The US Department of Veterans Affairs (VA) has put the number of suicides by American veterans at 22 per day in the year 2016. A report done by VA indicated that the suicides have increased by 32% since 2001. The number has drastically increased over the years, posing a national concern. The suicides are not limited to gender or age. All persons are affected; the report showed that 65% of the veteran deaths were of persons of 50 years and below (National Center for PTSD n.p.). It is on this basis that the Veteran Affairs has taken the role of identifying causes of suicide and taking steps to reduce the rates because every life is important, and the role of the veterans to the peace in America cannot be undermined. Veterans do not go to war with the aim of coming back home to commit suicide. However, their experiences shape the nature of the decisions they make. Some are adversely affected by war and do not receive adequate counseling to deal with depression. Depression subsequently leads to mental health problems, and the lack of appropriate care leads to suicide (Hudenko et al. n.p.).
VA indicates that life is too important to lose to suicide and that the core focus is to have a nation with zero veteran suicide rates. The study aims at understanding the evolving issues concerning suicide to identify the cause and possible remedy through recommendations to the Veterans Affairs, who should take the key role of continuous surveillance of activities of veterans, providing protection by determining risks and providing necessary intervention to mitigate the situation.
Post-Traumatic Stress Disorder (PTSD)
Soldiers suffer from PTSD when deployed, with prevalence being 9% before deployment and 18% after deployment (Litz and Schlenger n.p.). Iraq and Afghanistan are the places where most US soldiers are deployed nowadays (e.g., for Operation Enduring Freedom and Operation Iraqi Freedom). Soldiers in training and deployment do it with the intentions of creating peace in war-torn areas. They are prepared thoroughly for what to expect when they get to the battlefield, but it rarely matches what happens in reality. Post-Traumatic Stress Disorder (PTSD) is caused by the traumatic events that the people endure while they are at war. Returning home, they suffer from anxiety, fear, nightmares, and an inability to cope with a flashback of the experiences they went through (Litz and Schlenger n.p.). The study calls for an understanding of the relationship between PTSD and suicide.
Participation in the abovementioned operations increases the likelihood of a veteran suffering from PTSD due to the environment that they are exposed to. Soldiers are deployed for extended periods of time; there is minimal contact with their families, which prompts tensions and loneliness. They see their team members dying or being injured in the war zones. War also forces the soldiers to kill and wound other people, which constitutes experiences that people do not want to undergo. Military sex trauma is a major contributor to PTSD, which may occur during threats, harassment, or continued attacks (Litz and Schlenger n.p.). There is an emphasis on research on the impact that the harassment has on veterans for VA to reduce its prevalence. The research is conducted to enable VA to understand the resilience of people that have been at war.
Managing PTSD is possible, as VA recognizes that people should be able to identify symptoms of stress and take precautions before the situation escalates to the level of committing suicide. VA advises that people should establish that PTSD is usual after a traumatic experience. They should endeavor to spend time with close people (e.g., relatives) as opposed to choosing isolation. This could be accomplished through family or support groups and conversations with people that have been in similar situations. It is fundamental to stay focused on the future instead of dealing with the past. Having laid out such techniques to deal with PTSD, VA introduced and promoted the use of psychotherapy, behavioral therapy, and cognitive processing therapy (Allen et al. 137). The study advocates that treatment of PTSD should be simultaneous with other symptoms, including alcoholism and substance abuse. The department should not focus on dealing with one issue, as they are all a priority. VA may not know which problem is forcing the patients to commit suicide. Thus, everything must be considered equally.
The statistics on veterans suffering from PTSD keep changing. However, the researchers agree that there is a substantial influence of PTSD on suicide attempts. The manageability of PTSD means that it can be eliminated to create a country free of such suicides. VA needs to continually work with the veterans at all stages to avoid losing contact and guarantee that the needs of each veteran are met.
Mental Health and Suicide
Persons with mental health issues tend to have suicidal thoughts more often than healthy people do. The fact that a person thinks about committing suicide is considered the first step towards actual suicide. Mental health problems have led veterans to harming not only themselves but also those close to them. For instance, veterans who have returned from Iran and Afghanistan have been reported to kill their wives before committing suicide due to mental health-related problems. It is unfortunate that the veterans with mental health issues rarely receive the support they require promptly to avert the situation. The Joshua Omvig Veterans Suicide Prevention Act was established to deal with issues relating to PTSD and mental health.
The Act came into existence as a result of a veteran persistently seeking medical assistance due to war-related stress; despite threats of committing suicide, the staff duly discharged him. The event of him being found in his father’s house three days later raised the question as to whether the VA is doing enough to improve the well-being of veterans. The Act calls for in-depth research on issues relating to mental health to have an understanding of risk factors leading to suicide. The Act does not have a set of best practice rules for medical practitioners but calls the VA to work with various bodies, including the Substance Abuse and Mental Health Services Administration, to establish a guide on preventing suicide among the veterans (Cvetanovich 624).
Usually, veterans take a long time to get their issues addressed. Application for treatment has seen to take up to 770 days in Baltimore due to improper treatment planning. These inefficiencies saw the number of veterans awaiting treatment rise to 255,000 (Hegseth n.p.). The situation has gone out of hand to the extent that there had to be a public outrage for the government to start taking action. Engaging the veterans from the early stages of suicide risks meant that intervention was made available, with coping strategies identified. People with high levels of drinking were recognized as being at high risk; thus, their needs were addressed quickly (Maguen et al. 122). Putting patients on the waiting list is a weakness in the VA, as it is a department endowed with resources to quickly and efficiently meet the needs of veterans. Repeated studies have shown that wasting time increases suffering and suicide risks. Adequate staffing would bring in enough specialists to reduce queues in hospitals and the waiting list.
Suicide due to delayed treatment is gradually being averted by the VA, which ensures that patients have access to medical care within the same day that they seek help. The number of crisis intervention responders equipped with adequate skills and the ability to identify places where they can refer people to has increased (National Center for PTSD n.p.). Collaborations between agencies handling mental health issues are driving the efforts of the VA towards suicide rates reduction. However, the fact that the country is still not at the zero-suicide level and that people are waiting for treatment means that a lot still needs to be done. It is a loophole that the VA needs to fill to achieve its ultimate goal of zero veteran suicide rates.
Other Health Issues and Pain
Veterans suffer from both physical injuries and mental wounds. Some struggle with the pain that can sometimes be too unbearable. In such cases, they are often unable to cope with the anguish and turn to the option of suicide. In other cases, veterans come back home disabled, requiring care from someone else. They feel that they are a burden to the community due to their incapability. Through the suffering, they get the notion that they can relieve themselves and other people from pain by killing themselves. Health problems relate to the stress that individuals are suffering, elevating their desire to commit suicide (Rozanov et al. 2504). The VA needs to recognize that it is burdened with taking care of all veterans as a state resource. Managing pain is one of the institution’s responsibilities, and there must be the realization that there is more to pain than physical discomfort. Specialized training should be done to enforce suitable policies for the veterans.
Social Factors Leading to Suicide
Deployment to war zones means that people are separated from their families and their loved ones, being in high-stress dangerous areas. Studies have shown that unmarried soldiers that go to war are likely to be unsatisfied with their lives, leading to high risks of suicide (Jakupcak et al. 1004). Married persons discussed in the study had a low tolerance to the ideation of suicide, as they had a more fulfilling social life. Nevertheless, veterans that have been in combat exhibit poor communication and violent outbursts. This results in poor relationships with the people they are living with, especially due to frequent arguments. There is a tendency for the veterans to blame themselves for the situation they are going through, thereby rejecting help from any social communities. Veterans with little social interaction are less likely to seek assistance (Jakupcak et al. 1004). War veterans desire to be part of a traditional community with people that understand the situation they have endured without criticism. Thus, clinicians need to understand the fundamental importance of social life in managing symptoms related to PTSD. Pertinent information and knowledge need to be shared with persons treating the veterans and the families living with the soldiers.
Stigmatization of veterans with PTSD is a social factor leading to suicide. People do not understand PTSD and view soldiers with PTSD as weak. It leads to the soldiers not reporting alarming symptoms. People tend to keep the pain and unpleasant feelings to themselves if they feel they will be judged for their condition. It does not solve the problem, and, when noticed, it might be too late (McGrane 214). The lack of early detection means that the system has failed in its role of protecting the veterans. Stigmatization could occur by veterans being charged for crimes that they have committed despite their previous efforts to seek help. They will choose to keep away from searching for assistance if they are rejected initially. It is a form of stigmatization that pulls the efforts of the government back in its goal of keeping the veterans safe and content. Apart from that, politicians need to understand the intensity of their words, such as the comments made by President Donald Trump that veterans that commit suicide are weak (Holmes n.p.).
Summary and Recommendations
Veteran Affairs’ actions leave a lot to be desired in the delivery of service to the veterans. Despite numerous calls for changes in operations, reports still indicate that veteran suicide rates are rampant. Bureaucratic processes make it impossible for veterans to get quality service timely, which leaves them frustrated to the extent of committing suicide. The information available to the soldiers with PTSD has been consistently manipulated by officials to hide the actual state of the VA (Hegseth n.p.). The issue of the VA has been highly politicized over the years, dealing with corrupt officials that do not carry out their roles effectively. Though reforms concerning staff members were implemented in 2014, little has improved.
Accountability in the VA is handled lightly after the reforms were proposed; the same officials still make important decisions. No one is held accountable for the veteran suicides, with some happening just outside the hospital doors (Hegseth n.p.). Typical hospitals see their nurses taking responsibility for negligence and for failing to prevent deaths that should not have occurred. People taking responsibility and even going to jail would see the officials take the roles they are assigned seriously. Responsibility without accountability results in futile efforts.
The VA needs to improve record-keeping and management. It is evident that the figures on the number of deaths due to suicide are hypothetical. However, the officials should be aware of what happens to the veterans while they are actively on duty and when they return home. Research would enable the Department to be aware of the actual statistics and employ adequate resources to care for the veterans. With the proper data and information, they will understand whether the efforts driven towards suicide reduction are working and whether the changes to tackle the issue are effective. The VA claims that it takes only 24 days to get treatment, while the actual situation is that people go for up to several months before getting assistance (McCarthy g3649).
Policies concerning mental health by the VA have been developed, including diagnosis, prevention, treatment, and the mitigation of the occurrence. Such policies need to be enforced to ensure that evidence-based practices are used in handling the veterans. The Joshua Omvig Act calls for the assignment of a care manager to individual veterans, which is the same way parole officers work. It would enable the VA to monitor the progress of each soldier at home. The officers would keep tabs of the veterans to identify changes in behavior and provide timely care. Medical evaluations would be done promptly, and suicidal thoughts would be managed to reduce the prevalence of suicide.
PTSD, mental health issues, and other medical conditions are a key cause of veteran suicide. Restructurings have been recommended to mitigate the situation, but it is evident via statistics that a lot is yet to be done to alleviate the problem. The management needs to undergo a thorough reshaping to make people responsible for their actions. Policies need to be enforced, and the weight of the impact of veteran suicide needs to be fully understood by the government and the VA. With such steps, the ultimate goal of arriving at zero suicide rates will be achieved, and people will know that all lives matter.
Allen, John P., Eric F. Crawford, and Harold Kudler. “Nature and Treatment of Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Among American Military Personnel and Veterans.” Alcohol Research : Current Reviews, vol. 38, no. 1, 2016, pp. 133-140.
Cvetanovich, Brittany. “Joshua Omvig Veterans Suicide Prevention Act of 2007.” Harvard Journal on Legislation, vol. 45, 2008, pp. 619-640.
Hegseth, Pete. “The VA Scandal: Two Years On.” National Review, 2016, http://www.nationalreview.com/article/433760/va-still-unreformed. Accessed 24 October 2020.
Holmes, Lindsay. “Donald Trump Suggests Some Veterans Have PTSD Because They ‘Can’t Handle It’.” The Huffington Post, 2016, http://www.huffingtonpost.com/entry/donald-trump-veterans-mental-health_us_57f280bbe4b082aad9bc4903. Accessed 23 October 2020.
Hudenko, William, Beeta Homaifar, and Hal Wortzel. “The Relationship between PTSD and Suicide.” U.S. Department of Veterans Affairs, 2015, https://www.ptsd.va.gov/professional/treat/cooccurring/suicide_ptsd.asp. Accessed 23 October 2020.
Jakupcak, Matthew, et al. “Does PTSD Moderate the Relationship between Social Support and Suicide Risk in Iraq and Afghanistan War Veterans Seeking Mental Health Treatment?” Depression and Anxiety, vol. 27, no. 11, 2010, pp. 1001-1005.
Litz, Brett T., and William E. Schlenger. “PTSD in Service Members and New Veterans of the Iraq and Afghanistan Wars: A Bibliography and Critique.” PTSD Research Quarterly, vol. 20, no. 1, 2009.
Maguen, Shira, et al. “Suicide Risk in Iraq and Afghanistan Veterans with Mental Health Problems in VA Care.” Journal of Psychiatric Research, vol. 68, 2015, pp. 120-124.
McCarthy, Michael. “US Investigation Confirms Veterans Affairs Staff Kept Multiple Waiting Lists.” BMJ, vol. 348, 2014, p. g3649.
McGrane, Madeline. “Post-Traumatic Stress Disorder in the Military: The Need for Legislative Improvement of Mental Health Care for Veterans of Operation Iraqi Freedom and Operation Enduring Freedom.” Journal of Law and Health, vol. 24, 2011, pp. 184-215.
National Center for PTSD. “The Relationship between PTSD and Suicide.” National Center for PTSD, 2013, www.ptsd.va.gov/professional/co-occurring/ptsd-suicide.asp. Accessed 23 October 2020.
Rozanov, Vsevolod, and Vladimir Carli. “Suicide among War Veterans.” International Journal of Environmental Research and Public Health, vol. 9, no. 12, 2012, pp. 2504-2519.