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ROBERT SIEGEL, host:

General Peter Chiarelli, the Army vice chief of staff, now joins us from his office at the Pentagon. Welcome to the program once again.

General PETER CHIARELLI (Vice Chief of Staff, U.S. Army): Great to be with you, sir.

SIEGEL: The report acknowledges on the one hand the self-selection bias for risk taking among young adults who enlist in a time of persistent conflict, and on the other hand, the emphasis in the Army for combat command skills as opposed to the skills of running a base stateside. Since those are both contributing factors here, is it fair to say that the suicide rate is a function of the two prolonged wars that we're fighting?

Gen. CHIARELLI: Well, I think it's a function of many, many things. I think that the two prolonged wars we're fighting have caused stressors to occur in the force, but I don't think that they can be divorced from the other stressors the soldiers are under.

As we try to explain in the report, we see three strands. We see the first strand is exactly what you've just described, almost a decade of conflict, but then we have a soldier's strand, which is filled with stressors that every soldier goes through as he enters the Army and progresses through the ranks. And then we have the always dominant family strand. As soldiers meet, marry, have all the issues that families have compounded by many times being deployed overseas. So what the report has really showed us is that there are many contributing factors to being stressed in the service today.

SIEGEL: Talk about stress, I'm going to read a very stunning footnote that appears toward the beginning of this study. Here it is:

At 24 years of age, a soldier, on average, has moved from home, family and friends, and has resided in two other states, has traveled the world, deployed, been promoted four times, bought a car and wrecked it, married and had children, has had relationship and financial problems, seen death, is responsible for dozens of soldiers, maintains millions of dollars worth of equipment and gets paid less than $40,000 a year.

You read that, stress and depression don't seem very surprising. How much of that can reasonably be changed?

Gen. CHIARELLI: Well, I will tell you that the report goes on to say that a soldier in eight years of service in the United States Army goes through the life stressors that equate to an individual of 80 years of age who has a regular job and works in a community.

We put a lot of stress on young men and women early in their career. We think the key to this is resiliency. And that's why we've been working so hard for the last year with our comprehensive solider fitness program because we know - this is evidence-based - that we can teach people to be more resilient, which just means that they, in fact, will handle life stressors much better with this training than without it.

SIEGEL: On the other hand, it would seem that the most stressful thing one could experience would be multiple deployments to war zones. And yet multiple deployments don't seem to increase the risk of suicide at all, according to the study.

Gen. CHIARELLI: Well, I'd be careful - and we try to footnote this also, that we're looking at a single year, 2009, in our data. I would like to have more complete data before making that distinction.

But I quoted the fact that 79 percent of our suicides are soldiers that have no deployment history or one deployment. That's a critical piece to understand. You could make the argument, given that 21 percent of individuals are outside that group, that through life's experiences, some people build resiliency up, and some of those second and third deployments may be easier for some folks. But, again, we don't have enough data to make a pronouncement like that at this time.

SIEGEL: The study cites the Army surgeon general's finding that 14 percent of the force was prescribed some form of an opiate, a drug. Of those 95 percent taking oxycodone, almost 34 percent had two or more active prescriptions. Are you surprised by those numbers?

Gen. CHIARELLI: Well, we had heard anecdotally from the field from commanders that they had seen those numbers. The good thing about these numbers is that, I have to say, is those are all prescriptions made by a doctor. And some of them are for pain management and have nothing to do with behavioral health issues.

But a companion to this study is the work that the surgeon general has done, and that's to look for alternative methods of pain control. I think it'd be the desire of anybody to eliminate the need for as many drugs as possible. But we do know that drugs play a very, very important role in working many of the issues that our soldiers are in fact facing.

SIEGEL: At another point, though, the report observes this: illicit drug use surveillance and detection systems are inadequate. And then it cites the number, over 1,318 soldiers who had failed multiple drug tests are still serving.

Do you think such soldiers are still serving because manpower needs trump good judgment? There's an implicit pressure to keep people in the service? Or is it sloppy work? Or what is it?

Gen. CHIARELLI: Well, I don't really think it's that. We have been involved in a very - for a very focused period for almost a decade in moving soldiers, from resetting themselves and their equipment to training up for the next deployment, to deploying for 12 to 15 months, and doing that cycle all over again. It's our responsibility, our solemn responsibility to ensure that our soldiers are trained for battle. That has got to be our number one priority: to ensure that they are trained to go into harm's way.

And some of the processes that we have in place to track a very transient population that moves from unit to unit were not followed during this time period. They were lower in the priority list. And as we get more time at home, we've got to reemphasize those programs and make sure that we're doing everything we can to identify soldiers who are displaying high-risk type behavior and actions, to identify them and get them the help that they need.

SIEGEL: You address the issue of stigma, which we hear about a great deal. And even recent surveys find that - I believe it's a small majority of officers, I believe, feel their career might be jeopardized if they sought some kind of mental health service. Are they wrong? That is, can people reach the rank of general if they've had a couple of anti-depressant or anti-stress prescriptions along the way or perhaps some talks with a psychiatrist?

Gen. CHIARELLI: I can guarantee you that that is, in fact, the Army's position. We are doing everything we can to stamp out stigma. This - it requires a cultural change. This is not an easy thing to do. I know it's easy to point at the Army when it comes to stigma for behavioral health issues, but I don't think the Army is any different from civilian world when it comes to some of the stigma involved with behavioral health. I think we're making progress at getting at this problem, but I fear we'll never totally eradicate the stigma involved with behavioral health issues, these hidden injuries of war, but I promise you that the Army leadership is totally committed to making that happen.

SIEGEL: General Chiarelli, thank you very for talking with us once again.

Gen. CHIARELLI: Thank you, sir.

SIEGEL: That's General Peter Chiarelli, vice chief of staff of the U.S. Army.

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