Military Suicides: Understanding “Moral Injury”

As America commemorates Memorial Day honoring those who gave their lives for their country, let us recognize the tragedy of military suicides among active duty soldiers and veterans.

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In 2014, 273 U.S. servicemen died by suicide compared to 58 killed in action in Afghanistan (55) and Iraq (3). And 7,403 vets took their own lives in 2014—18 percent of all adult suicides in the United States—according to the Veteran’s Administration. A factor receiving increasing attention in military suicides is known as moral injury.

Military service by definition is fraught with moral quandaries, from whether a particular war is “just” or an individual action within a “just” war is morally right. Psychiatrist Jonathan Shay, a specialist in combat trauma who has studied Vietnam veterans, says moral injury “is present when there has been a betrayal of “what’s right,” either by a person in legitimate authority or by one’s self, in a high stakes situation.” Both forms of moral injury impair the capacity for trust and elevate despair, suicidality, and interpersonal violence, Shay says.

Laura Greenstein of the National Alliance on Mental Illness (NAMI) illustrates the dilemma:

Imagine you are a young soldier leading your unit on a foot patrol in an Afghan village. One moment your environment is peaceful, the next your unit hears a loud explosion and you realize you are taking fire from the enemy. You find a secure position to radio your overhead observer, to determine where the threat is originating. It’s your job to take out the enemy before any soldiers or innocent civilians are harmed. Your overhead observer gives you the location and describes the enemy for you: an 11-year-old Afghan boy who is firing at your unit with a machine gun. At this point, you are ordered to take out the enemy. You follow the orders to save your soldiers and the innocent civilians in the village.

Six months later, you finished your deployment and are welcomed home by your friends and family. You begin to remember many of the experiences from your deployment, several you wish you could forget—including the day with the 11-year-old boy. This experience has made you question who you are, the morality you believe you had and causes you to worry that people may view you differently.

Writing in The Conversation, Holly Arrow and William M. Schumacher explain how mental health treatment and positive social interactions can help the healing:

Preliminary evidence suggests that cognitive-behavioral therapy (CBT) modified to treat issues related to moral injury can reduce depression as well as guilt- and shame-related thoughts. Treatment can come in other forms, as well. Psychotherapist Edward Tick, for example, organizes trips to Vietnam for U.S. veterans to meet their Vietnamese counterparts, for the healing of decades-long wounds.

However, we don’t need to be trained therapists to make a difference. Everyday social connections can also help the morally injured heal. In his dissertation, the second author of this article conducted a series of interviews with veterans exposed to potentially morally injurious events and found consistent differences between those with higher levels of depression and suicidal thoughts and those with fewer symptoms. Veterans who weren’t doing so well felt isolated and lacked support by friends, by family and by peers. Veterans with few symptoms felt supported by family, friends, peers and by their community. That’s the rest of us.

When we discover that someone has a military background, replacing the perfunctory “Thank you for your service” (which rarely leads to a meaningful exchange) with questions that start a conversation can create a new connection. The hopes, dreams, insecurities and mistakes of those who have served may be somewhat different based on their military background; many won’t be different at all.

Photo: Airmen of the 374th Security Forces Squadron, Yokota Air Base, Japan, May 15, 2017. Airman 1st Class Donald Hudson/U.S. Air Force
[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]

[Veterans Crisis Line connects Veterans in crisis and their families and friends with Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1-800-273-8255 and Press 1, chat online, or send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year.]

[Visit the NAMI Veterans and Active Duty page for treatment resources, disclosure, and staying healthy during the transition to civilian life.]

 

Thank You for Your Service

By David Shapiro

Thank You For Your Service, the 2016 documentary by Tom Donahue, opened my eyes to the mental trauma that our military veterans can fall victim to. Among the shocking realities highlighted by the film is that 20 veterans take their own lives every day in the United States. Thank You for Your Service goes beyond the statistics to reveal the failed mental health policies within the U.S. military.

It is a privilege for Family & Children’s Service in Ithaca to share this important movie with our community and participate in advocacy for improved mental health care for our veterans and active service men and women. The screening of Thank You For Your Service at Cinemapolis on May 17-18 is sponsored through Family & Children’s Pamela and Robert Swieringa Education Center, carrying on a tradition we began last year in using cinema as a powerful public educational platform during Mental Health Awareness Month.

Thank You for Your Service features all manner of players and experts discussing the mental health crisis in the U.S. military, including former Defense Secretary Robert Gates, ex-CIA chief David Petraeus, and war correspondents like Sebastian Junger and Dexter Filkins. But most importantly, the film gives voice to the voiceless veterans themselves. The Hollywood Reporter aptly summarized the story in its review of Thank You for Your Service:

The interview subjects all agree that the Defense Department and the Veterans Administration have not sufficiently attended to veterans’ mental health needs, and the problems they cite are numerous. Among them are bureaucratic inefficiencies, lack of funding, the overprescribing of psychotropic medications, a lack of qualified therapists, and extended tours of duty that result in soldiers serving far longer than they bargained for.

But it’s not the expert commentary, as illuminating as it is, that gives the film its power. Rather, it’s the handful of veterans who discuss their emotional struggles, both while serving in Iraq and Afghanistan and after their discharge. One describes watching his best friend being burned alive, while another relates how he felt so guilty over civilians killed as a result of his actions that he attempted to find their family members to apologize. They talk about suffering from nightmares and PTSD; resorting to drugs and alcohol to numb the pain; and, in one case, playing Russian roulette.

Thank You for Your Service has won awards, but its producers are determined to achieve something else: change. They are urging movie-goers to take action in support of a proposed Behavioral Health Corps in the armed services that would focus on addressing critical mental health needs.

“If the public takes one message away from this film: reach out to your member of congress and request that they support a behavior health corps in the military,” says Daniel Rice, president of the Thayer Leader Development Group. “That will be the best action that they can take to help address the plague of suicides that our veterans are suffering.”

David Shapiro is chief executive officer of Family & Children’s Service in Ithaca

Cinemapolis Program Details:

May 17: Film at 6:30 p.m., Panel Discussion at 8:30 p.m.

May 18: Film at 7 p.m.

Also in Mental Health Awareness Month:

Family & Children’s Service Annual Celebration

Honoring:

Adga Osborn Award recipient Joan Jacobs Brumberg

Family Partner of the Year Serendipity Catering

Volunteer of the Year Bert Odom-Reed

Guest Speaker:

Karl Pillemer

Director of Bronfenbrenner Center for Translational Research.

Tuesday May 16

8-9:30 a.m.

Ithaca Country Club

189 Pleasant Grove Road

Click here to purchase tickets

TC3’s New President: Orinthia T. Montague

“Anything I can do to have students reach their goals, whatever the goals may be, that’s what really drives me.” —Orinthia T. Montague

The State University of New York Board of Trustees announced May 3 that it approved the appointment of Orinthia T. Montague to become the fourth president of Tompkins Cortland Community College.

Montague, who replaces long-serving TC3 President Carl Haynes, has served for the past seven years, most recently as vice president of student affairs and chief diversity officer, at Normandale Community College in Bloomington, Minnesota.

According to TC3’s press announcement, Montague has led Normandale’s efforts and partnerships with public and private secondary schools, as well as community and business collaborations; a partnership with Bloomington Public School District and Hennepin County provides direct higher educational opportunities to close the gap for underrepresented populations with a focus on homeless students, foster children, and teen parents.

Addressing Montague during a campus forum, Haynes said: “I think what’s most impressive about your credentials and what you bring to our college and to our campus is your long history of experience with student success, student life, and the commitment you have made to that in many different parts of your career. I’m truly pleased to be turning this office… No, I am downright excited about turning this office over to you as our next president.”

Montague, speaking at TC3, also emphasized her commitment to student success:

“I’m a first generation student, from the country of Jamaica. I’m an immigrant. I’ve had so many people concerned about my student success, and the little things and the big things that it takes for me to achieve and move forward with my goals. So I’m passionate about doing that for others.

“I want people to experience what I experienced with this support, within my community, external to my community, intentional, and unintentional support, structured, unstructured. Anything I can do to have students reach their goals, whatever the goals may be, that’s what really drives me.”

TC3 Board of Trustees Chairperson Elizabeth Burns praised Montague’s selection. “Dr. Montague has served in a number of important roles in institutions of higher learning, and her passion for working towards success of students of various backgrounds is a good match for this College and for the challenge of moving us forward,” she said.

Montague received a bachelor of arts degree in interpersonal communication from Truman State University; a master of arts in counseling from Lindenwood University; and a doctorate in higher education administration from the University of Missouri–St. Louis.

She follows in the footsteps of three other presidents since TC3 was established: Hushang Bahar (1968–1986); Eduardo Marti (1986–1994); and Haynes (1994–2017).

Haynes has spent 48 years at TC3, joining as a member of the business faculty in 1969. He has overseen tremendous growth in his 23 years as president, including doubled enrollment, construction of a new student center, athletics facilities, and several residence halls, and creation of a solar farm. Recently TC3 opened Coltivare, an Ithaca restaurant in support of its farm-to-bistro initiative that includes degree programs in culinary arts and sustainable farming and food systems.

Cornell’s Walk for Suicide Prevention

Cornell University’s Phi Sigma Pi (PSP) national honor fraternity sponsored a suicide prevention walk on April 28 to benefit The Sophie Fund of Ithaca and the national Suicide Prevention Lifeline.

“Phi Sigma Pi organized this walk because we wanted to increase campus conversation about mental health,” said PSP brother Elizabeth Cavic (’18), who studies Human Development in the College of Human Ecology. “We believe that people not engaging in these critical conversations about mental health perpetuates the stigma surrounding poor mental health, which contributes to further stigmatization.”

Scott MacLeod, a donor advisor of The Sophie Fund, thanked Cavic, her fellow PSP brothers, and all those who participated in the walk. “We’ve had the honor of working with Phi Sigma Pi on other mental health projects, and are very grateful for the support it gives to mental health awareness and suicide prevention efforts,” he said.

MacLeod and his wife Susan Hack established The Sophie Fund in 2016 to support mental health initiatives aiding young people in the Ithaca area. The fund is in memory of their daughter, Sophie Hack MacLeod (’14), who died by suicide in Ithaca in March 2016.

PSP is a co-educational fraternity open to undergraduate students that embraces the ideals of scholarship, leadership, and fellowship. The PSP Beta Nu Chapter at Cornell was founded in 1994 and has about 80 active members in a given semester.

[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]

Risky Business

May is Mental Health Awareness Month and #riskybusiness is Mental Health America’s theme this year. The Sophie Fund will be sharing materials from the #riskybusiness awareness campaign throughout the month.

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As MHA’s awareness campaign explains:

“When you or someone you love is dealing with a mental health concern, sometimes it’s a lot to handle. It’s important to remember that mental health is essential to everyone’s overall health and well-being, and mental illnesses are common and treatable.

“Yet, people experience symptoms of mental illnesses differently—and some engage in potentially dangerous or risky behaviors to avoid or cover up symptoms of a potential mental health problem.

“That is why this year’s theme for May is Mental Health Month—Risky Business—is a call to educate ourselves and others about habits and behaviors that increase the risk of developing or exacerbating mental illnesses, or could be signs of mental health problems themselves.

“Activities like compulsive sex, recreational drug use, obsessive internet use, excessive spending, or disordered exercise patterns can all be behaviors that can disrupt someone’s mental health and potentially lead them down a path towards crisis.”

Click here to take MHA’s interactive quiz about when you think behaviors or habits go from being acceptable to unhealthy.

Click here to download MHA’s toolkit and spread the word about #riskybusiness yourself.