Las Vegas Sun

May 25, 2015

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J. Patrick Coolican:

Veterans suicide rate: The war at home

J. Patrick Coolican

J. Patrick Coolican

Click to enlarge photo
Click to enlarge photo

Sun editorial

We know that suicide is a terrible problem in Nevada, with a rate 50 percent higher than the national average. Among military veterans and especially young veterans, however, it’s a crisis, according to new data from the Nevada Department of Health and Human Services.

From 2008 to 2010, the Nevada veteran suicide rate was 2.5 times higher than the rate for all Nevadans and nearly quadruple the national nonveteran suicide rate.

In 2010, suicide accounted for more than a quarter of deaths among veterans 24 and younger.

All told, of the 1,545 Nevada suicides between 2008-2010, veterans accounted for a stunning 373 of them, or nearly a quarter.

The explanation: The wars in Iraq and Afghanistan have taken a brutal toll on our young men and women. And they have come home to a bad economy and communities that are often clueless about what veterans have experienced or how to help them.

“Those high numbers are reflective of a decade of war and the impact that has on those who have been asked to serve in that war,” said Luana Ritch, a veteran and public health expert who compiled the data for the Nevada Department of Health and Human Services.

There’s no great repository of data that tracks veterans’ health, other than the Department of Veterans Affairs. But many veterans aren’t in the VA system. And veterans’ death certificates sometimes neglect to mention military service.

Given these data collection issues, it’s possible the problem is even worse than the figures show. Also owing to data collection issues, it’s not clear if the veteran suicide problem is better or worse in other states.

What we do know, however, is that nationally the problem is significant.

The VA estimates that a veteran takes his or her own life every 80 minutes — 6,500 suicides per year. That’s 20 percent of all suicides in the United States.

The Center for a New American Security published a report last year, “Losing the Battle: The Challenge of Military Suicide,” highlighting the dire situation. The report notes that during peacetime military service members historically experience lower suicide rates than the overall population.

Some experts believe there are three bulwarks of suicide prevention: feelings of “belongingness,” feelings of usefulness, and an aversion to pain and death.

The damage to these prevention protections could explain the rising prevalence of military and veteran suicide during wartime. Once home from war, veterans may feel separated from their comrades and alienated, useless on the homefront and tolerant of extreme pain and death because they’ve seen a lot of it and are numb to it.

In 2005, I spent six months studying the neuroscience of post-traumatic stress disorder at Ohio State University and learned about the tragedy of veterans — as well as rape and accident victims — who often suffer silently, tormented without knowing what afflicts them. What I learned is that the public tends to misunderstand post-traumatic stress.

Repeated exposure to extreme stress, like the kind soldiers experience in war, can change your brain chemistry. Symptoms include extreme anxiety and watchfulness to the point of paranoid delusions, nightmares and sleeplessness, rage, depression and an inability to form close relationships. The symptoms can be treated with medication and counseling, but there’s no cure for altered brain chemistry. Veterans suffering from PTSD often self-medicate with drugs and alcohol, which can accelerate the downward spiral.

“Losing the Battle” also blames high suicide rates on systemic failures: a flawed mental health screening process; a cultural stigma attached to seeking help; an insufficient number of care providers; too much prescription medication (an astounding 14 percent of the Army population is prescribed an opiate, according to the report); and finally, multiple agencies across multiple jurisdictions have trouble getting on the same page.

The repercussions for an all-volunteer military could be severe, as family and friends could attempt to dissuade a potential recruit from enlisting if they believe military service will result in psychological harm or even suicide.

I called the VA in Southern Nevada and in Washington but never heard back from them.

Linda Flatt of the Nevada Office of Suicide Prevention shared some information. Warning signs include: thoughts, fantasies, planning and discussion of ways of hurting or killing oneself; recklessness; rage, guilt, anxiety, depression; withdrawal from family and friends; drug and alcohol abuse; and feelings of hopelessness.

Prescription medication and firearms can be especially dangerous for people at risk of suicide; they should be stored safely.

If you or someone you know may be at risk, call the National Suicide Prevention Lifeline at 800-273-8255 or the Veterans Crisis Line at 800-273-8255 and press 1.

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