Those in active duty face risks beyond the battlefield

Deaths by suicide outpace combat-related deaths


JINSA participants visit Hurlburt Field in Florida; Justin (Jay) Strauss is third from left. /JAY STRAUSSPROVIDENCE – In 2012, 349 active military personnel (from all branches of the United States military) committed suicide.

That represents a 15 percent increase from the 301 suicides occurring in 2011, according to accounts widely reported by The Associated Press, which summarized data from the Pentagon.

Suicide statistics for military personnel are up from a historical standpoint and are now slightly higher than those for the general civilian population.

Although combat fatalities are reduced, thanks to drones and other modern weaponry – as well as our departure from Iraq – more military personnel deaths are attributable to suicide than to combat injuries.

It’s no surprise, then, that Justin (Jay) Strauss, a board member of the Jewish Institute for National Security Affairs (JINSA), voiced his concern about military personnel’s repeated tours of duty.

Strauss, of Cranston, had visited Hurlburt Field, a U.S. Air Force installation in Destin, Fla., earlier this spring on a JINSA-sponsored expedition. “[Soldiers] come home … and are then redeployed,” said Strauss. “They are doing a marvelous job, but repeated combat tours [in Iraq and, earlier, in Afghanistan] are deleterious to the health of the troops and their families. It’s rampant overuse almost to the point of abuse.”

In contrast, military personnel serving in World War II and later typically experienced one or two combat tours, with 11 months as an average tour of duty, said Strauss.

Unlike combat troops drafted during World War II and, more recently, in Vietnam, today’s volunteer military has three parts: active duty personnel, the National Guard and the Army Reserve, explained retired Army Lt. Gen. Theodore (Ted) Stroup, a member of JINSA’s board of advisors. In contrast to drafted military personnel fighting in Vietnam, we’ve relied more heavily during the past 12 years, he said, on the National Guard and Army Reserve.

A look back at history

Since World War II, the military has become increasingly knowledgeable about mental injuries that can occur in a combat zone and delineations of injuries have become more refined, Stroup said in a phone interview from his home in Falls Church, Va.

As long ago as the Civil War, combat stress was the reason given for some of the Union Army soldiers discharged due to stomach ailments. During World War I, soldiers affected with concussion-type injuries were diagnosed with “shell shock,” he explained.

Throughout World War II, the medical discovery of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injuries (TBI) had not been defined yet, he said. During World War II, the American military began to become more attuned to stress-related combat injuries, he said.

However, it’s only in the past 25 years or so that the military has become more attuned to combat stress and able to define medical terms like PTSD and TBI and link them to battlefield casualties, said Stroup.

In fact, despite its young age,  Israel has taught America about treating combat stress, especially after the 1973 Yom Kippur War. According to Stroup, the Israelis, who learned early on about the need to treat combat stress, assign psychologists to accompany battalions (500 to 800 people) to treat the stress on-site.

According to Strauss, Jews represent about 2.5 percent of the active military – a percentage that is consistent with the percentage of Jews nationally.

No statistics exist, however,   identifying the religions of those committing suicide, retired Army Medical Service Lt. Col. Jacob Romo, Ph.D., said in a phone interview. “Data is not reported that way; religion is not the variable that they are interested in.”

Different stressors in today’s wars

Stroup noted that injuries – from being shot directly to experiencing tremendous explosions from roadside bombs – have put more physical stress on soldiers, some of whom develop TBI.

Too, it’s important to note, he said, that military personnel may also experience PTSD even when they don’t experience any physical assault – witnessing the deaths of fellow soldiers, for example, can leave soldiers profoundly affected.

“The military is struggling with people with PTSD coming in for help; they measure in the thousands as opposed to the 349 who committed suicide in 2012,” Dr. Romo added. If someone on active duty is concerned that his symptoms – PTSD or otherwise – will interfere with his career, “he’s not going to seek help,” said Dr. Romo.

Calling it “a major crisis in the military,” and one that the Army chief of staff and his predecessors have been struggling with, Dr. Romo, who was a department commander with the Massachusetts Jewish War Veterans, asked, “How do you convince a warrior that it is not ‘unsoldierlike’ or a sign of weakness to come for help? It’s a major issue in the Army.”

“The signature wound of [Iraq’s war] is not going to be amputation but brain injuries – PTSD, TBI and the residual effects,” said Stroup, paraphrasing language from a January 2009 report, “Invisible Wounds, Psychological and Neurological Injuries Confront a New Generation of Veterans,” by Iraq and Afghanistan Veterans of America (

Frequent deployments

Stroup seemed to echo Strauss’ concern about frequent and repeated deployments. When our fathers’ generation went to war in active combat, soldiers and their family members knew that soldiers wouldn’t come home until the war was over. World War II was the last declared war with a clearly identified enemy state and a defined mission to defeat such an enemy.

In this war, soldiers are gone for about a year, and then come home for 12 to 18 months and then go back for another year. Volunteer soldiers with repeated tours of combat experience psychological impact.

“Johnny goes to war, Jill goes to war … and have to reintegrate [again and again],” Stroup said, adding that the absence of a defined end state exists, regardless of which party occupies the White House.

Many soldiers today face a stressor that their counterparts  fighting in Vietnam or earlier wars rarely, if ever, faced. As both parents in a family may be deployed now at the same time, they must leave their children to be cared for by relatives or close friends. That disruption, of course, can bring additional stress to the entire family.

Citing a study by Dr. Elspeth Ritchie, a former Army psychiatrist, about suicides by military personnel, Dr. Romo noted some alarming statistics: 55 percent of those who died by suicide did not have a history of behavioral mental health issues. And, only 10 percent of those committing suicide had been deployed to Iraq or Afghanistan. “Direct combat experience was not the primary issue for those in active duty,” he said.

What’s to be done?

Both the Army and the VA are taking suicides seriously, said Stroup, starting at the very top. Training classes are given to leadership and troops are put into buddy systems to help soldiers watch out for one another.

Is there a solution? A larger base of military personnel would reduce the need for repeated deployments, which would eliminate one stressor. However, with a push to reduce, rather than expand, the size of the military, that’s not a realistic outcome.

Asked whether he believes returning to a drafted, rather than an all-volunteer, Army would be wise, Stroup said, “The country wouldn’t stand for it.”  Stroup, who oversaw both enlisted and volunteer personnel during his many years in the military, also said that the volunteer soldiers were superior to those drafted.

Although our troop size is smaller now that we’re out of Iraq, the fact that more military personnel are dying by suicide than in combat distresses Kim Ripoli, associate director of the Rhode Island Office of Veterans Affairs.

“Even one suicide is too many. I don’t want anyone to feel that they have no other recourse; there are resources [for help],” she said.