Veterans and Suicide

American soldiers committed suicide at a rate of 22 per day in 2016, according to the Department of soldiers Affairs (VA). According to a VA report, there has been a 32% rise in suicides since 2001. Over the years, the number has dramatically grown, raising concerns across the country. All people are impacted by suicides, regardless of their gender or age, as evidenced by the report's finding that 65% of veteran deaths occurred in people 50 years of age or younger. It is on this basis that the Veteran Affairs has taken the role of identifying causes of suicide and taking steps to reduce the deaths because every life is important and the role of the veterans to the peace in America cannot be undermined. Veterans do not go to war with the aim of coming back home to commit suicide. However, their experiences shape the nature of decisions they make. Some are adversely affected by war and do not receive adequate counseling to deal with the depression. The depression subsequently leads to mental health and lack of appropriate care leads to suicide.

VA indicates that one life is too important to lose to suicide and their core focus is to have a nation with zero veteran suicide. The study is aimed at understanding these evolving issues on suicide to identify the cause and possible remedy through recommendations to the veteran health affairs (VHA) who should take the key role of continuous surveillance of activities of veterans, providing protection through identification of risks and providing necessary intervention to mitigate the situation.

Post-Traumatic Stress Disorder (PTSD)

Soldiers suffer some level of PTSD when deployed with prevalence being 9% before deployment and 18% after deployment (Litz & Schlenger, 2009, p.2). Iraq and Afghanistan are the places where most soldiers are deployed in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Soldiers in training and deployment do it with the right intentions of creating peace in war-torn areas. They are prepared intensely for what to expect when they get to the field, but it rarely matches to what happens on the ground. Post Traumatic Depression (PTSD) is caused by the traumatic events that the people endure while they are in a war. On return from war, they suffer from anxiety, fear, nightmares and an inability to cope with a flashback of the experiences they went through (Litz & Schlenger, 2009, pp). The study calls for an understanding of the relationship between PTSD and suicide that go through and those that are attempted.

Participation in the (OEF/OIF) increases the likelihood of a veteran suffering PTSD due to the environment that they are exposed. Soldiers are deployed for extended periods of time through which there is minimal contact with their families which causes tension and separation. They see their team members dying or being injured in the war zones. War also calls the soldiers to killing and wounding other people who are experiences that people do not want to undergo. Military Sex Trauma is a major stressor in Iraq and Afghanistan which may occur regarding threats, harassment or continued attacks (Bagalman, 2016, P. 15). There is an emphasis on research on the impact that the harassment has on depression by the veterans for VHA to work through it to reduce prevalence. The research is to enable VHA to understand the resilience of people that have been at war.

Managing PTSD is possible as VHA recognizes that people should be able to identify symptoms of stress and take precaution before the situation gets out of hand to the level of committing suicide. VA advises that people should establish that PTSD is normal after a traumatic experience. They should endeavor to spend time with people as opposed to choosing isolation. This could be accomplished through family or support groups through talking to people that have been in similar situations. It is fundamental that the people stay focused on the future as opposed to dealing with the past. Having laid out such techniques to deal with PTSD, VHA introduced and promoting the use of psychotherapy, behavioral therapy and cognitive processing therapy (Allen et al., 2016, P. 137). The study advocates that treatment of PTSD should be simultaneous with other symptoms including alcoholism and substance abuse. The department should not focus on dealing with one issue while the other wait as they are all a priority as VHA may not know which is weighing down the patients to the levels of committing suicide.

The statistics on veterans suffering PTSD and eventually suicide keep changing in time. However, they all agree that there is a level of suicide caused by PTSD. The manageability of PTSD means that it can be eliminated to create a country free of such suicides. VHA needs to continually work with the veterans at all stages to avoid losing contact to guarantee that the requests of each are met.

Mental Health Leading to Suicide

Persons with mental health issues have high suicide attempt. The fact that a person thinks about committing suicide, it is considered the first step towards actual suicide. Mental health problems have led veterans to not only harming themselves but those close to them. Veterans who have returned from Iran and Afghanistan have been reported to killing their wives before committing suicide due to mental health related problems. It is unfortunate that the veterans suffering mental health problems rarely receive the support they require promptly to avert the situation. The Joshua Omvig, Suicide Protection Act, was established to deal with issues relating to PTSD and mental health.

The Act came into being as a result of a veteran persistently seeking medical assistance due to stress related to return from war, and despite give threats of committing suicide, the staff duly discharged him. Being found in his father’s house three days later raised the question as to whether VHA is doing enough to improve the well-being of veterans. The Act calls for in-depth research on issues relating to mental health to have an understanding of risk factors leading to suicide. The Act does not have a set of best practices rules for medical practitioners but calls the VA to work with various bodies including the Substance Abuse and Mental Health Services Administration to establish a guide on preventing suicide among the veterans (Cvetanovich, 2008, p. 624).

It is unfortunate that veterans take ages to get their issues addressed. Application for treatment has seen to take up to 770 days in Baltimore due to improper planning on the treatment. These inefficiencies saw the number of veterans awaiting treatment rise to 255,000 (Hegseth, Pete, 2016). Taking longer than necessary to get medical assistance primarily relating to mental health has resulted in increased suicide risks. The situation has gone out of hand to the extent that there had to be a public outrage for the government to start taking actions. Engaging the veterans from early stages of suicide risks meant that intervention was made available and coping strategies identified. People with high levels of drinking were recognized as having high risks, and thus their needs addressed quickly (Maguen, Shira et al., 2015, p. 122). Putting patients on the waiting list is a weakness in VHA as they are a department that is endowed with resources to enable them quickly and efficiently meet the needs of veterans in need. History has shown that wasting time increases suffering and suicide risk. Adequately staffing would bring enough people to reduce queues in hospitals and the waiting list that has been piling over the years.

Suicide due to delayed treatment by veterans with mental health issues is gradually being averted by VA ensuring that patients have access to medical care within the same day that they seek help. Crisis intervention responders have increased who are equipped with training, intervention skills and the ability to identify places where they can refer people (National Center for PTSD, 2013). Collaborations between agencies handling mental health issues are driving the efforts of VA towards suicide reduction. However, the fact that we are not at zero suicide and people are waiting for treatment means that a lot needs to be done. It is a loophole that VHA needs to fill to achieve its ultimate goal of zero suicide.

Other health issues and pain

Veterans in war suffer injuries while in battle when they return home. Some struggle with the pain which could be too unbearable levels where they are unable to cope and thereby entertain thoughts of suicide. Veterans sometimes come back home disabled requiring care from someone else. They thus feel they are a burden to the community due to their incapability. Through the suffering, they get the notion that they can manage the pain of self-harm as opposed to staying alive. Health problems cumulate to the stress that individuals are suffering elevating their need to commit suicide (Rozanov, Vsevolod, and Vladimir, 2012, p. 2504). VHA needs to recognize that they are burdened with taking are of the veterans as a state resource. Managing pain is on their docket and should realize that there is more to pain than the physical pain that one experiences. Training should be done on this and steps are taken to enforce such policies. Releasing a patient on a wheelchair without adequate counseling is a crime that sees the country losing people, and someone should assume the responsibility for such actions.

Social factors leading to suicide in veterans

Deployment to war zones means that people are separated from their families and their loved ones and are in high-stress areas. Studies have shown that soldiers that are unmarried and go into war are likely to be unsatisfied with their lives leading to high risks of suicide (Jakupcak, Matthew et al. 2010, p. 1004). Married persons from the study had a low tolerance to the ideation of suicide as they have a fulfilling social life. Veterans that have been in combat exhibit poor communication and violet outbursts as opposed to calm talk with people. This results in poor relationships between the people they are living with especially due to frequent arguments. There is a tendency for the veterans to blame themselves for the situation they are going through and thereby refusing help from any social communities. Veterans with little social interaction are less likely to seek assistance (Jakupcak, Matthew et al. 2010, p. 1004). People from war desire to be part of a traditional community with people that understand the situations they have been through without critic. Clinicians need to understand the fundamental importance of social life in managing and reporting symptoms relating to suicide and PTSD. Information and knowledge need to be shared with persons treating the veterans and the families living with them.

Stigmatization of veterans with PTSD is a social factor leading to suicide. People do not understand PTSD and thus view soldiers with PTSD as weak or pretending. It leads to the soldiers not reporting symptoms of PTSD. People tend to keep to themselves if they feel they will be judged for their condition which does not solve the problem and when noticed it might be too late (McGrane, Madeline, 2011, p.214). Lack of early detection means that the system has failed in its role of protecting the veterans. Stigmatization could occur through being charged for crimes the veterans have committed despite their efforts to seek help such as through the Veterans Crisis Line. Veterans the call to the line believe that utmost confidentiality will be upheld on what they decide to share. If the same information is disclosed in opening cases against them, then there is lost confidence. They will thus choose to keep away from calling and keep to their problems. It is a form of stigmatization that pulls the efforts of the government back in their goal of keeping the veterans alive. Politicians need to understand the intensity of their words such as the comments made by President Donald Trump that veterans that commit suicide are weak (Holmes, Lindsay, 2016)

Summary and Recommendations

Veteran affairs leave a lot to be desired in the delivery of service to the veterans. Despite numerous calls for changes in operations, years down reports still come back indicating that veteran suicide is still happening. Bureaucratic processes make it impossible for veterans to get quality service in time which leaves them frustrated to the level of committing suicide. The information available to the officer who has PTSD has been consistently manipulated by officials to hide the actual state of VA (Hegseth, Pete, 2016). The issue of VA has been highly politicized over the years and thereby dealing with officials that are corrupt and do not carry out their roles effectively. Though reforms including a reshuffling of staff members were made in 2014, by the year 2016, little had been done to improve the situation.

Accountability in VA is handled lightly as after the reforms were proposed; the same officials still sit in office. No one is held accountable for the suicides by veterans with some happening just outside the hospital doors (Hegseth, Pete, 2016). Typical hospitals see their nurses taking responsibility for negligence and for failing to prevent deaths that should not have occurred which are a policy not applied to VHA. People taking responsibility and even going to jail would see the officials take the roles they are assigned seriously. Responsibility without accountability results in a team of persons that work through the say with little regard to the consequences of their actions.

VA needs to improve record keeping and management. It is evident that the figures on the number of deaths due to suicide are hypothetical, yet they should be aware of what happens to the veterans while they are actively on duty and when out of duty. Research would enable the department to be aware of the actual statistics of people and thereby deploy adequate resources to care for the veterans. With the proper data and information, they will understand whether the efforts being driven towards suicide reduction are working and the changes that need to be made to tackle the issue. VA claims that it takes only 24 days to get treatment while the actual situation is that people go for up to 115 days before getting assistance (McCarthy, M., 2014, p. 3650).

Policies on dealing with mental health by VHA have been developed including diagnosis, prevention, treatment and the mitigation of the occurrence. Such policies need to be enforced to ensure evidence-based practices are used in handling the veterans. The Joshua Omvig Act calls for the assignment of a care manager to individual veterans which is the same way parole officers work. It would enable VA to monitor the progress of each officer that is at home. The officers would keep tabs of the veterans to identify a change in behavior, ensure their clients get quality care within a reasonable time. Medical evaluations would be done in time, and suicidal thoughts would be managed to reduce the prevalence of suicide in veterans. The lives of all veterans are valuable, and no suicide should go unaccounted.

Conclusion

PTSD, mental health, medical conditions are a key cause of suicide by veterans who have been to war. Restructurings have been recommended over the years to mitigate the situation, but it is evident through 22 suicides in a day that a lot is yet to be done to alleviate the situation. Restructuring needs to be done on the management to get persons to take accountability for their actions. Policies need to be enforced, and the weight of the impact of veteran suicide understood by the government, the VA, and the VHA. With such steps, the ultimate goal of arriving at zero suicide will be achieved, and people will know that all lives matter.

Work Cited

Allen, John P., Eric F. Crawford, and Harold Kudler. “Nature and Treatment of Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Among American Military Personnel and Veterans.” Alcohol Research : Current Reviews 38.1 (2016): 133–140. Print.

Cvetanovich, --Brittany. "Joshua Omvig Veterans Suicide Prevention Act of 2007." Harvard Journal on Legislation, vol. 45, 01 July 2008, p. 619. EBSCOhost, 165.193.178.96/login?url=http%3a%2f%2fsearch.ebscohost.com%2flogin.aspx%3fdirect%3dtrue%26db%3dedslex%26AN%3dedslex65DDEB06%26site%3deds-live.

Hegseth, Pete. "The VA Scandal: Two Years On". National Review, 2016, http://www.nationalreview.com/article/433760/va-still-unreformed.

Holmes, Lindsay. "Donald Trump Suggests Some Veterans Have PTSD Because They 'Can't Handle It'". The Huffington Post, 2016, http://www.huffingtonpost.com/entry/donald-trump-veterans-mental-health_us_57f280bbe4b082aad9bc4903.

Hudenko, William et al. "The Relationship Between PTSD And Suicide - PTSD: National Center For PTSD". Ptsd.Va.Gov, 2015, https://www.ptsd.va.gov/professional/co-occurring/ptsd-suicide.asp.

Jakupcak, Matthew et al. "Does PTSD Moderate The Relationship Between Social Support And Suicide Risk In Iraq And Afghanistan War Veterans Seeking Mental Health Treatment?". Depression And Anxiety, vol 27, no. 11, 2010, pp. 1001-1005. Wiley-Blackwell, doi:10.1002/da.20722.

Litz, Brett T., and William E. Schlenger. "PTSD In Service Members And New Veterans Of The Iraq And Afghanistan Wars: A Bibliography And Critique". PTSD Research Quarterly, vol 20, no. 1, 2009

Maguen, Shira et al. "Suicide Risk In Iraq And Afghanistan Veterans With Mental Health Problems In VA Care". Journal Of Psychiatric Research, vol 68, 2015, pp. 120-124. Elsevier BV, doi:10.1016/j.jpsychires.2015.06.013.

McCarthy, M. "US Investigation Confirms Veterans Affairs Staff Kept Multiple Waiting Lists". BMJ, vol 348, no. may30 1, 2014, pp. g3649-g3649. BMJ, doi:10.1136/bmj.g3649.

McGrane, Madeline. "Post-Traumatic Stress Disorder In The Military: The Need For Legislative Improvement Of Mental Health Care For Veterans Of Operation Iraqi Freedom And Operation Enduring Freedom". Journal Of Law And Health, vol 24, 2011, pp. 184-215.

“PTSD: National Center for PTSD.” The Relationship Between PTSD and Suicide - PTSD: National Center for PTSD, 12 Sept. 2013, www.ptsd.va.gov/professional/co-occurring/ptsd-suicide.asp.

Rozanov, Vsevolod, and Vladimir Carli. "Suicide Among War Veterans". International Journal Of Environmental Research And Public Health, vol 9, no. 12, 2012, pp. 2504-2519. MDPI AG, doi:10.3390/ijerph9072504.