very easy and oftentimes necessary to focus on the struggling individual, but at the same time there are others impacted by this depression or suicide attempt who also need help navigating these choppy waters.
One barrier for supporting and treating war ravaged individuals is a shortage of military and VA mental health providers. The military is struggling to fill mental health job vacancies and provide care to members. The Rand Corporation noted in their aforementioned report that the VA is also struggling to fill shortages.
Another major barrier for seeking treatment is stigma. The Brown University report noted, “In general, veterans tend to have a stigma against mental health care and tend to match the general public’s negative view of those who seek help as dangerous and worthy of social avoidance. A retired Marine officer revealed to me that he has actively avoided the diagnosis while suspecting he has PTSD. He said, “No matter what, when you go, and you spend a year in a combat zone or wherever, your mind works in a different way, and even if you’re in a combat zone, but you’re not involved in combat, your mind works in a different way.”
He felt it was better to look resilient and strong than to look like the persistent stereotype of a mentally broken veteran. Stigma seems to be ingrained in military culture and carries over even after a military member leaves the service, regardless of whether the member served on a front line or as a support to the war. Even those who did not directly see battle still come home changed.
Allocating additional funding specifically for more mental health practitioners and programs can help these barriers be reduced. The 2021 VA budget allocated $10.3 billion for mental health services and $312 million for suicide prevention outreach. The DoD has a $50.8 billion budget to fund the Military Health System, with $30.7 million earmarked for unit-based mental health and physical therapy providers. But is it getting to who really did it? Is it putting the right people in place to treat the incoming need?
For example, advocate Abbie Bennet noted in 2019 that “with 50 percent of psychiatrists across the country operating cash-only private practices (which do not take insurance), many make $300,000 to $400,000 per year and have little financial incentive to work for the military.” Psychiatrists that work for the government earn “at best 20 percent less,” the report shows.
This scenario is similar to the VA and is not limited to psychiatrists. Crafting initiatives and incentivizing programs that change the culture of the military and the VA are imperative to meeting the needs of these suffering military members, veterans, and their families. Another article detailed that a DoD Inspector General report in August 2020 found “patients seeking outpatient mental health treatment often experienced delays (up to 79 days) or never obtained care at all due to inconsistencies in standards, inadequate staffing, outdated provider information and other shortcomings in the military’s health system.”
Reducing red tape and increasing access to these programs by recruiting and retaining effective therapists is essential for the wellbeing of those who fought for us and those of us who care for them when they come back. Furthermore, funding and supporting nonprofits that care for and support these individuals is also important and can continue to decrease stigma.
Losing four times as many military and war veterans to suicide than died in combat is heartbreaking. These lives were unnecessarily lost for a multitude of preventable reasons. There are many factors that do and could contribute to someone wanting to take their own life. As the Brown study identified, suicide rates in the military have typically been lower than civillian counterparts, but the previously protective nature of military service in regards to suicidality now seems to be a liability.
Our country owes a debt of gratitude to those who shouldered the burden of war, and it is time to help them and their families carry the load.