The suicide rate in the U.S. military is out of control. During some periods, more active soldiers have taken their own lives than been killed in combat. U.S. military suicides hit a record 349 in 2012, although they declined to 265 in 2015. It’s even worse when the soldiers become vets. A Department of Veteran’s Affairs report in 2012 showed that 22 veterans a day were killing themselves—almost one an hour.
Memorial Day candle vigil march at Bagram Airfield, Afghanistan, May 26, 2014. Staff Sgt. Evelyn Chavez/Air Force/Department of Defense
New research published in JAMA Psychiatry, the journal of the American Medical Association, is providing further guidance for effective suicide prevention in the military. The study found that 60 percent of U.S. army suicides occurred among soldiers who had not yet been deployed to combat roles. In general the study highlighted the importance of transitional periods for suicide prevention efforts.
The JAMA researchers also found female soldiers were more likely to attempt suicide than their male counterparts. A 2015 Veterans Administration study showed that female military veterans commit suicide at nearly six times the rate of women in the general population—and 12 times the rate if the women are between the ages of 18 to 29.
The Christian Science Monitor and NBC News covered the JAMA study here and here.
The Monitor cited a 2015 report by the U.S. Office of Inspector General criticizing bureaucratic inefficiency in the Pentagon’s suicide prevention efforts:
The Defense Suicide Prevention Office lacked clear processes for planning, directing, guiding, and resourcing to effectively develop and integrate the Suicide Prevention Program within the DoD. We recommend the Defense Suicide Prevention Office provide an implementation strategy to adapt Department of Defense applicable evidence-based suicide prevention research findings into standard practices across the Department.
Building resilience was the theme of remarks by Greg Eells, director of Counseling and Psychological Services at Cornell University, and David Shapiro, F&CS’s president and CEO. Here are Shapiro’s remarks:
I’d like to spend a few minutes talking with you about some of the work being done at Family and Children’s Service. Last year I talked about meaningful connections and the relationship that exists between meaningful connections and happiness. Having people in your life you can trust is also an important part of being able to bounce back when under duress, or soldier on when times are tough. What I’m talking about is resilience and how important it is for us to build relationships as a part of building resilience in ourselves.
I want to tell you about some of the different ways Family and Children’s Service is connected within the community in ways that help foster resilience.
First, with Cornell. Each year hundreds of students, faculty and staff come to F&CS seeking support. Our relationship with Cornell’s Student Health Center, Gannett, is so strong and longstanding that students seamlessly transition from receiving on campus services into our community based mental health clinic. As Gannett continues to expand their behavioral services—to extend more access to their growing student base—I know that we too will be called upon to respond to those same needs.
Second with the United Way. Last year the United Way of Tompkins County provided $127,000 in annual support for our counseling, psychiatric and rural outreach services. Because of this support Family and Children’s Service` provides counseling and psychiatry services to people without insurance and, more often, under-insured clients with out of pocket costs that would otherwise be too significant to bear. The United Way also supports our rural outreach services which provide mentorship in rural communities to youth and adolescents in need of social, emotional and behavioral support.
More than a decade ago, Family and Children’s Service collaborated with Cayuga Medical Center and the Tompkins County Mental Health department to bring child psychiatry to our community. Alone, bringing this resource into Tompkins County demonstrated the importance of this connection. But together this partnership has meant so much more to our community, as vulnerable children are discharged straight from CMC’s behavioral unit, into F&CS’s mental health clinic ensuring the needs of these kids don’t fall through the cracks. Cayuga Medical Center has also been an important partner along with the City of Ithaca, Downtown Ithaca Alliance, Ithaca Renting Company and Tompkins County in providing outreach services in our downtown business district.
Tompkins County also enables F&CS to support some of the county’s most vulnerable youth by providing funds that support the specialized clinical and case management programs offered by F&CS that focus on improving social, emotional and behavioral development needed by:
—Children, younger than 5 years old often who have already been exposed to violence, addiction, poverty and despair.
—Adolescents and teenagers facing immediate mental health crises.
—And more youth and adolescents, at risk of being removed, running away from their home, or sometimes already having left and are now homeless.
—And aging adults, looking to strengthen their support system so that can age gracefully in their homes.
These are just examples of some of the important community connections that exist in order for F&CS to advance our mission. There are so many more.
Tompkins County is blessed with an abundance of community organizations and social supports for people in need. However, I want to challenge us to think about these services in a broader context that looks not just at whether the services exists, but also asks if there meaningful ways for these services to connect around a common good.
The truth is, in a fast paced, technologically driven world, many people are finding it more and more difficult to build meaningful connections and are forced to face the world alone. And just like each of us individually needs each other to support one another, as an organization we need to build connections too if we want give our clients the best chance at success.
To borrow a quote from Hellen Keller, “alone we can do so little, together we can do so much.” Thank you for being here, together, with me today. Each time we come together around a common good, we grow as a community and are better prepared to face the challenges ahead of us.
It’s hard to articulate what it’s like in the deepest depths. But the best way I can explain it is you almost feel like you are separate from yourself. You don’t feel like you are physically inhabiting that space in the moment. That’s an awful feeling. No matter what anyone says to you in that moment, how much they love you, how great you are, that you have a great life…none of it, your brain cannot process it or register it. …I’d do anything to be a super-chill hippie. That would be my ideal life.
There has been a disturbing rise in mental ill-health among university students in Britain. Eighty percent of the 54 universities responding to a survey reported observing a “noticeable increase in complex mental health crises” among their student populations in 2015 compared to 2014.
In the survey conducted by AMOSSHE, a student services organization, 90 percent of the schools reported working on critical/serious incidents with the police and/or coroner during 2015; two thirds noted that they had worked on three or more such incidents in 2015. Nearly half of the schools reported one or more student death in 2015 involving suicide or suspected suicide.
At one institution—the University of York—24 percent of students seeking support from the Open Door counseling center presented with depression. Eighteen percent of Open Door users reported having suicidal or self-harm thoughts nearly every other day. In the period from January 1 to February 8 this year, ambulances were called to respond to 12 cases of self-harm or suicide attempts involving York’s students.
In response, Vice Chancellor Koen Lamberts commissioned a task force to consider actions that the university could take to better support students with mental health problems. The task force submitted its report in March—which cites the AMOSSHE survey results—and in early May York’s University Executive Board agreed to implement its recommendations.
Read the full York report and recommendations here.
The main findings: the severity of mental ill-health among students at UK universities has been increasing and continues to rise; and there are serious gaps in mental health provision, with delayed and inappropriate support for students in need of care. In a 2013 National Union of Students survey cited in the report, nearly eight in ten respondents indicated that they had experienced mental health difficulties over the previous year.
The recommendations: take immediate steps to improve University support for student mental health; and ensure a high-level and coordinated approach to improve mental health services for students. Among the eight required actions to implement the recommendations: ensuring support for “first contact” staff providing crisis support for students; improving the capacity of academic departments to identify and support students whose health and personal circumstances give cause for concern; strengthening university governance structures for student welfare; developing and implementing a new Student Mental Health Policy.
Here’s the report’s Executive Summary:
1. The prevalence and severity of mental ill-health among students at UK universities has been increasing and continues to rise. Evidence comes from national data on students reporting a mental health condition at the time of admission, student wellbeing surveys, suicide data and sector-wide evidence from student support services.
2. The prevalence and severity of mental ill-health among students at the University of York has been increasing and continues to rise. Evidence comes from a range of sources, including Open Door, Health Centre and ambulance call-out data. We were also provided with soft information pointing to a heightened sense of pessimism in the wider student community.
3. NHS mental health services are regularly failing to meet the needs of vulnerable people including students. While the government has made improving mental health services a priority, mental health services are struggling from the combined impact of rising demand and chronic underinvestment. Evidence comes from a variety of sources, including NHS England. Within the higher education sector, evidence from the leaders of student services points to serious gaps in mental health provision, with delayed and inappropriate NHS support for students in need of care.
4. These shortfalls in NHS mental health provision are evident at the University of York. They have been exacerbated by additional pressures in York and N Yorkshire, including the sudden closure of Bootham Park hospital in autumn 2015 along with other mental health provision. While the data are incomplete, they suggest those living in York, including York students, face particular difficulties in accessing early interventions (e.g. psychological therapies), crisis intervention and both inpatient and outpatient care.
5. The higher education sector recognises that student wellbeing is the foundation of learning and future success. A university experience that is enriching and fulfilling depends on positive mental health and access to support during periods of mental ill-health. A range of frameworks, good practice guides and online resources are now available to enable universities to improve their policies and practices.
6. Our recommendations are framed by the twin pressures we have identified: increasing, and increasingly complex, mental health difficulties among students at a time of increasing gaps in NHS provision. They are framed, too, by an appreciation that the University needs to give much greater priority to the mental health and wellbeing of students.
7. We make two overarching recommendations: to (i) take immediate steps to improve University support for student mental health and (ii) ensure a high-level and coordinated approach to improve mental health services for students in York and N Yorkshire.
8. Our Action Plan is designed to deliver these objectives within the next 12 months. It includes 8 areas of internal action to improve University policies and provision and 3 areas of external action to drive forward improvements in local mental health services for students.