Military suicide prevention efforts fall short despite increased funding

[Ryan Robertson]

WHEN IT COMES TO PREVENTING SUICIDE AMONG ACTIVE DUTY MILITARY MEMBERS AND VETERANS, THE NUMBERS DON’T ADD UP. 

THAT’S THE MESSAGE FROM THE VETERAN’S ADVOCACY GROUP GRUNT STYLE FOUNDATION. ACCORDING TO A PRESS RELEASE FROM THE FOUNDATION, THE VA RECEIVED AN ESTIMATED $571 MILLION FOR SUICIDE PREVENTION EFFORTS IN FISCAL YEAR 2024, AND IT REQUESTED EVEN MORE MONEY FOR THIS FISCAL YEAR.

IN ADDRESSING THE PROBLEM, MARINE CORPS VETERAN AND FOUNDATION PRESIDENT TIM JENSEN SAYS, 

“Every day, we lose 17 of our brothers and sisters to suicide. That’s not just a statistic; those are our friends, our battle buddies, our family members. The VA’s current budget allocates approximately $570 million specifically for suicide prevention initiatives, yet the crisis continues to worsen.”

[Ryan Robertson]

ON THE OTHER SIDE OF THE MILLIONS OF DOLLARS BEING SPENT ARE MORE THAN 156,000 SERVICE MEMBERS AND VETERANS WHO TOOK THEIR OWN LIVES OVER THE LAST 20 YEARS.

TO BETTER UNDERSTAND WHY THIS CONTINUES TO HAPPEN, THIS PAST NOVEMBER I SAT DOWN WITH DR. KARI THYNE, AN AIR FORCE VETERAN AND THE ASSOCIATE PROFESSOR OF INTERDISCIPLINARY STUDIES AT JOINT SPECIAL OPERATIONS UNIVERSITY, AND DR. JOHN EDGAR CATERSON, A FACULTY MASTER INSTRUCTOR ALSO AT THE JOINT SPECIAL OPERATIONS UNIVERSITY. 

WE EDITED OUR CONVERSATION DOWN FOR TIME PURPOSES, BUT THE ENTIRE THING WILL BE AVAILABLE IN FULL ON THE WEAPONS AND WARFARE YOUTUBE CHANNEL. 

WITH THAT, HERE’S THIS WEEK’S DEBRIEF.

ALL RIGHT. DR CARRIE TYNE. DR JOHN EDGAR CATTERSON, JE YOU GO BY WITH YOUR FRIENDS, HOPEFULLY I CAN CALL YOU THAT OVER THE COURSE OF OUR CONVERSATION. WANT TO THANK YOU BOTH SO MUCH FOR JOINING ME TODAY. WE ARE TALKING ABOUT SUICIDES IN THE MILITARY. THE ANNUAL REPORT ON SUICIDES JUST CAME OUT 2023 SLIGHTLY HIGHER THAN 2022, BUT THE ACTIVE DUTY NUMBERS HAVE SHOWN AN INCREASE FOR THE LAST DECADE OR SO. DR CATTERSON, IF YOU COULD, WHY DO YOU THINK THOSE NUMBERS, DESPITE THE EFFORTS TO COUNTERACT THIS? WHY DO YOU THINK THERE’S BEEN A STEADY INCREASE IN ACTIVE DUTY SUICIDES OVER THE LAST DECADE.

[Dr. John Edgar Caterson, Faculty Master Instructor, Joint Special Operations University]

“You know, I think it’s, you know, kind of like compound interest, you know, with all the things that the military has been through in the 20 year, you know, G wat, Global War on Terrorism, and even as we’ve kind of ramped down on that, just like anything else that would that impacts us in the area of our mental, our emotional, our spiritual health, it catches up with us. And I think that you know, the traditional approaches that we’ve used to combat military suicide has not had the impact that we were hoping that would have.”

[Ryan Robertson]

DR THYNE I WANT TO BRING YOU IN HERE REAL QUICK WHEN WE’RE TALKING ABOUT MORAL INJURY, AND OBVIOUSLY THE BOTH OF YOU WORK IN THE SPECIAL OPERATIONS COMMUNITY, BUT IT’S NOT, AS YOUR TIME IN THE AIR FORCE HAS SHOWN, IT’S NOT JUST NECESSARILY SPECIAL OPERATORS DURING DEALING WITH MORAL INJURY. IT COULD BE ANYBODY FROM ANY SERVICE. WHAT ARE SOME CASES OF MORAL INJURY THAT YOU’VE SEEN THAT HAVE IMPACTED A SOLDIER’S MENTAL DISPOSITION? AND I’M NOT NECESSARILY LIKE SAYING, YOU KNOW, GIVE ME SPECIFICS, BUT LIKE, IN GENERAL, WHAT ARE SOME CASES OF SOME MORAL INJURY THAT MIGHT HAVE OCCURRED THAT AREN’T NECESSARILY SPECIAL OPERATOR, I HAD TO KILL THIS PERSON TO GET THROUGH A DOOR, KIND OF THING? BUT JUST MORE GENERAL, YOU KNOW, WIDER SCALE THINGS.

[Dr. Kari Thyne, Assoc. Prof. of Interdisciplinary Studies, Joint Special Operations University]

“Sure we, in fact, we just talked about it, and I’m I’m actually briefing Dr catterson’s work, so he’ll jump in if I get it wrong. But what the research is showing is that moral injury can be caused by a variety of things, like you’ve said, witnessing things. It’s not just in in the doing of things. It’s witnessing others violate their moral values, beliefs and principles. So the number one cause of moral injury is actually witnessing the moral failure of leaders. So that when, when we when we’re out and about and talking to people, that’s what they are reporting. So there is a misstep or a mismatch between what people are expecting to see from their leaders and what they are seeing from their leaders. And part of our education lesson is to try and to let leaders know they they know, but to remind them that they are constantly being watched for what they do and for what they don’t do by everyone around them, whether they realize it or not, and their actions can can very, be very impactful to those Around particularly, particularly when they’re failing to meet or actually violating, on purpose, a moral code.”

[Ryan Robertson]

THE STIGMA THAT’S OFTEN ASSOCIATED WITH GETTING TO GETTING MENTAL HEALTH AND ASKING FOR HELP. THE THE ANNUAL REPORT SHOWED THAT THE NOT THE MAJORITY, BUT A LARGE NUMBER OF FOLKS WHO HAD, YOU KNOW, HAD HAD COMMITTED SUICIDE WITHIN WITHIN A YEAR OR WITHIN 90 DAYS OF THEIR COMMITTING SUICIDE, HAD HAD SOUGHT SOME KIND OF MENTAL HEALTH. THEY’D BEEN DIAGNOSED WITH A BEHAVIORAL, EMOTIONAL PROBLEM. THEY HAD, YOU KNOW, SPENT TIME IN AN IN TREATMENT FACILITY, MAYBE. SO THERE’S, IT WASN’T, IT WASN’T A MAJORITY, BUT IT WAS A LARGE NUMBER OF FOLKS, BUT THEY THEY STILL WENT THROUGH WITH THE ACT, RIGHT? WHAT’S, WHAT’S THE DISCONNECT THERE AND AND HOW DO WE OVERCOME THAT?

[Dr. John Edgar Caterson, Faculty Master Instructor, Joint Special Operations University]

“There is a distinction between the two. I mean, PTSD is really kind of like a startle reflex. It’s a memory loss. It’s, it’s, fear flashbacks that come versus moral injuries. Is is more nuanced than sorrow, grief, regret, shame, alienation and even disgust. And so when we, when we put in simple terms, even you know, when we train on this all the time, all throughout our courses. Uh. Whether it’s the pre command course or in the Chapman courses, or in any of our orientation courses for or in the advanced one at the senior listed Academy, is that you’re looking at PTSD is really kind of like a traumatic threat to a personal well being, right? Versus moral injury is a traumatic violation of personal values, right? So, and this is going to nuance itself as you move towards suicide ideation, PTSD is based on fear and adrenaline, versus moral injury is based on morals and ethics, right? And you’re looking at physical or psychological wound for PTSD versus really an invisible or a soul wound, even some would say a spiritual wound is what moral injury is. And moral injury can be a precursor to suicide, but PTSD can result from moral injuries.”

[Ryan Robertson]

WHEN WE’RE TALKING ABOUT FOLKS MIGHT HAVE SOUGHT OUT HELP, BUT BECAUSE OF A LACK OF, I’M JUST GONNA SAY, LACK OF KNOWLEDGE ON THE FRONT LINES FOR THE PEOPLE NEEDING HELP, THEY DIDN’T RECOGNIZE NECESSARILY, THAT PERSONAL DISGUST WAS SUCH A HUGE FACTOR IN THAT SO MAYBE THAT’S WHY, EVEN THOSE IN 2023 A LARGE NUMBER OF PEOPLE DID SEEK OUT HELP, BUT STILL WENT ON TO COMMIT SUICIDE. MAYBE IT’S BECAUSE THE THE KNOWLEDGE THAT PERSONAL DISGUST WAS SUCH A CATACLYSMIC FACTOR WASN’T YET PART OF THE INSTITUTIONAL KNOWLEDGE. IS THAT ACCURATE? DR TYNE, I SEE YOU NODDING ALONG.

[Dr. Kari Thyne, Assoc. Prof. of Interdisciplinary Studies, Joint Special Operations University]

“When I was in they used to give us these yellow cards, and it was, you know, how, how will you know if someone’s going to commit suicide? And it’s, it had things like they’re giving away their valued personal possessions. You know, they seem withdrawn. And so it was a laundry list of things, but I’m not sure I would really be what it brought into focus for me was that unless it’s someone I work very closely with meaning day, each day I am working with this person. I don’t really know if there’s a dramatic change in their demeanor or a subtle change in their demeanor, or if they’re giving away their valued personal possessions, and certainly everyone didn’t exhibit all of these traits. So as far as effectively helping me prevent suicide. I’m not sure that that it did that for me, so, but I like the card, and I like the idea behind the card now that I’m on the other side of it, and you can see things once you’re out of the military that you couldn’t see when you were in no matter how thoughtful or educated you are. We just have some sort of professional and personal blinders on that drop when you get with the benefit of perspective. So when I heard Dr Catterson and another member of his team brief this, I thought, this is the word that needs to get out to the force. This is that yellow card. So if you hear people expressing anger, guilt and shame, be a good friend. Listen to them. They’re processing and trying to deal with something that is very important to them. So lend an ear. But if you hear people expressing anger, guilt and shame, along with personal disgust, drop what you are doing and go to them immediately, because people tend to resolve feelings of personal disgust by killing themselves. And that’s something that I I can say as an educator in front of a wide variety of audiences, and that’s something concrete that people can latch on to, and they’re like, ah, that’s something I will recognize. I will recognize people talking about their actions with personal disgust, even if I am transiting the area and I can do something about that, or I can go circle back around to people who know this person and so. But the other side of that is that organizational change or cultural change, takes 10 to 15 years. So it’s not something even as trite as it is, even if we put it on bumper stickers and we and we splattered the Department of Defense with it, it’s not something that is going to change our organizational culture in a meaningful way without other partnered initiatives and kind of a widespread focus on it. And so part of this, there’s an element of time that we are just going to have to work through.”

[Ryan Robertson] 

DOCTOR THYNE. DOCTOR CATTERSON, THANK YOU SO MUCH FOR JOINING ME TODAY. IS THERE ANYTHING ELSE THAT EITHER OF YOU WOULD LIKE TO ADD TO THE CONVERSATION, A QUESTION I DIDN’T ASK YOU FEEL LIKE NEEDS TO BE ANSWERED?

[Dr. John Edgar Caterson, Faculty Master Instructor, Joint Special Operations University]

“No, you’ve done a great job, but just so that there’s a preview, you know, we’re hoping by next summer, you know, two, two of the works that we’re involved in, one is called the invisible enemy, will come out, which looks at a moral injury, typology and treatment. As it looks at everything we’ve been talking about today to continue of looking at ethics, ethics training, moral training, that moves into to addressing head on moral injury, PTSD and suicide, ideation, all that stuff. And the other one is that we’re trying to get finished up is the invisibility cloak, which is the work that Dr time has pioneered that gives that pre pre emphasis as well. Because we even the titles of both of those invisible enemy invisibility cloak, they are intriguing, and we do think that they, they will be useful for for the for the team of developing the pre, pre.”

[Dr. Kari Thyne, Assoc. Prof. of Interdisciplinary Studies, Joint Special Operations University]

“I’m glad to have met you and your and your and your writer, Brett. Brett, I’m glad that you guys are working in this space, and I admire you for being part of the conversation and for bringing this to the forefront of other people who, who’s who? We need everybody or as many people. We need a coalition of the willing to take on this problem. And I do think it is a problem that we can, if not, solve, we can at least be a lot better at it. ”

[Dr. John Edgar Caterson, Faculty Master Instructor, Joint Special Operations University]

“That’s right. ”

[Ryan Roberton]

I WANT TO THANK DOCTORS THYNE AND CATERSON FOR SITTING DOWN WITH US. I ALSO WANT TO ENCOURAGE YOU TO GIVE OUR FULL CONVERSATION A LISTEN. YOU CAN FIND THAT, IN VIDEO OR PODCAST FORM,  ON THE WEAPONS AND WARFARE YOUTUBE CHANNEL.

FINALLY, IF YOU OR SOMEONE YOU KNOW IS STRUGGLING WITH MORAL INJURY OR YOUR MENTAL HEALTH, THE STORY BELOW WILL PROVIDE LINKS TO THE RESOURCES ON YOUR SCREEN.