Beginning in 2005, the Army watched the suicide rate among active duty soldiers surpass the record high set the year prior.
In 2009, after redeploying 18,000 soldiers from combat in two theaters, Fort Campbell, Kentucky, led the Army in suicide rates, a distinction of which it is not proud. That year also proved to be the fifth consecutive record-breaking year for the number of suicides within the Army as a whole. The all-time high of 162 active duty suicides that year had never before, and hopefully will never again, be achieved.
Now two years later, soldiers from the 101st Airborne Division (Air Assault) are once again returning home after a yearlong deployment. This redeployment of 17,000 soldiers comes with a heavy toll—135 Screaming Eagles made the ultimate sacrifice in service to their country. These were brave men and women who died fighting to bring freedom to the oppressed and to weaken the foothold of a global network of terrorism.
Now the true test for Fort Campbell begins.
Can the military community reabsorb these soldiers into their garrison without achieving the negative notoriety received during their last reintegration? Has the U.S. Army taken the lessons learned in 2009 and applied the appropriate remedies to detect and heal the invisible wounds of war?
Much has been learned about how to fight and defeat an insurgency over the last decade. The collection and proliferation of human intelligence on the battlefield has enabled our combined forces to rapidly locate and engage a hostile target before that elusive target can slip into the concealment afforded by a sympathetic populous.
We now realize that our prolonged armed conflict has the potential to inflict upon our forces two very different, yet similar, types of wounds—physical and emotional. Both are very real. Both can be very painful.
Physical injuries are easy to detect, are almost always treated, and can result in a medal.
Emotional injures can be inflicted by direct or indirect combat. The act of engaging a hostile combatant and watching him fall or providing immediate first aid to a fallen comrade can leave behind a mental scar. For some soldiers, managing the stress and strain associated with a 12-month separation from family and friends, the disruption of their individual social networks, can also cause injury to their emotional wellness.
Both physical and emotional injuries can result in death, but it is the emotional injuries that have led to the rising rate of suicide amongst our Armed Forces. As with the physical, however, emotional injuries can be successfully treated if detected early enough and appropriate care is provided.
A lot has changed at Fort Campbell in the past two years. New facilities for the treatment of wounded warriors have been erected. Not only have new buildings specifically dedicated to the care and treatment of soldiers been constructed across the installation, but also new housing to accommodate their families, new barracks to provide soldiers a greater sense of privacy and individualism. New community centers have helped establish a feeling of family and community in this gated military oasis.
Additionally, new professional health care providers have been hired to accommodate the increased demand on services, nearly doubling the number of clinical social workers and licensed counselors. New programs and services also have been added to existing state-of-the-art intervention services.
The Army as a whole has taken a holistic approach to soldier wellness, developing programs in cooperation with prestigious institutions of higher learning. These programs have incorporated five pillars of wellness—spiritual, emotional, physical, social, and family. Each pillar is devoted to developing individual soldier readiness.
The first of several such programs is the Army Comprehensive Soldier Fitness program. The main objective of the program is to increase the resilience of soldiers and families by developing and increasing their strengths in all five pillars. Enhanced resilience, achieved by a combination of specific training in the five pillars of wellness and improved physical fitness can decrease post traumatic stress, decrease the incidence of undesirable and destructive behaviors, and lead to a greater likelihood for post-adversity growth and professional success.
Soldiers will be assessed in each of these five categories and the results will direct individualized training, intervention, or treatment programs, as needed to improve individual strength and resilience. Newly enlisted soldiers will undergo an assessment as they begin their military service and periodically throughout their careers.
The baseline assessment for soldiers currently serving takes the form of the Global Assessment Tool (GAT). A parallel tool is being developed for spouses. This online survey provides an individual with a starting point in all of the pillars of wellness except physical, which is measured twice annually at the unit level. This tool provides an opportunity to track self-development and growth in these areas over time. GAT also provides immediate results that allow soldiers to identify their own personal strengths and weaknesses. They’re able to immediately begin web-based training that will help them enhance their performance and build resilience.
Soldiers will take this assessment every two years or 120 days following contingency operation deployments.
Every deploying soldier is also required to participate in two self-assessment surveys, Pre- and Post-Deployment Health Assessments.
These surveys are part of the overall framework of Force Health Protection, which is designed to provide comprehensive health surveillance for service members affected by deployments. The overarching goal is to provide countermeasures against potential health and environmental hazards for optimal protection of our troops. Early detection and management of deployment-related health concerns can reduce long-term negative health consequences and improve the quality of life. Pre- and Post-Deployment Health Assessments are bookends. Together they can help provide both baseline pre-deployment health care information and a basic health screening upon redeployment.
Fort Campbell’s aggressive pursuit of the detection and treatment of mild Traumatic Brain Injury has been at the forefront of medical science. An entire clinic, the Traumatic Brain Injury Warrior Resiliency and Recovery Center, has been dedicated to the task. Once patients’ issues are clearly defined, they begin a 12-week program that, in essence, is rehabilitation for the brain.
Machines that help the brain relearn to balance the body, reacquire visual and spatial memory or regain verbal expression are only part of the treatment program. Spouses of injured soldiers are allowed to attend consultations and are encouraged to participate in the recovery process. This helps the family understand what the soldier is going through and provides tools to further accelerate the healing process at home.
Master Resiliency Trainers provide an additional resource to help soldiers build resiliency.
Developed in cooperation with the University of Pennsylvania, the program is designed to enhance a soldier’s mettle, mind, and mental thinking as well as continuing to build upon the five pillars of wellness. The program focuses on building soldiers’ core strengths of physical fitness, emotional awareness, social communications, family values, and spiritual beliefs.
This program, about a year old, concentrates on the knowledge and skills necessary to overcome extreme adversities soldiers face in and out of combat, and is projected to be incorporated at every level of the military education system and training curriculums. The skills learned will teach soldiers to control their thoughts and emotions, which in turn will help them better manage their personal and professional relationships.
With specific regard to suicide, Fort Campbell has mandated the implementation of a suicide intervention training program entitled, “Applied Suicide Intervention Skills Training,” or ASIST.
The ASIST training course is offered to military “green tab” leaders and Department of the Army civilian supervisors. The training provides these caregivers with the knowledge and confidence to engage soldiers exhibiting high-risk behaviors to lessen or prevent the immediate risk of suicide. The training is highly interactive, practical, and oriented toward the specific stress triggers soldiers and their families face. The training emphasizes helping a person at risk stay safe and seek professional assistance. Shiny new buildings, well-collaborated programs, and sound policies don’t save lives. People save lives.
For Fort Campbell to be successful in reducing the devastating impact suicide has on families, units, combat readiness, the men and women serving at, working on, and living inside its gates; Fort Campbell must be willing to forego their own personal fears and prejudices. They must learn to recognize what stress looks like. They must know how to identify the warning signs of suicidal ideations.
Most of all they must be willing to engage a peer, a neighbor, or a family member who is showing the symptoms, or high-risk behaviors that lead to suicide. Once caring leadership and an engaged community identify soldiers at risk, the multitude of professional health care providers stationed at Fort Campbell can begin to treat the invisible wounds of war.
Retired Army Major Joe Varney is Fort Campbell’s Suicide Prevention Program Manager.