There Are No Vaccines for PTSD and Suicides in the Military

The latest information released by the US Army reveals that last year American soldiers attempted suicide at the rate of about 5 per day. There were 160 successful suicides last year and during June the rate was 1 per day. Military research has reported that one in 10 Iraq veterans may develop a severe case of PTSD.

We Are Not More Dangerous to Ourselves Than The Enemy
As statistics such as these continue to emerge there is a continued outcry that something should be done about this. A report issued by the US Army in my opinion minimized the fact that these psychological causalities are a result of combat and the realities of war. The army review concluded “simply stated, we are often more dangerous to ourselves than the enemy.” It went on to say that commanders have failed to identify and monitor soldiers prone to risk-taking behavior and as a result suicides among soldier have soared. I believe that this is a misguided view that somehow if we did the right thing we could prevent these events. There were 250 recommendations in the recent report and the Army has already implemented 240 of them. While these are positive things done to provide good mental health care, they won’t prevent PTSD and sadly it won’t eliminate suicides.

We haven’t been able to prevent the increasing number of Americans being killed by IEDs. War is hell and soldiers get killed. We train them the best way that we know how but inevitably soldiers die when there is a war. Maybe one soldier, despite the best training available isn’t quite as good in a combat zone as another one. Some may be able to know when to zig rather than zag. Some have better instincts than others and that may make them more likely to survive. Some inherently may be able to handle the stress of war better than others. However, the best training in the world and all the preventive measures in the world will not eliminate combat injuries and death. Nor can PTSD and suicides be avoided. The most combat-savy soldiers in our military cannot hide from a bullet with their name on it nor can the most well-adjusted soldiers avoid being affected by extraordinary human experiences in a war zone.

Of course we should always strive to improve our training, safety, and efficiency in the battle field. And of course we should always strive to provide the best medical care (which includes psychological care) to our soldiers.

Soldiers Injured With PTSD Deserve to Receive a Purple Heart
Families Deserve Presidential Condolence After Soldier Suicide
We honor our soldiers who are injured serving their country. We give Purple Hearts to soldiers who have been wounded, and bury with honor those who have given their lives for their country, with the exception of those soldiers who suffer psychological injuries. There is no Purple Heart for them. There is no letter of condolence from the President to the families of those who died from suicide. This is outrageous! These men and women have all volunteered and knew they could be in harm's way. There is no basis for treating them as if they purposefully became psychological causalities. There is no way to minimize the grief of their loved ones but this failure to acknowledge their loss only compounds it.

APA Will Weigh In On This Issue
At the last Assembly of the American Psychiatric Association I co-authored an action paper with Roger Peele asking the APA to take a position asking the president of the United States to write letters of condolence to families of soldiers who have died by suicide. It was passed by the assembly and now awaits action by the board of trustees. The voice of American psychiatry on this particular issue will be a powerful influence on the president, who has previously said that he will reconsider the current policy. I also look forward to seeing our APA president make public statements on this issue once it becomes an APA position.