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SUICIDE: HEALTH OFFICIALS EXPECT SURGE IN NEED

FOR CARE AS TOURS END -- Returning veterans

could become part of ominous trend.

 

 

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Returning vets could become part of ominous national trend

SUICIDE: Health officials expect surge in need for care as tours end.

By GEORGE BRYSON
gbryson@adn.com

That's the warning local public health officials are culling from a new study that finds male veterans twice as likely to die by suicide as men with no military service -- and even more so if they're physically or mentally impaired.

Such news is particularly worrisome now, veteran advocates say, with hostilities in Iraq having left 52,000 U.S. troops either wounded or hospitalized for ailments ranging from insect-borne boils to severe depression.

According to the Department of Defense, 111 active-duty U.S. troops in Iraq have committed suicide since the beginning of the war.

With one of the highest concentrations of veterans in the U.S. -- and suicide rates that often lead the nation -- Alaska was already at risk for suicide, according to Portland State University public health specialist Mark Kaplan, lead author of the new study. But now Iraq adds a new factor.

"That's the perfect storm," Kaplan said of the convergence of Alaska and an influx of newly disabled vets. "This (study) foreshadows some ominous trends."

Tracking the lives of more than 320,000 U.S. men -- about a third of whom were veterans -- the Oregon-based research team found that over a period of 12 years (from 1986 to 1997) more than 500 members of the study group committed suicide, including 197 veterans.

Those with the highest risk for suicide were veterans who were white, college-educated and living alone in a rural area, most often in a Southern or Western state, the study found. Veterans were half again more likely than non-vets to kill themselves with guns.

Notably, those whose daily activities were limited by physical or mental impairments were 4.4 times more likely to take their lives than vets who were unimpaired.

"They had problems functioning at school, at work, at home," Kaplan said. "That really stood out in our analysis."

PSYCHOLOGICAL DAMAGE

A new Pentagon study raises similar concerns for vets. Released last week, it found that 38 percent of all soldiers and 49 percent of all National Guard troops who served in Iraq and Afghanistan returned home with some type of psychological ailment -- from anger to depression to alcohol abuse.

Some of them are taking their own lives, as a drumbeat of vet suicide stories in other states have already shown.

"The military has definitely seen a lot more suicides from the returning members," says Beth Williams-Case, a Veterans Administration social worker who interviews new enrollees at the VA office in Anchorage.

"I can't give you any numbers, but I know what I see at Elmendorf (Air Force Base) -- that suicide prevention has really kicked into high gear."

Other civilian mental health workers in Anchorage say they're already beginning to notice the difference.

"I've talked to several servicemen coming back, and they just tell me they want to keep my name as a referral, because, they say, 'You're going to have a bunch of people coming,' " says Mark Andrews, a counselor who specializes in trauma-related disorders at Good Samaritan Counseling Center off Tudor Road.

"It hasn't hit big-time yet -- but it's coming."

On DeBarr Road, at the North Star Behavioral Health System (which primarily treats children and adolescents), business director Angie Aiken says the clinic expects a rising caseload at the end of this year -- when about 3,800 more troops currently deployed in Iraq return home to Fort Richardson. That's because her staff of psychiatrists and counselors will probably have to treat some of their children.

"We're seeing a greater increase of kids in need already, because the families have split up," Aiken says. "Then when the parents return, it's quite difficult for them, because often the parents who are returning are traumatized in some way."

Compared to the past, a larger percentage of returning troops are physically or emotionally wounded, says Jerry Jenkins, executive director of Anchorage Community Mental Health Services.

That's because vast improvements in body armor and battlefield medical care are saving the lives of thousands of U.S. soldiers who would have died in previous wars. That's good, says Jenkins, a former Army ranger. The bad part is -- they'll be coming home with the memory of it all. He's heard that same concern voiced by other vets in local mental health circles.

"These are conversations we're having now because we have an idea of what has happened (in Iraq). And what's about to happen (at home)," Jenkins says.

SOCIAL WOES

If the government fails to adequately care for its returning vets, expect to see skyrocketing rates of divorce, homelessness and suicide, says Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, based in New York.

"Veterans will show the psychological scars of these wars for years to come."

Hoping to prevent that, the VA has conducted an extensive survey of Vietnam-era vets who committed suicide. It hasn't yet released its findings.

But Jonathan Shay, a psychiatrist with the U.S. Department of Veterans Affairs in Boston, estimates that more Vietnam vets have died by suicide than all of the 58,000-plus troop casualties listed on the Vietnam memorial wall -- if you define suicide broadly as death by deliberately reckless behavior. Like the previously rational soldier who decides to walk across a minefield at night.

"The multitude of (vet suicide) deaths are ambiguous," Shay said in a telephone interview. "They're single-vehicle accidents. Single motorcycle accidents. They have shoot outs with police. They're bar fights, where somebody goes in, unknown, and picks a fight with the biggest, meanest looking person in the room."

One deeply depressed vet he knew didn't do drugs, Shay says -- until one night he killed himself with a heroin overdose.

Says Shay: "I am morally certain that was a suicide."

VETS TOUGH TO TRACK

Across the U.S., more than 30,000 people kill themselves each year -- almost double the number of homicides -- and approximately one-fifth of those cases involve veterans, according to Kaplan. Suicide is the eighth leading cause of death among all U.S. men.

With its small population, Alaska contributes relatively few suicide cases (about 140 a year) to the national total. But the suicide rate (20.8 per 100,000 people from 2003 to 2005) is almost twice the U.S. average.

According to the Statewide Suicide Prevention Council, Native populations in Western Alaska continue to suffer the brunt of Alaska's suicides in per capita comparisons. While Natives make up less than one-fifth the state's population, they account for more than a third of the state's suicides.

In sheer numbers, however, more non-Native Alaskans commit suicide than Natives. According to the recently completed Alaska Suicide Follow-Back Study -- which examined 426 suicide cases in Alaska over the past three years -- a majority of the cases involved non-Native, urban males born in some other state who took their lives with a gun.

Alaska's death statistics don't record the veteran or military status of people who commit suicide, says Ron Perkins, executive director of the Alaska Injury Prevention Center, which conducted the follow-back study.

But according to Kaplan, lead-author of the Oregon research, the number of vets who commit suicide nationwide is much larger than reported in previous studies, since most were based on data provided by the VA.

"One thing we found is that three-quarters of veterans are not served by the VA," Kaplan said. So a huge portion of the vet population was previously ignored.

Co-authored by Nathalie Huguet, Bentson H. McFarland and Jason T. Newsom, the veteran suicide report is due to be published in the July issue of "Journal of Epidemiology and Community Health."

Find George Bryson online at adn.com/contact/gbryson  or call 257-4318.

CHART: Alaska ranks high in veterans and per capita suicides.

Suicide risks for veterans

Male veterans: 2 times more likely to kill themselves than male non-veterans.

Disabled: 4.4 times more likely than unimpaired vets.

Living alone: 3.4 times more likely than vets living with others.

White: 3.2 times more likely than non-white vets.

College-educated: 2.7 times more likely than less-educated vets.

Western state: 1.9 times more likely than Northeastern state vets.

Rural: 1.5 times more likely than urban vets.

Underweight: 2.4 times more likely than normal-weight vets.

Source: "Suicide among male veterans: a prospective population-based study."

PERFECT STORM?

U.S. veterans by state

(2002)

RANK STATE PERCENT TOTAL

1 Alaska 17.1 71,552

2 Montana 16.2 108,476

3 Nevada 16.1 238,128

4 Wyoming 16.0 57,860

5 Maine 15.9 154,590

Total U.S. veteran population: 26,403,703 (12.7 %)

Source: 2000 U.S. census

U.S. suicides by state

(2004)

RANK STATE PER 100,000 TOTAL

1 Alaska 23.6 155

2 (tie) Montana 18.9 175

2 (tie) Nevada 18.9 440

4 New Mexido 18.7 356

5 Wyoming 17.4 88

Total U.S. suicides: 32,439 (11.1 per 100,000 people)

Source: Suicide State Data Page (2004), American Association of Suicidology Suicide in Alaska

Suicide in Alaska

Interviews with relatives of 56 people who committed suicide -- out of a total of 426 cases in the past three years -- provides the following small-sample portrait of Alaskans who take their own lives:

• 54 percent had an illness or disability.

• 61 percent were born outside Alaska.

• 62 percent were taking prescription medication for mental or behavioral health problems.

• 43 percent drank alcohol daily (63 percent drank at least weekly).

• 66 percent expressed thoughts of hopelessness or a wish to die.

• 84 percent owned one or more firearms (compared to 32 percent who own firearms in the general U.S. population, according to the Centers for Disease Control).

• 87 percent had verbal fights or arguments with others.

Source: Alaska Suicide Follow-Back Study, Sept. 1-2003 to Aug. 31, 2006

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Larry Scott  --