Health Care Happenings

Suicide in our military and veteran communities is a threat to the health of the all-volunteer force and is an issue of national security!

That was the overarching theme of a panel discussion I attended this week in Washington, DC, hosted by the Center for a New American Security. Discussions centered on the agency’s newly released report called, “Losing the Battle: The Challenge of Military Suicide.”

A very disturbing topic and the statistics that go along with the report are startling to say the least.

Suicide Statistics (approximate rates):

1% of Americans have served in the military—yet, 20% of suicides in the U.S. are former servicemembers.

1 Servicemember died every 36 hours during the period 2005-2010.

18 veterans die a day—1 veteran dies every 80 minutes.

The report tells me we have a lot more to learn, and a whole lot more to do. Suicide among servicemembers and veterans as well as in our civilian communities is a crisis that will truly require a national commitment if we intend to win the war.

Authors of the report, Dr. Margaret Harrell and Nancy Berglass provide a framework for understanding the phenomena of suicide, the obstacles for reducing suicides, and offer constructive recommendations on how the Department of Defense, military services and the Department of Veterans Affairs (VA) can address these obstacles that put the health and well-being of our force at risk.

“Eliminating suicides isn’t realistic, but we can address the obstacles,” said Dr. Harrell during the panel discussions.

“Removing stigma within the military, veteran and civilian cultures is one of the toughest aspects of preventing suicides,” said General Peter Charelli, Vice Chief of Staff of the United States Army, another participant in the panel discussions.

A stability or cohesion period for units after deployment, continuity of mental health services when members transfer, involvement of unit commanders in legal investigations, and improving coordination and data collection between the Departments of Defense, VA and Health and Human Services were just a few of the report recommendations.

The panel highlighted some of the positive steps the agencies have taken to help troops, veterans and families in crisis, but all acknowledged there is so much more that can and should be done.

Dr. Janet Kemp, VA’s National Mental Health Program Director for Suicide Prevention mentioned one of the best initiatives the agency has implemented is the Veterans Crisis Line which has fielded almost a half a million calls and is credited for saving more than 7,000 actively suicidal veterans.

Kemp went on to say, “Any veteran suicide is a lost battle, but I think we are winning the war.”

So why is the issue of suicide so important to our national security and challenges the health of America’s all-volunteer force?

Well the authors pose some interesting questions for all of us to think about:

• “If military service becomes associated with suicide, will it be possible to recruit bright and promising young men and women at current rates?
• Will parents and teachers encourage young people to join the military when veterans from their own communities have died from suicide?
• Can the all-volunteer force be viable if veterans come to be seen as broken individuals?
• And how might climbing rates of suicide affect how Americans view active duty servicemembers and veterans—and indeed, how servicemembers and veterans see themselves?”

THOUGHTS?

In their effort to get the word out about entitled benefits the VA launched a 4-part Video Campaign to encourage awareness by the Veteran and their families.

Check out the VA’s New YouTube Video Outreach Message via the “care package” metaphor that encourages Veterans to use their earned benefits from healthcare and education to home loans and job assistance.

The New York Times reported today that under rules to be proposed this week the Department of Veterans Affairs plans to add Parkinson’s disease, ischemic heart disease and hairy-cell leukemia to the growing list of illnesses presumed to have been caused by Agent Orange, the toxic defoliant used widely in Vietnam.

These illnesses will be added to the list of more than a dozen conditions the VA already recognizes as being presumptively linked to Agent Orange exposure in Vietnam, including Hodgkin’s disease, prostate cancer and Type 2 diabetes.

According to the Times article, the most common of the three illnesses, ischemic heart disease, restricts blood flow to the heart, causing irregular heartbeats and deterioration of the heart muscle.

Parkinson’s disease is associated with a loss of cells that secrete dopamine, a brain chemical essential for normal movement. Patients develop tremors, rigid posture, impaired balance and an inability to initiate movement.

Hairy-cell leukemia, a rarer condition, is a slow-growing cancer in which the bone marrow produces too many infection-fighting cells, lymphocytes, that crowd out healthy white blood cells, red blood cells and platelets.

The Institute of Medicine released a report in July that found “limited or suggestive evidence” of an association between exposure to herbicides and an increased chance of Parkinson’s disease and ischemic heart disease in Vietnam veterans. The report also found “sufficient evidence,” a stronger category, of an association between herbicides and hairy-cell leukemia.

The report, written by a 14-member panel appointed by the institute, was based on a review of scientific literature. The institute is required by Congress to monitor the health effects of herbicides used in Vietnam and produce updates every two years.

Some doctors and researchers say the expansion of Agent Orange benefits has been based on weak or inconclusive science, given the lack of studies on Vietnam veterans. Those skeptics argue that diseases like prostate cancer or Type-2 diabetes are just as likely the result of aging, lifestyle or genetic predisposition as exposure to Agent Orange.