You have heard me talk on many occasions about the importance and value of our Sailors and the contributions they make to our Fleet and our Navy. One of the more tragic issues we face today is suicide. In FY09, Fleet Forces lost 14 Sailors to suicide and had more than 485 reported cases of suicidal behavior. Last year we conducted five suicide prevention workshops in Fleet concentration areas with Fleet leadership at all levels and, frankly, I think our leadership gets it. They understand the tragedy that occurs when a Sailor takes his or her own life. Not only is it a loss of life for a Sailor, but it leaves permanent scars on those left behind.
However, this is not an issue that can be solved by a policy message or a single training session. I am interested in your feedback on how we reach Sailors who are at the point of taking such a desperate and destructive act as suicide. How do we get to them with help before they reach this point? What can we do as a Navy family to help those around us deal with life issues - be they emotional, financial, whatever - that they may see as simply insurmountable? If you have been involved with a shipmate who was thinking of suicide, how did you handle it? All the best, JCHjr
ADM J. C. Harvey, Jr.
16 comments:
I would recommend a private hotline stating there would be no repercussions when coming forward due to a mental health problem first. Sucide could be due to medication and/or depression.
14 suicides in a year, ANY year, is a tragedy. I agree with your thinking here, sir. Admiral, I did a couple of tours in VietNam a hundred years ago at the age of 18-20 years old, but I learned very quickly to spot shipmates who were troubled, and in trouble, emotionally. There were a series of very subtle changes in their behavior that I saw could trigger the pent-up desire to "end it all" and I would ask and ask if anything was wrong that I could help them with by letting them "vent." When I didn't get what I thought was a normal response, I'd ask and ask again. When all else failed, I let my chain of command know that I was concerned. In my case, there was one particularly-disturbed "good friend" that I had to"help" by "turning him in" to the chain of command for what I realized were potentially suicidal gestures, comments, etc. I lost a "good friend," but he's at least still alive to be mad at me! I think the lesson we all need to learn is to be keenly aware of our friends and shipmates' norms and get more expeditiously and thoroughly involved when they tell us that "nothing is wrong, don't worry about it." These Sailors and Marines are ALL someone's loved ones, and I think we owe it to each other to get involved, even at the cost of a friendship if necessary. One Sailor or Marine suicide a year is one too many!
Admiral,
I have had more than a little experience with this topic. My family has been touched by the tragedy of suicide and I have had shipmates on 2 of 10 ships successfully complete the act of desperation.
In command I had dozens of suicidal ideation cases and one serious attempt by an officer that I would have bet my retirement pay would never have attempted the act. The challenge is to KNOW your people and I think that we should have command climate surveys (or something similar) at least quarterly. It is not that hard to get them done (people will tell you that it is, but it isn't that difficult). I think the addition of more more chaplains or mental health professionals on the deck plates during phases of deployment work ups or even on deployment would help. That said, this IS a tough job and we have to be careful of telling people 'everything is going to be fine' with the need to put them in harms way. There is no way to screen out the problem (many people will tell you they can) but I think that we need to provide the CO/XO/CMC with an outside assessment group who can provide feedback.
My suggestion would be develop a process that assesses mental health and command climate along the same lines as the Safety center does with safety surveys.
Thanks again for allowing contribution.
Very respectfully,
Shipmate
Suicide is complicated. Here is one piece of it: Sometimes the culture of the sailor pulls him away from his family. Yet, the family is the primary support of human beings. Sometimes that pulling away is in the form of repeating scare stories of how one's spouse will "leave you when you're gone so don't get too attached." In some cases, a sailor will not even marry the woman he loves; the mother of his baby, because of this "culture of fear". The truth is, a spouse is more likely to leave the military person if they feel left out of their loved one's thoughts and dreams; their important life. Commanders can help change this culture by talking with sailors who remain unmarried even though living together. Ask them why they're not married. Encourage them to be brave, not just i battle, but in love; to love fully, not withdraw from fear. When the relationship is solid, spouses do not stray. I did a tremendous amount of research on this for my dissertation some years ago ("Wives who leave their husbands...") and have worked with many military personnel. WE're all in this together. Try it.
I agree with "old Navy vet" and "shipmate". In addition, I have a few thoughts. Clearly, suicide is complicated. What we do know is that relationship problems are a number one cause. We also know that a strong family system is the strongest force for prevention. Not all families are blood relatives and buddies (their Wingman) are essential for picking up signs of suicide. In addition, I believe commanders can do a great deal to encourage strong families by dispelling the myth that one's spouse will leave you if you're gone. The thought creates the depression as much as the actuality. It's true that a spouse will leave if you are "gone" emotionally or psychologically from them. But people have amazing capacities for enduring long absences if they feel loved and included in the other's hopes and dreams. They need to feel like they're fighting together, against the "enemy." With electronic advances, there is no reason for an absence of contact. Commanders can help by talking to a person who has not married the mother of the sailor or who is looking at divorce. Encourage the sailor to be as brave in relationship as they are on the battlefield.
Dr. Vaughan makes several excellent points in her discussions. I was the "wingman" for the friend I had to turn in in VietNam, but that was light years ago. It was almost 30 years later that I actually addressed the post-traumatic-stress-syndrome I was experiencing myself.
Even as a Chief Petty Officer, who should have known better, I honestly feel that had I not had that umbilical-cord to my wife that Dr. Vaughan describes I may NOT have it through some of the extended shipboard deployments with few liberty ports "to blow off steam," the endless days at sea without relief or fresh water. My wife and I wrote to each other every single day and numbered the letters so that we could read them in order when they finally arrived.
I think, in addition to Dr. Vaughan's observations, what is NOT being said here is, it is NOT a stigma to see a psychologist or psychiatrist if you are having troubling thoughts or suicidal ideations for NO APPARENT REASON that you can think of. That's why people like Dr. Vaughan are in their chose professions. They have a calling to help people, but they can only reach out so far. It is our job as fellow human beings, husbands, wifes, lovers, shipmates, "wingmen," et. al. to get more actively engaged and ensure that people "at risk" are seen by a professional(s). Skippers, XOs, DIVOs, make an appointment to see a psychologist at the hospital to talk about these things, or even your own feelings. Invite the doctor to lunch in the wardroom if that's what it takes for him/her to give a presentation to your Sailors and Marines on things to look for. Invite the Family Support Group and the ship's ombudsman to attend as well. And, as Dr. Vaughan so aptly points out, make every single Sailor or Marine around you feel good about themselves, especially if they're not getting that message from home. As I stated in my first post, ONE shipmate's suicide is too many. 14 suicides is a terrible tragedy, and it senda the message that if it's too tough to cope with, just end it. I cannot even begin to describe to you how GREAT I felt after having talked to a psychologist JUST ONCE!!! I, of course, saw him many times thereafter, until we mutually agreed that we didn't need to see one another any longer...and the funny thing is??? I don't feel the least bit emasculated or weird for the experience and I got a lot of help and his discussions helped me divulge a lot of pent-up frustrations with "problems" I couldn't even hang a name on until he pointed them out to me. I remember, after I spoke to him on the first consult, 5 minutes in, he asked politely, "So, senior chief, how long do you think you've been clinically depressed?" I was blown away. I finally responded, "I think about 20 years or so." He said, "Well, then we have work to do." And, we did!
So, again, thanks for asking for these kinds of inputs. Your insightfulness is being recognized by the people who can use it the most: your Sailors and Marines in USFF's constituency. And, to the readers of this blog: if you think you need help, your Navy Family is standing by, ready, willing, and able to help. GO SEE THEM ASAP!!! You will feel renewed, and ready to re-engage in our constant struggle against our most formidable enemy: US!
Admiral Harvey, your words sound so wonderful, but unfortunately hard to believe. I do not want to take this debate on this forum; Unfortunately, I have already been forced to take my issues to the media. I would like to have a serious discussion with you not CDR H, pertaining to this matter. If you have been kept up to date, then you know who I am and should have no problems contacting me.
I find your comments quite interesting given the fact that I have sent various faxes and emails to various individuals as well as yourself regarding this topic and how it pertains to my husband and I am being told to basically keep my thoughts and feelings to myself that as a spouse I have no rights to make demands on the Navy. Yet you clearly sound concerned but actions speak louder than words. I look forward to hearing from you soon.
Respectfully,
EN1's wife.
Navyspouse, if you would call my office at (757) 836-3660 today and leave a number where I can reach you, I'll call you back this afternoon.
Unfortunately, your previous faxes/e-mails have not reached me so I'm unfamiliar with the issues that are of such concern to you.
I look forward to talking with you. All the best, JCHjr
Admiral Harvey,
I recently completed my community mandated suicide prevention and awareness training. The training was good and covered the Operational Stress Control Program (presented by a SME), and the usual suicide prevention and awareness training (signs, actions to take, resources for help, etc.)
The "canned" brief was followed by a more personal appeal for proactive intervention from an individual that had recently experienced the tragedy of suicide in their own family.
The call to action was effective, but what I would really like to see is a case-study/studies covering SUCCESSFUL intervention and SUCCESSFUL re-integration of the effected individual back into the fleet or transition to an equally productive lifestyle.
I have faced the challenge of conducting an intervention on a near-peer subordinate regarding different mental health challenges (compounding other, until then unrecognized, problems) other than suicide. I know that I faced perceived barriers to action when I made what I thought at the time was a very difficult decision to intervene. I also believe that this individual likely owes his career to the relatively junior Chief Petty Officer who courageously raised the issues at hand to me.
In retrospect, I believe that the situation was handled correctly (the individual continues to be a very productive member of the Navy team), but it was a near fought thing with non-trivial pushback from the chain of command. Fortunately in this particular situation, an LDO Captain provided much needed top cover, and I (the intervener) and the person who needed help escaped without serious career ramifications. That outcome was far from certain for a number of tense weeks, and I feel fortunate that the right individual with what I believe to be the right outlook was there for support.
That’s a long way of saying that I think cases of successful intervention would cover some important ground in breaking down what I perceive to be still unresolved institutional barriers to proactive intervention in a number of situations related to mental health.
In closing, I would like to say that the relatively recent change to the security clearance policy (reporting requirements when seeing a mental health professional on the SF-86) is a positive and progressive step forward. Based on the polling question asked during the aforementioned training, I do not believe the word has filtered down to all levels of the organization, and there are still perceived barriers to intervention that should be proactively addressed.
Very Respectfully,
Old Navy Vet/Dr Vaughan/Shipmate, thanks very much for your responses - you've made clear the complexity of this issue and the extreme difficulties we have in reaching those most in need of help due to fears of the stigma attached to seeking help.
Improving access to those who are qualified to give help - such as the confidential hotline suggested by Sheryl Lee - is essential.
We all have to help break down the barriers - be they personal, cultural or institutional - that get in the way of our Shipmates getting the help they need.
At the end of the day, we must realize that we are our "brother's keeper" and we must act when we see the need to act. All the best, JCHjr
Update: Just today I received some good news from Lt. Col. Ed Vaughan, the originator of the "WingMan Project"; an on-line source of short real-life video clips that demonstrate signs of potential suicide and what one can do to help. It is successfully used at a number of USAF bases. They are currently launching a "ShipMate Project" for the Navy, based on similar criterion. While it is being put together, please go to WingmanProject.com for a demonstration. Thank you Adm. Harvey for your good works in this important area.
Please excuse. The correct site is: WingManProject.ORG
or http://wingmanproject.org/Videos.aspx
Admiral,
The only thing that reached me seven years ago when my selfishness overrode the tenuous grip I held on reality was a shipmate brave enough to intervene. In retrospect, I was displaying all the signs of a downward spiral: reckless behavior, increased alcohol consumption, declining work performance. I had even started planning how I would end my life. By the grace of God, I had the luxury of a relentless pain in the rear of a shipmate who would not give up on me. Granted, he was the boat IDC, but still a great friend. He saw to it that the Command got involved in securing the treatment I needed.
In my opinion, though, the issue is not how to save people like me. I was well liked on my ship, had plenty of people looking out for me and I was fairly outgoing. The two experiences I have had with sailors taking their own lives during my career involved relatively reclusive people. Some people are introverted by nature and may cause others to feel uncomfortable. The introversion is further exacerbated by sailors who make fun of or shun the quiet sailors because the quiet sailors are "weird." Introverted or not, however, every sailor has a story worth an audience. The most awkward sailor on my last ship, for example, turned out to be something of a trivia wizard. Furthermore, once I played to that strength, he opened up to other sailors in our GQ station. He is still an awkward sailor, but people don't poke fun at him anymore.
It all goes back to what you have previously said about valuing sailors. From a Junior SWO perspective though, I have served with fellow JOs who haven't the first clue how to relate to or interact with their sailors on a personal level. As often as I promise them that it is well worth the investment in time to find out about their sailors lives, it is also an obligation of leadership that the concern be, in the words of Dale Carnegie, GENUINE. I have been a sailor on the deckplates and I can see through a JO who doesn't care. I can tell you that my DIVO had a cursory relationship with me when I was being eaten up inside by various demons. I am not naive enough to believe that a JO can save the world, but it is worth reiterating that genuine interest in those whom they are tasked with leading is an obligation of leadership.
The upshot, Admiral, is that I think that JOs could use a dose of humility and personnel management skills to boot. Intrusive leadership does not have to burden either party.
A fellow JO told me once - "I would get involved in the lives of my sailors, but I am afraid that it will seem like I am fraternizing." Fair enough, and certainly events of the previous two weeks serve to further highlight the dangers of fraternization. I will close by saying the following though: 1. The line between being genuinely concerned about your sailors' lives and fraternization is distinct. 2. If genuine concern can prevent the loss of just one sailor by suicide, I will take on those who cry "fraternization" any day.
Very respectfully,
LTJG SWO
Old Navy Vet-
Not Navy, or US, my answer was 'probably about 5 years'.
The important thing is the removal of that stigma, I tried the DIY approach, now I have alcohol issues I'm also dealing with.
Nobody chooses depression, but it is real, in a recent counselling session my chief head shrinker asked what I had achieved this year, my answer, very little.
Turn that around and I could come up with a number of things, change companies, change jobs, you've got family and friends etc etc. All of which of course was applicable to me.
As I'm sure you know there's a difference between knowing something logically and actually feeling it.
Dear ADM Harvey. Thank you for taking the time to address the topic of suicide. I am a Major in the Army and have seen a number of cases of suicide and suicide attempts, and I have also experienced my own hardships that left me with lingering issues that I had to deal with. Through those situations, I came to write a book in order to help out other Service Members. The book that I wrote is a story about the unique challenges that I have faced, and what many other military members and their families have sturggled with too. I wrote this book initially as a personal journal of what I went through before, during, and following my failed attempts to save my marriage, because I needed to find a healthy way to deal with my pain and frustrations. The more I wrote, the more I felt able to finally release my hurt and bitterness, and I realized that there are thousands of other men and women – both in the service and out of it, who are experiencing the same pain, frustration, and sense of isolation that I went through. My hats off to you and to our other leaders who are working tirelessly to help the men and women who serve.
Very Respectfully,
Daniel O. Wilt, Jr.
Major, U.S. Army
Military Police
I believe Navy Times wrote an article on suicide and provided some data about the amount of help these people received before the act. Despite going to counselors, sailors still commit suicide. Fleet and Family Service Center has patients sign a paper that states their command will be notified if they have suicidal ideations. How can the sailor open up when there is a fear of repercussions? What happens to those sailors who are reported on message traffic that they had suicidal ideations? Are their careers over? Fortunately/unfortunately, some do get help from outside the institution through private counselors. I am aware that some SEALs get this private help in order to save face and keep their job. Perhaps we should look at the legal paper work sailors have to sign before they get help.
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