By JOHN KOOPMAN
San Francisco Chronicle
May 12, 2008
The suicide figures among veterans have caught congressional attention. Two senators have demanded the resignation of Ira Katz, the VA official who wrote "Shh" at the top of the e-mail dealing with suicide attempts and disputed the statistics in public testimony while confirming them in internal documents. A House committee has scheduled a hearing on veterans' suicides this week.
Kerri Childress, a VA spokeswoman, said the department has more than 17,000 mental health workers and is hiring 3,700 more, making the VA the largest mental health provider in the nation. The VA has also created a veteran suicide hot line, which is available 24 hours a day, seven days a week, and the agency has suicide prevention coordinators at each of its medical centers.
The VA has not disclosed what proportion of suicidal veterans served in Iraq and Afghanistan. But testimony in a lawsuit -- brought by veterans groups seeking an order to force the VA to promptly screen and treat those at risk of suicide and set timetables for handling claims for medical benefits -- indicated there was evidence that returning troops are taking their own lives in greater numbers. Witnesses and plaintiffs said there has been a steady increase in the veterans' suicide rate since 2001, and a comparatively high rate among veterans ages 20 to 24. The suit was heard by federal District Court Judge Samuel Conti, who has yet to make a ruling.
During the trial, witnesses testified the suicide rate for those veterans was anywhere from two to 7.5 times the rate among the general population.
The causes for this increase in veterans' suicide rates aren't well understood, but mental-health professionals say the biggest problem is post-traumatic stress disorder. The ailment, better-known as PTSD, is thought to afflict up to 30 percent of the troops who have served in Iraq and Afghanistan.
Dr. Frank Schoenfeld, assistant chief of mental health at the San Francisco VA Medical Center, said suicidal impulses and PTSD are two distinct afflictions, but that the stress and trauma of war, or serving during war time, can exacerbate suicidal impulses.
"We've seen this throughout military history, whether Vietnam or the first Gulf War and earlier," he said. "There are increased mental-health problems and a corresponding increase in suicide rates. That this is happening with veterans returning from Iraq is not surprising."
Schoenfeld said the issue might affect younger veterans more, because they are less likely to seek treatment and they don't have strong family ties, as do older veterans. They might be more likely to seek solace in alcohol or drugs, which only make matters worse.
Dr. Mel Blaustein, an expert on suicide and a former army therapist, said some veterans can feel isolated and helpless. If those feelings spiral out of control, the individual feels intense emotional pain, and might believe the only way to relieve it is to commit suicide.
For troops in Iraq and Afghanistan, the conditions are ripe for mental health problems.
All service in the war zones is not the same. Many live comfortably on bases with all sorts of amenities. Others live in tents or old buildings with no running water, and get ambushed or shot by snipers while on patrol in dirty, filthy neighborhoods.
But they all share one thing: the ever-present possibility of instant death. Anyone in a convoy on a roadway might be blown up by a roadside bomb, what the military calls "IEDs" or improvised explosive devices. Even on the most secure base, insurgents lob mortars and rockets, and people die in their sleep, or walking to the post office.
Janie Patterson, the suicide prevention coordinator for the VA Medical Center in Palo Alto, Calif., said much of her job involves training VA personnel how to identify and offer help to veterans who might be thinking of killing themselves. The trick, she said, is finding those veterans and convincing them that it's all right to have those problems and it's all right to seek help.
"Everyone thinks a mental problem means you're nuts," she said, "instead of, you just need help. It's like drinking or gambling or any disability. There are avenues to help you function."
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Scripps Howard News Service, http://www.scrippsnews.com
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