09.27.12 8:45 PM ET
Suicide Crisis: Why the Military Needs Mandatory Mental-Health Services
As the Army grapples with a record suicide rate, it held an unprecedented service-wide stand-down at bases around the world Thursday to dedicate the full day to mandatory suicide-prevention training. This came after Defense Secretary Leon Panetta declared that lowering the rate of suicide in the military is a top priority, saying “leaders ought to be judged by how they lead on this issue."
Having worked as a mental-health clinician with service members, I know the dispiriting statistics are attached to names and personal stories.
Last week, Derek Smith, a 29-year-old Army police officer stationed at Fort Belvoir, Va., parked his patrol vehicle, walked into a wooded area and shot himself. Others, whose names have not been made public, include a 21-year-old air traffic controller who shot himself in his Fort Wainright, Alaska, barracks; a 26-year-old second lieutenant who died at an indoor firing range in Virginia, and a 29-year-old sergeant who had returned from his fourth deployment to Iraq and Afghanistan. These are just a few of the active-duty U.S. service members who have committed suicide—on average one every 27 hours, along with an average of 18 veterans who kill themselves every day.
Unfortunately, many never sought help, or the wait to get it was too long and clearly too late.
Marine Capt. Nicholas Borrelli, son of a recently retired 33-year Marine Col., was stationed at Marine Corps Recruit Depot San Diego following his second deployment tour in Iraq. The transition from being in combat to serving at boot camp, where you can get in trouble for not having your uniform properly ironed, was a difficult one for him. He started excessively drinking and found himself caught in fits of rage and frustration that he couldn’t control. One night after drinking too much and getting into a fight a with his girlfriend, he “beat up his apartment.” He smashed the windows, broke the shower door and punched three holes in the wall. He wrapped his blood soaked leg with a towel and passed out on the floor. The next morning he crashed his motorcycle on the freeway off-ramp by missing the turn. Abandoning his bike, his girlfriend picked him up and rushed him over to the Emergency Room. He was lucky his injuries were minor, the worst being the 40 stitches needed for the gash on his leg.
In the hospital, Borrelli’s father pleaded with him to get help, and he went to his commander the following day. Borrelli explained to his boss that he felt he had lost all control over his impulses. Instead of sympathy or support for being honest, he says he was informed that he could be referred over to the on-base mental-health unit—but the repercussions might be costly to his career and standing in the military. The captain was next in line for a promotion to company commander, and seeking help could put that in jeopardy, he says he was told. He decided against the referral, telling the commander that he’d figure it out on his own.
I first met Captain Borrelli four days after that encounter, during one of my routine, mandatory individual sessions with each Marine in the Recruit Training Regiment. They could confidentially share personal struggles (I didn’t keep any notes) and I would provide coping strategies and appropriate referrals if needed. I viewed the sessions as emotional-intelligence training, and because every Marine went through it from the top of the chain to the bottom, the stigma issue was removed.
While Borrelli was initially reluctant to open up, it didn’t take long before he began to share his story.
His boss—who I worked with and like, and who is an excellent Marine—says he doesn’t remember the conversation about whether or not Borrelli should seek help, but did remember reporting him for not showing up for work the day after the accident. In any case, the problem isn’t this commander, but perverse institutional incentives—if Borrelli had sought help, it might have cost him the promotion he’d work hard to merit.
But clearly Borrelli needed help, and my role was to make sure that he didn't fall through the cracks. I was able to help him recognize how much pain he was in, and that similar to physical injuries, his psychological trauma needed immediate attention. Together we walked over to MHU and made his first appointment.
Borrelli attended weekly individual sessions and began feeling better immediately. “Talking made it help,” Borelli told me recently. “It was like my whole world had collapsed down on me, and I couldn’t figure out how to get out of it.” Eighteen months later he left the Marine Corps and made it his commitment to help other service members, attending graduate school at USC School of Military Social Work. He now works as a social worker for the Travis Manion Foundation, a nonprofit that serves vets and their families.
Borrelli and his best friend, Capt. Miles Bower, whom he met at an Infantry officer course, have developed a peer-support mentorship program in San Diego, where they empower vets to take the next leap in their life. “People had dreams that they sacrificed to serve for our country,” Borelli shared. “Now they are out and they don’t know what they want to do. Their passions have been suppressed, and they are scared. I try to bridge the gap. Encourage them that they can do it and be successful.”
Borrelli, a gifted surfer, also volunteers once a week at the Armed Services YMCA where he coaches wounded Marines and Sailors on riding the waves. His specialty is working with amputees to knee-board or boogie-board. “The ocean has healing powers. In therapy I learned that whenever I’m down or stressed, I need to get myself in the water. It immediately calms me down and is a lot more effective than drinking,” he said.
But despite many such individual efforts and the billions of dollars we spend on countless programs, the suicide rate has continued to rise. While I am hopeful that events such as the Army’s stand-down today will help, I can’t help but wonder how many lives we could save by focusing on consistently applied and forward-looking strategies instead of reactive ones and special one-day programs.
“If I had not been exposed to the mandatory proactive counseling program, I don’t think I’d be alive today,” says Borrelli.
We need to require mental-health services for the at-risk population including every person in our active-duty military: every rank, in every service branch. We owe it to them. The least we can do for the service they provide is to step up to them rather than stand back and wait for them to come forward for help.
As we’ve already witnessed, by that point it can be too late.