Draft
7 July 2008
CAS SUPPORT BRIEFING NOTE: Suicides among Veterans from the Long War and Previous Wars.
References
- “Risk and Protective Factors for Homelessness among OIF and OEF Veterans”
Iraq Vet project
Sword to Plowshares Project
Dec 7 2006`
- “United States Military Casualty Statistics: OIF and OEF”
CRS Report to Congress
Hanna Fischner
August 17, 2007
- “Armed Forces Suicides Surpass Combat Deaths”
Independent Newspaper (UK)
4. “Suicides and suicides Rates”
Stats Can 1997
AIM
1. The purpose of this BN is to provide LFWA with comparisons of suicide rates and ratios among different conflict zones and different armed forces. By comparing other countries numbers of suicides and potential suicides we can possibly look at our systems and see what we can do to better prevent and prepare for Canadian suicides among veterans and serving members.
BACKGROUND
2. The Casualty Support position was devised to help give insight into the needs of casualties and also to continue to tell the story of the wounded soldier to civilian and military assets. LFWA has been the lead in new policy changes in regards to care of the wounded and care of the fallen.
DISCUSSION POINTS
3. Homelessness with Iraq vets in the US is becoming a huge issue Just over 600 Iraq vets have sought homeless health care services from the DVA. (VA Homeless Program Assessment 2006). Unemployment rates are 15% for ages 20 to 24 in Afghan and Iraq vets. Over 500 000 claims to VA have been filed and the delay in getting financial settlements and the correct medical treatment will make for an increase in suicidal behavior and homelessness.
4. The US military is having problems in several areas. Service members are enduring repeated extended deployments, combat exposure, and continual family disruptions all risk factors for homelessness.
5. Transitional Services for reg force are improving but reserve units transition programs fall short of the standard that the reg force has done. Geographic diversity of the reserve units that deploy on missions which can create a lack of knowledge of programs available, earned benefits and even difficulty navigating the claims process.
6. Only 1/3 or returning soldiers from Iraq and Afghan have screened at risk for PTSD. Non- visible injuries may go undiagnosed and untreated and may be difficult to prove for claim purposes with VA. DOD has consistently returned troops to combat operations that have been diagnosed as having PTSD or having the risk factors for PTSD. Members are receiving "less than honorable discharge" for PTSD activities and behavior and this prevent them from ever being serviced by VA mental health care. The level of care that the VA offers is inconsistent at best with some facilities offering incredible care and others not achieving that standard. The plan for returning members is that Vets get free health care for 2 years upon retirement (but of course many PTSD, CSI, OSI or TBI symptoms take a long time to appear.) In 2006 VA treated 2600 vets with PTSD although the belief is that the number with some form of PTSD is in the range of 34000.
7. Traumatic Brain Injury (TBI) occurs in 20% of infantry and 10% of other troops have at least some form of mild brain injury. Many troops are also experiencing multiple concussions throughout their tour of duties. A new facility is being built to house and treat those that have TBI and also to those vets that have been exposed to an overpressure explosion that could create a TBI event.
8. Soldiers with amputations fall in the number of 730 and in many ways as the Canadian experience is also an example, the numbers are way below the public perception. The VA is treating 264, 000 from both wars and there appears to be about 2,000 VSI and SI a year treated by the VA. Suicide rates in soldiers are up since last year and are posing a huge concern. (32 in 2006 (1500 attempted) and 89 in 2007 (2500 attempted) with a total of 17.5 suicides per 100,000 people.
9. The types of injuries that vets face from the battlefield can be broken down into these areas.
a. Rates of amputation 1005 of whom 708 suffered major limb amputations
b. 488 by IED (48.6%)
c. 871 wounded in OIF (Iraq)
d. 48 wounded in OEF (Afghan)
e. Brain injury 3294 (TBI)
f. 3094 wounded in OIF
g. 200 wounded in OEF
h. 180 considered penetrating
i. 195 considered severe
j. 2279 from blasts
k. 294 from falls
l. 284 from vehicle accidents
m. Suicides in numbers for the US Army
n. 2005 suicides 87
o. 2006 suicides 99
p. 27 in OIF
q. 3 in OEF
r. 69 outside war zones
s. 948 “serious” attempts at suicide
t. 17.3 per 100 000 soldiers in 2006
u. 10.5 per 100 000 United States general population
v. (when adjusted to match the Army’s age and gender) 20 per 100 000 United States general population (adjusted)
w. Suicides in numbers for the US Marines
x. 2004 suicides 34
y. 2005 suicides 26
z. 2006 suicides 24
aa. 12.4 per 100 000 per Marines in 2006
bb. OIF Evacuations (as of Aug 4, 2007…..36471 evacs)
cc. Battle Injuries 22.4%
dd. Non Battle Injuries (including suicide) 20.5%
ee. Disease 57.2%
ff. OEF Evacuations (as of Aug 4, 2007…..6710 evacs)
gg. Battle Injuries 12.6%
hh. Non Battle Injuries (including suicide) 22.9%
ii. Disease 64.4%
jj. UK Suicides in numbers compared to killed in action.
kk. Number of suicides of vets of these campaigns (Gulf Wars, Afghan campaign, Northern Ireland) 687.
ll. Compared to the number killed in action in these campaigns (Gulf Wars, Afghan campaign, Northern Ireland) 438.
mm. In 2006 the UK Forces had 49 suicides.
nn. Canadian suicides rates among civilians (1997)
oo. Males 19.6 per 100 000
pp. Females 5.1 per 100 000
qq. Total 12.3 per 100 000
10. In the CF we have had 3 non battle injuries in theatre at Camp Mirage, Kabul Multinational Brigade HQ and Kandahar Airfield. (Some are under investigation and still are not ruled suicide).
11. The American Department of Defence (DOD) has come up with several ways and methods to prevent suicides and other problems that they see building as their vets return to duty and return to civilian life. So the US DOD recommendations to help solve these problems are as follows.
12. DOD and VA to work better together, provide more assistance to returning vets as they cope with transition, bolster support of the families, work towards and electronic record keeping system that is compatible with all systems in place, identify and treat PTSD and TBI more readily
13. Wounded Warriors Act enacted by congress to write some of the President’s Commission on Care of America’s Returning Wounded Warriors (began after the Walter Reed Scandal of 2007) recommendations into law.
14. They are also going to extend from 2 years to 5 years for free medical care for combat veterans. There is also hope that a current program on trial in Washington DC may prove useful as they will use the same medical examination for both DOD and VA. What this will do is make the VA physicians adopt the DOD rules and embrace the services standards thus following the decisions of the military boards in regards to discards or releases.
15. Casualty Support Units (called Warrior Transition Units in the US system) have been developed for the returning troops to help them in the recovery and rehabilitation process.
16. The final big change is the Benefit’s Delivery at Discharge programs under which a soldier can start applying before their discharge date and thus make a more seamless transition to civilian life and or retirement.
CONCLUSION
17. Suicide and the loss that occurs within the unit, the family and even the public are immense. As a soldier decides that this life has nothing more to offer, depression kicks in, and counseling either doesn’t start or fails miserably we in the CF have to know that we have tried. Not all suicides are preventable as the mental disorder that is causing this reaction needs to be addressed first. Families should also be exposed to what their soldier did in the CF and through that exposure begin to understand their lost family member.
RECOMMENDATION
18. We need to continue to offer suicide intervention training as part of the pre-deployment package. This may allow the soldiers on tours to see warning signs and act in an appropriate manner.
19. The numbers of soldiers that decide on suicide as an option are quite small but they and the event of their deaths has profound complications on those that remain. Families look for blame and in many cases look to us. We can help by allowing the mental health team to be available to the families and showcase what we do. What occurs often is that families don’t understand what we do and how we do it in the CF. We can bring these families into the fold and have them partake in a day of training with the CF to better understand a soldier’s mindset and to see all the good their family member has done within the CF. Families of fallen soldiers have done this type of training and it has been very effective.
Prepared by: MCpl Paul Franklin Cas Sup G1, LFWA
Reviewed by:
Date prepared: 5 July 2008
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