By Prudence L. Gourguechon on 8/5/2009 12:58 PM
Journalist Erica Goode, past winner of APsaA’s Excellence in Journalism Award, wrote a moving and disturbing story in last Sunday’s NY Times (August 2, 2009) putting the problem of veteran suicide “above the fold”, where it will, I hope, provoke further thought and action.
Goode is to be congratulated on avoiding the use of clichéd explanatory pronouncements by mental health experts, that purport to know what is behind this painful phenomenon of young soldiers, men and women, who have survived multiple tours of duty, the trauma and confusion and combat, the loss and injury of friends, taking their own lives after they come home, to presumably safer lives.
The Times comprehensive story touches on numerous potential contributors — guilt and responsibility, the absence or distance of a supportive cohort, the dangers of a stoic culture, substance abuse, marital discord, economic stress, and apparently inadequate treatment access and quality.
I was most curious about how the pattern and number of suicides for current vets compares with returning Vietnam soldiers. Both Iraq / Afghanistan and Vietnam are unpopular and questionable wars, certainly not the “good war” of World War II.
But I would think the returning soldiers now would have an easier time if not an easy one, and be less likely to suicide, since the surrounding culture is at least sympathetic and kind if still uncomprehending of what they went through.
If the percentages of suicides are higher now, why?
- Is it because of the deterioration of VA mental health services since the early 70's (I do suspect a vast deterioration in the quality and training and sophistication of VA mental health people since the early 70's, which preceded the transformation of public mental health by the contaminating and limiting concepts of managed care, EBM, CBT etc.) The stories Goode includes -- the never mailed drugs, the focus on smoking for Blaylock, the inadequate and incorrect assessments -- are understated in her story but truly ghastly.
- Is it because of a change in the screening procedures for military recruits? Would Blaylock, with his previous mental health instability (and warnings by peers) not have been accepted in Vietnam era army?
- Is it because of the patterns of recruitment and deployment, with less likelihood now, compared to returning Vietnam vets, that a returned soldier will be near his buddies?
And what about the predominance of marital issues being apparent precipitants? My memory is that marriages broke up all the time after vets returned from Vietnam, but I don’t remember hearing the emphasis on marital difficulties as a precipitant. In the general population, I wonder how high a correlation that has with suicide, and if it is seen to be causal. There seems to me to be something more to it. But I don't know what.
I welcome the thoughts and comments of colleagues on this provocative story. |