2011 Issues   /   October 2011

Many Servicemembers Who Commit Suicide Have Never Seen Battle

USM By U.S. Medicine
October 6, 2011

Many Servicemembers Who Commit Suicide Have Never Seen Battle Cont.

Evaluation of Prevention Programs

Woodson said more research is needed, including using metrics to evaluate suicide prevention programs in the military.

“One of the things that we have to be careful of in a resource-constrained environment is that we don’t fund programs that are not effective, and we allow others that would be effective to wither on the vine,” he said.

Some prevention programs seem to work better than others, Woodson said. For example, servicemembers in custody following arrest are at higher suicide risk, making more critical programs to evaluate their mental-health status.

Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD explained in his written testimony that just providing sufficient mental-health providers and programs for troops is not enough. Awareness of who is at risk is also vital.
Field testing is complete on the behavioral health component of DoD’s electronic health record, the Armed Forces Health Longitudinal Technology Application (AHLTA), and will be implemented later this year, he said. The system will allow a provider to flag a patient by entering a “Behavioral Health Alert” that designates a patient as either a danger to self or to others.
“Once the alert is put in the system, AHLTA users will see the alert when the patient’s record is reviewed, and all providers will be able to see the treatment plan established by the mental-health provider,” he explained in his written statement.
Woodson also said the joint VA/DoD Clinical Practice Guideline for the Assessment and management of Suicidal Behaviors is under development by the VA/DoD CPG committee’s panel of subject matter expert.
“The guideline will provide clinicians with evidence-based or evidence-informed guidance on the assessment and management of an individual with suicidal ideation,” he wrote.

Peer-to-peer programs seem to work, Woodson said, adding that a key factor is for troops to have access to high-quality mental health care by mental health professionals who understand how to evaluate and treat for suicide risk.

Hazing and Suicide

Near the end of the hearing, Rep. Judy Chu, (D-CA), told the subcommittee and military witnesses about the death of Lance Corp. Harry Lew, a marine who killed himself in Afghanistan in April.

Chu said that Lew was found sleeping on watch one evening while serving in Afghanistan, something that had happened before. At 11:30 p.m., his sergeant called for “peers to correct peers,” she said.

“At 12:01 pm, Lance Corp. Lew was beaten, berated and forced to perform rigorous exercise,” she continued. “He was forced to do pushups and leg lifts wearing full body armor and sand was poured in his mouth. He was forced to dig a hole for hours. He was kicked, punched and stomped on, and it did not stop until 3:20 a.m. At 3:43 a.m., Lance Corp. Lew climbed into the foxhole that he just dug and shot himself and committed suicide.”

Chu then revealed that Lew was her nephew.

“He was 21 years old, and he was looking forward to returning home after three months. He was a very popular and outgoing young man, known for joking and smiling and breakdancing,” she said.

Chu wanted to know whether hazing was expressly prohibited by the services and how the services were preventing “suicide from hazing.”

The military leaders insisted hazing was not tolerated.He HHddd

“This is unfortunate,” said Lt. Gen. Robert E. Milstead Jr., USMC deputy commandant for manpower and reserve affairs. “Hazing is inconsistent with the Marine Corps core values. It is expressly prohibited.”

Woodson expressed his sorrow for Chu’s loss and also said that hazing was “inconsistent” with DoD policy.

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