Sunday, September 1, 2013

Suicide Prevention starts with what works

Suicide Prevention starts with what works
Wounded Times
Kathie Costos
September 1, 2013

Suicide Prevention month begins today but as we've seen in the past, it has done little good before. We need to start with a fresh look at something we just don't talk enough about. What works to prevent suicides instead of what doesn't. As you read the numbers below keep in mind there are hundreds of attempted suicides and many of them trying more than once. This also comes after the crisis hotline has taken in thousands of call.

"The Army, by far the largest of the military services, had the highest number of suicides among active-duty troops last year at 182, but the Marine Corps, whose suicide numbers had declined for two years, had the largest percentage increase – a 50 percent jump to 48. The Marines' worst year was 2009's 52 suicides. The Air Force recorded 59 suicides, up 16 percent from the previous year, and the Navy had 60, up 15 percent." At least that is what all the major news publications were reporting however, they left out the National Guards and Reservists.

The latest report from the DOD on Army suicides says "CY 2012: 185 169 have been confirmed as suicides and 16 remain under investigation but the report also includes "CY 2012: 140 93 Army National Guard and 47 Army Reserve." When you add the totals together there were 492 military suicides along with over 8,000 veterans.

We need to begin with honesty. If we ignore what the truth is, then we will repeat the same mistakes over and over again.

Today is a good time to also focus on what the military got right since I am alway slamming what they got wrong producing more suicides after all these years. This isn't a hopeless situation unless they admit the have been mislead on the programs they have been pushing. There is no way to spin the results no matter how hard they try. Telling reporters that most had not been deployed doesn't work because that would mean their mental health evaluations on recruits are useless as well as their training because if they cannot keep non-combat forces from committing suicide they have zero chance of preventing suicides among combat forces. For what else they got wrong you can read it in The Warrior Saw because when it comes to PTSD, it is not just what they see with their eyes during combat, it is how they see themselves afterwards as well.

What works comes with three parts and the military has what they need already in place. Experts agree that the mind, body and spirit must be treated in order to heal as much as possible.

The military has mental health professionals trained to evaluate and treat servicemen and women. What they lack is specialized training on trauma. Without this training they do the same thing other psychiatrists and psychologist do, misdiagnose Post Traumatic Stress Disorder as something else. The only way to get PTSD is after trauma but it includes so many different things that if they are not looking for PTSD, they will find another illness instead. The answer is to train them on trauma. The best Psychologists and Psychiatrists are not only trained, they are veterans as well so they are able to not just understand but share common experiences.

Some of the best training for me was between 2008 and 2010 when I went to just about every class within traveling distance for Crisis Intervention focusing on the responders to traumatic events because as they care for the survivors, they need even more care due to how many times they are exposed to events as part of their jobs.

They also need to have sexual trauma experts to treat the men and women victimized by criminal acts against them. It has been proven that PTSD occurs after this assault but when you add in the fact the perpetrators are one of their own, one they would have trusted with their lives in combat, this is harder to heal from.

Then the military needs to utilize physical trainers to focus on teaching the troops to help their bodies calm down again when no longer in danger. After all, they taught the troops how to use muscles they didn't even know they had in training, they also need to help them adapt back again.

The military has in place Chaplains. These Chaplains need to be trained as well in the basics of trauma intervention. Once this is done they have a tool to help them focus more on healing and less on judging. Too often a soldier has turned to the Chaplains for the moral injury only to be told they are going to hell. Chaplains are just as vital in all of this as any of the other experts.

If the military uses the best they have in the right way, you'll see less suicides and whole lot more healing.

Here are some resources to help you understand what I am talking about.

The International Fellowship of Chaplains. I had this training in 2008 with Dr. David Vorce. "Chaplain Vorce is a proud father of six (6) children, a former U.S. Marine, a psychiatric nurse, and a retired Lieutenant with the Saginaw County Sheriffs Department where he served in the Special Operations Division. He also has 20 years as a Police Chaplain and nearly 36 years as a martial arts instructor. Doctor Vorce has a Doctor of Education Degree, a Masters Degree in Counseling, a Bachelors Degree in Biblical Studies, and is FBI certified in the areas of Critical Incident Stress (CIS), Critical Incident Stress Debriefing (CIDS), Critical Incident Stress Management (CISM), Grief and Loss and Chaplaincy."

Another training in 2009 was with Center for Disaster and Extreme Event Preparedness. "The Center for Disaster & Extreme Event Preparedness (DEEP Center) conducts train­ing, research, and service in the areas of disaster behavioral health, special populations preparedness, and disaster epidemiology.

DEEP Center is a leading provider of disaster behavioral health training worldwide. Since 2003, DEEP Center has conducted more than 500 full-day, live lecture training programs to a cumulative audience of more than 20,000 participants across the United States, Canada and Latin America.

DEEP Center Mission
Applying disaster science and training to maximize well-being and resilience for disaster responders and survivors.

DEEP Center is home to the Miami Center for Public Health Preparedness (Miami CPHP) which focuses on special populations in disasters, with specific emphasis on disaster training for Hispanic populations.

Miami CPHP Mission
Disaster preparedness for all cultures. Cultural competence for all responders."

Spiritually there is none better than Point Man International Ministries. I am proud to be part of this group especially when they have been working on the spiritual part of healing since 1984.
Seattle Police Officer and Vietnam Veteran Bill Landreth noticed he was arresting the same people each night, he discovered most were Vietnam vets like himself that just never seemed to have quite made it home. He began to meet with them in coffee shops and on a regular basis for fellowship and prayer. Soon, Point Man Ministries was conceived and became a staple of the Seattle area. Bills untimely death soon after put the future of Point Man in jeopardy.

However, Chuck Dean, publisher of a Veterans self help newspaper, Reveille, had a vision for the ministry and developed it into a system of small groups across the USA for the purpose of mutual support and fellowship. These groups are known as Outposts. Worldwide there are hundreds of Outposts and Homefront groups serving the families of veterans.

PMIM is run by veterans from all conflicts, nationalities and backgrounds. Although, the primary focus of Point Man has always been to offer spiritual healing from PTSD, Point Man today is involved in group meetings, publishing, hospital visits, conferences, supplying speakers for churches and veteran groups, welcome home projects and community support. Just about any where there are Vets there is a Point Man presence. All services offered by Point Man are free of charge.

We talk a lot about Peer support but when done wrong, it can do more harm than good. When done right, wow, it works. Talking to someone you trust in a safe place who isn't going to say the wrong thing or try to fix you on the spot helps when there is not a professional available. Some are too reluctant to seek professional help because it has been reported that others in the unit have no clue what PTSD is all about and pass judgment. Imagine having to talk to someone you heard belittle what you are going through when talking about someone else. They are the last person you'd want to open up to.

If the military trains someone in each unit with a basic understanding of what PTSD is, they can fill in the gaps. This will eliminate others from having the wrong idea of what PTSD is.

The Pentagon has spent over $4 billion on mental health between 2007 and 2012 but as we've seen already the numbers are not good. Part of the problem has been experts like this.
"Tania Glenn, who has a doctorate in psychology and is a licensed clinical social worker, delivered a feelings-free, scientific analysis of the human body's physiological response to high-stress situations during a briefing Aug. 5, to help Airmen here understand their biological processes downrange.
Though based out of Austin, Texas, Glenn travels cross-country providing respite to service men and women who bear the physical and emotional scars that accompany more than a decade of war. Though she is an accomplished psychologist, Glenn is clear on one point: the "F-word:" Feelings. Feelings shall be referred to most sparingly and only when completely necessary, she said."

"I'm a boots-on-the-ground kind of person and we don't use the F-word," she joked. "I talk about the brain and the body and what happens during trauma and stress. These reactions have nothing to do with feelings, they're about survival. I work every day to help men and women recover from trauma and PTSD because if there's one thing I can't stand, it's seeing warriors suffer."
Reading this caused me to leave this comment.
Not part of the answer but part of the problem. Just as doing a study in rats to "prevent PTSD" when emotions are left out of it when we're talking about military folks, that is a huge mistake. Being willing to die for someone else is tied to the emotional part of the brain, not the animal part they always seem to talk about.
She replied.
Thank you so much for your comments. I think something was lost in translation from my presentation to the article. In no way do I ever discount the very strong emotions that come with trauma. My point was that clinicians must know how to navigate this area very carefully, especially with military members. The fall back questions like "How do you feel?" or "How did that make you feel?" really anger hard charging, high functioning warriors.

People have the wrong idea about feelings when it comes to the military folks and responders. If they didn't care, they wouldn't be doing the jobs they do. If they didn't care, they wouldn't be willing to die for one another or for us.

Back home in the states, we need to repeat what works and stop pushing what has failed. It isn't as if this stuff is new as you can see from above, but too few are working on what has succeeded and that includes congress.

Congress needs to start holding hearings and listening to veterans along with family members talking about what worked instead of only listening to the problems we face. The answers are out there but if they do not look for them, we'll repeat burials that didn't need to happen.

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