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The rate of suicide in the military has spiked in the last decade. The reasons are complicated, and that makes treatment complicated too. For the past few days, we've been reporting on the problem. At Fort Bliss, the Army base in Texas, a program to help prevent suicide is showing good results.
Yesterday, we heard about soldiers learning what to do if they think someone else might be suicidal. Today, the story of one soldier's decision to seek help for himself. A big obstacle to asking for help has been the military's macho warrior culture. As NPR's Quil Lawrence reports from Fort Bliss, that may be starting to change.
QUIL LAWRENCE, BYLINE: Here's the old-school military attitude toward mental health in a nutshell.
SERGEANT GUS: You don't want to say anything because you're afraid that you will be called a wuss.
LAWRENCE: This soldier asked us to use only his first name because of the stigma around mental health issues. Sergeant Gus is not a wuss. He did a 15-month combat tour in Iraq.
GUS: Let me go straight to the point. Well, I've been having a lot of issues since Iraq, and I just didn't take care of them, didn't get any help, anything.
LAWRENCE: He'd go out with his guys, get drunk, start fights. That was their idea of therapy. And then in 2010, he deployed again.
GUS: Just went to Afghanistan. We thought it was going to be like Iraq, but it was actually worse.
LAWRENCE: Sergeant Gus is a native of El Paso. He's stationed here at Fort Bliss. The desert and mountains look a bit like Afghanistan, especially in the spring.
GUS: May is like a really bad month for me, you know? It was an anniversary of one of my friends. He died May of 2010, and it was just - it's been three years now, but I still can't get over it, you know? And what happened is we land, right?
LAWRENCE: We land. His unit got dropped off by helicopter near a village in the mountains. They met with locals for hours, but the Taliban had seen where the chopper landing zone was.
GUS: The Taliban, they're smart guys. They go over there and set up a machine gun.
LAWRENCE: It was an ambush. When the helicopter came back, all the soldiers crowded in to get on board. That's when the Taliban machine gun opened up. Sergeant Gus was stuck, already inside the chopper.
GUS: I couldn't do anything. I couldn't fight. I couldn't do anything. I'm just in the bird there taking lead, you know, like - and I'm just looking out through the door, and I'm just - one of my friends was getting pulled like a duffel bag. We just threw him in the front, you know, like throw him in there. I'm not even paying attention until I see him, like, at my legs and everything. So that kind of - they did the best they could, but there's nothing you can do, really, when - like fish in a bucket or whatever people say.
LAWRENCE: Sergeant Gus had survivor's guilt. He didn't know that's what it was. He came home safe, but not well. He got married pretty soon after and went on his honeymoon to Las Vegas.
GUS: I got pretty hammered, you know? So we get to a hotel room, and my wife was passed out. And I started watching the movies, and the first movie I see is "Saving Private Ryan." Then I just felt, like, this weird sensation inside my chest, like before you get in a fight, you know, when you're a kid and - or when you know you're in trouble and you get that anxiety. I felt that, and I couldn't get it out of my chest. And I had - I just kept thinking about over there, you know, I just locked myself in the bathroom.
And this is the part that I regret the most because I couldn't think of anything could, like, make me feel better, you know? Booze wasn't helping. I need to stop this feeling because I feel, like, bad. I just grab a bottle of booze, and I just break it. So I just start cutting my chest, trying to get that feeling out of my stomach. And then my wife woke up, and I was on the floor, bleeding all over the place.
LAWRENCE: He recovered. His wife pushed him to get counseling, but he's still worried his men would think he was weak. So he asked one of them what he should do.
GUS: I talked to the guy that I thought was going to make the most fun of me if I ever talked to anybody, and he was one of my good friends. So I talked to him, and he's the one who asked me, go get help, man, like you don't lose anything. What's the worst that can happen?
LAWRENCE: The advice he got, it's exactly what Major General Dana Pittard wants to hear.
MAJOR GENERAL DANA PITTARD: It takes time for a cultural change to take hold, but we don't have time.
LAWRENCE: General Pittard just completed nearly three years as commander of Fort Bliss. He oversaw a reduction in the suicide rate there, even as suicides were up across the rest of the military. But Pittard knows not everyone has gotten the message.
PITTARD: If you've got a toxic squad leader of the 10-person squad you're in, who thinks like that, says that you're a coward or whatever, then that's the Army to you.
LAWRENCE: Sergeant Gus went to the Warrior Resiliency Program at Fort Bliss. They taught him techniques to control his anxiety attacks. The month-long program included R & R, but that's in between some pretty intense group therapy.
GUS: The program was hard because it actually made things a little bit more realistic again, you know, just talking about it, talking to therapists, talking to other soldiers. And it kind of like - it's like reopening the scars, you know? It's in their agenda. They know they're going to poke where they're not supposed to, but they have ways to deal with that.
LAWRENCE: Sergeant Gus says he's happier now, but he still gets depressed sometimes, especially when the springtime light in El Paso makes the mountains look just like Afghanistan.
SIEGEL: That's NPR's Quil Lawrence, and he joins me now to talk more generally about what he saw at Fort Bliss and the problem of suicide in the military. And, Quil, what happens next for Sergeant Gus? Is he still in the program? How has this all affected his career?
LAWRENCE: When you check into mental health treatment, you need to be evaluated before you can redeploy in the military. Sergeant Gus told me he can now let these waves of anxiety pass over him without pulling his car off the road, for example. But he was diagnosed with chronic PTSD, which means his infantry career is over. He'd been told he could stay in the Army in a non-combat job, but he'd rather go out and use the G.I. bill to go to school. He wants to become a teacher.
The Army's policy is confusing and extremely unclear about who decides when someone is well enough to go back to war. There are some prominent generals in recent years who've gone public about getting help themselves, including Major General Dana Pittard, who just left command at Fort Bliss. But even he, when he decided to get counseling - this was a few years ago - he did that in a private civilian setting out of concern that it would affect his career.
SIEGEL: Quil, the problem of suicide in the Army became very public several years ago. In 2009, then-Army Vice Chief of Staff Pete Chiarelli, General Chiarelli, took note of a spike in the rate in January and then issued a big report in July, promised to stamp out the stigma of seeking out mental health care, noted that suicide in the Army seemed to be unrelated to deployment, just as common among soldiers who hadn't deployed at all. If the Army has been so concerned about this for four years, why do we still seem to be in the same position that we were back in 2009?
LAWRENCE: There are a lot of theories and not many conclusions on that. It used to be that the rate in the military was half the civilian rate. People said that the military was somehow insulated from the problem of suicide in society. But then in 2004, it started to climb and about doubled, and now it may be headed above the civilian rate.
Most people would assume. They look at 2004 and see these heavy deployments and think that that's the cause, but, in fact, as you heard in our coverage this week, half of the suicide attempts of the people we spoke with had no war-related reasons. Half of them did. PTSD is a contributing factor, so are traumatic brain injuries, and so are the drugs that are often prescribed for many of these things. And then there are plenty of things that are the same with civilians: drug dependency, relationship issues, money issues.
The Army is in a really good position to study suicide. They've got a huge controlled population they can look at, and there's a major study ongoing. But one of the lead researchers told me that suicide is not like food poisoning where you can just find out what everyone ate at the salad bar and then go take out the tuna salad. It's a combination of factors that are not consistent. So it's a very hard subject to study.
SIEGEL: Well, are there any programs in the Army that are actually reducing the rate of suicide, anything that works?
LAWRENCE: There are many different programs being tried across the military at once. Fort Bliss has reduced their rate over three years, so that's an interesting one to study. General Pittard, the commander there, said that he looked back on the records, and over 10 years, they had almost never lost a soldier to suicide when that soldier was in treatment. So he made a blitz on getting people into treatment.
It's hard to argue with the results they've had at Fort Bliss. They had - went from 12 suicides in one year to seven, down to five. But some of the experts I spoke to cautioned me that it is a very small sample to be dealing with and making conclusions about.
SIEGEL: Thank you, Quil.
LAWRENCE: Thank you, Robert.
SIEGEL: That's NPR's Quil Lawrence.
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