|Story & Photo by Rob McIlvaine, Army News Service
WASHINGTON, D.C. — The Army released a study on behavioral health and
reported that the number of suicides decreased this past year and more
Soldiers are seeking treatment for their problems.
The report “Generating Health and Discipline in the Force, Ahead of the
Strategic Reset,” was discussed at a Pentagon press conference by Gen.
Peter Chiarelli, Army vice chief of staff. The three-year study outlined
the problem of suicide in the Army and related issues of substance
abuse, spouse abuse and child abuse.
Gen. Peter Chiarelli, Army vice
chief of staff, responds to a question at a Pentagon press
conference where he outlined the Army 2020 Generating Health and
Discipline in the Force, Report 2012, referred to as the Army
Nearly two years ago, only 210,000 Soldiers sought behavioral health
practitioners for their problems, Chiarelli said, adding he remembers
the public reaction to this number. ‘My gosh, you’ve got that many in
the Army? That’s not good, is it?’”
“I told them we’d like to see that number go up. And in fact, it has
gone up. It’s gone up to 280,000. I think we have begun the process in
the Army of de-stigmatizing behavior health issues. That to me is
absolutely critical. People who need help, get the help that they need.
I think we’ve (been able to do this with the help of) commanders and
leaders at all levels,” Chiarelli said.
Three years ago, then Secretary of the Army Pete Geren and Chief of
Staff Gen. George Casey appointed Chiarelli to look at driving down the
number of suicides seen occurring in the Army.
He found that drug abuse, suicide attempts, alcohol abuse, prescription
drug abuse and anger-management issues are all high-risk behavior that
Soldiers might enter into. In fact, most Soldiers who end up committing
suicide demonstrate these high-risk behaviors, he said.
“For the calendar year 2011,” he said, “if you take a look at all the
categories, the overall suicide numbers decrease by 10 percent, from 350
to 315. The only category where we had an increase of five suicides was
in the active- duty category,” Chiarelli said.
Most important, he said, is the increased numbers of Soldiers who have
received early intervention and treatment.
“This shows why I think we have arrested this problem and hopefully will
start to push it down, because we have leader involvement. They’re not
walking past the problem and are getting Soldiers the help that they
need. And that to me is a very positive sign,” Chiarelli said.
Traumatic brain injury
“One of the huge advances that we’ve made downrange today are the
protocols that are in place that have caused us, just last year, to
diagnose 9,000 Soldiers who were in concussive events downrange, to give
them an initial screening, and hold them off the battlefield, off the
battlefield for another 24 hours for a second screening. If they fail
any of those two screenings, they are sent to one of our concussion
recovery centers. Some of them stayed up to 21 days until their brain
looked normal, after healing from the concussive event,” he said.
Traumatic brain injury (TBI) and the cognitive issues involved, he said,
occur when concussions are not treated.
“I think this is a huge step forward that we made. We have diagnosed so
far into this war 126,000 cases of TBI throughout the 10-plus years of
this war. But I’ve got to tell you, if they’re treated properly, most
Soldiers will have a full recovery from traumatic brain injury. The
problem is if they return and get a second concussion before the brain
has healed,” he explained.
Post-traumatic stress (PTS)
“PTS is one of the key ones,” Chiarelli said. “It represents a prevalent
psychological injury with over 70,000 Soldiers diagnosed by the Army
since calendar year 2003. That’s not 70,000 out of 1.1 million. That’s
70,000 out of a much greater number because we have Soldiers entering
and leaving all the time.”
The problem with PTS, he said, is it shares many of the same symptoms as
TBI. But doctors cannot, with any kind of guarantee, conduct a diagnosis
for PTS in every single instance.
This is because, he said, in some of the most difficult cases, the
symptoms don’t appear for weeks, months, or even years after the event.
“I don’t think we’ve done a good job in explaining the immaturity in the
science of the brain,” he said. “I was quoted a figure that basically
said that from the time an initiating event for PTS takes place to the
time that somebody gets into treatment is 12 years. Twelve years
nationally — that’s not with Soldiers, that’s nationally.”
“And the horrible thing about that is all the bad things that happen in
between. The abuse of alcohol, the abuse of drugs, prescription drugs,
the anger-management issues — all those things that happen in between,”
“We continue to close the gap in drug surveillance and drug
rehabilitation programs. Although we had an increase in fiscal year
2011, we think due to an increase in surveillance, illicit drug use
declined by 19 percent from earlier highs in 2006 and 2008.
“Last year, we saw over 24,000 Soldiers in our Army substance abuse
program. I know, because of the connection of alcohol abuse to
post-traumatic stress, many people who go untreated for PTS
self-medicate with alcohol. I know that after 10 years of war, those
numbers have gone up, so seeing an increase in the number who are in the
program is a positive step,” he said.
“What concerns me the most is an increase in violent sex crime offenders
by 64 percent from 2006 to 2011. This is unacceptable,” he said. “We
have zero tolerance for this. Army leaders take sexual assault
seriously. We’re expanding our surveillance and response against these
crimes. We’ve identified numerous sex crime factors, such as alcohol and
the newly designed barracks that offer privacy, coupled with a lack of
leadership. This impacts the youngest and most-junior female Soldiers
and the perpetrators mirror that age, he said.
“We also had an increase in 2006 to 2011 in domestic violence. It
increased by 33 percent, from 293 to 383. And our child-abuse cases
increased by 43 percent in that time period from 201 to 287.
Alcohol, associated with domestic violence, increased by 54 percent, and
with child abuse by 40 percent, he said.
“And research informs us that PTS is a factor in partner aggression. A
person diagnosed with PTS is three times more likely to participate in
some kind of partner aggression.
“That is why it is so critical to eliminate the stigma associated with
PTS and get people in for treatment for their alcohol problem, their
drug-abuse problem, prescription drug-abuse problem, or anger-management
problems, spouse abuse and child abuse. That to me is critical. And the
National Institute of Mental Health lays this out as not just an Army
problem, this is a national problem.”
Looking ahead to reset
Similar to any post-war period, reset and recovery must remain focused
on the health and discipline of the volunteer force, Chiarelli said.
“We have an opportunity to avoid mistakes of prior post-war environments
by applying science and the many lessons learned to mitigate health,
discipline and readiness challenges,” he said. “I often tell folks if
you were to ask somebody what good comes out of war, they would point to
military medicine and the advances that are made that benefit us all.
And I think if you were to ask somebody today what is the greatest
advancement in military medicine in this war, they would probably point
to the advancements we’ve made in prosthetics.”
“But I honestly believe 10 years from now with some of the things that
I’m seeing and the advancements we’ve made in brain science, that 10
years from now if you were to ask that question people are going to look
back and say, ‘you know the greatest advancements that were made in
these particular conflicts was our understanding of the brain,’”