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Running head: Veteran Suicide Epidemic: What Really Caused it?

Veteran Suicide Epidemic:

What Really Caused it?

Daniel R. Gaita, MA, MSWi

April 27, 2017

Introduction
Between 2001-2007 the United States Armed Forces veteran suicide rate had been on the

decline (Kemp & Bossarte, 2012) despite continual combat operations across two war fronts,

repeated long-term duration deployment orders, and the heaviest losses of life since the Vietnam

War. The rate of veteran suicide, despite Americas withdraw from operations in Afghanistan and

Iraq did not begin to spike until 2008. The objective of this problem solution paper is to

investigate why, introduce contributing factors worthy of future investigation while also offering

suggestions, which may provide both long and short-term resolutions.

Background
Veteran Suicide Epidemic: What Really Caused it? 2

Since the 2012 release of the Department of Veterans Affairs (VA), Mental Health

Services, Suicide Prevention Program, Suicide Data Report (Kemp & Bossarte, 2012), much

attention, legislation, resources, and research has been directed toward efforts to understand what

had caused the sharp increase in veteran suicide. Researchers had hypothesized that combat

deployments and combat related moral injury were primary factors yet their studies continued to

demonstrate no reliable correlation and actually showed a decreased rate of suicide amongst

veterans that have deployed (JAMA, 2014; Kang, Bullman, Smolenski, Skopp, Gahm & Reger,

2014; Reger, Smolenski, Skopp, Metzger-Abamukang, Kang, Bullman, Perdue, & Gahm, 2015;

Leardmann, Powell, Smith, Smith, Boyko, & Hoge, 2013; Bush, Reger, Luxton, Skopp, Kinn,

Smolenski, & Gahm, 2013). While much work has been done within the mental health arena to

treat Post Traumatic Stress in veterans (Thompson, 2016; VA, 2016, Kemp & Bosarte, 2012)

what remains a mystery is why. Why did the Department of Defense lose so many of her service

members and veterans at such a staggering rate after 2008, and not prior? This is the question

this paper seeks to answer while also providing forward thinking suggestions so future

generations may avoid repeating the same apparent errors of social discipline. Errors that have

arguably corrupted our moral compass leading to the precipitation of spiritual malfeasance and

an epidemic of avoidable suicides.

US Suicide Trends

Veteran Suicides

A trend that has interestingly been ignored in most of the media and press coverage over

the veteran suicide epidemic is that the rate of veteran suicide had actually been on the decline

since the start of the global war on terror following the attacks of September 11th, 2001 and had

reached a low point in 2007 (Kemp & Bossarte, 2012; VA, 2016). It wasnt until 2008 that the
Veteran Suicide Epidemic: What Really Caused it? 3

sudden uptick in suicide rates appeared, peeking to 22 per day in 2009 (Kemp & Bossarte, 2012)

and reversing the trend downward to 20 a day in 2014 (VA, 2016). Interestingly, recent research

has found that 50% of veteran soldier suicides were committed by those that had previously

attempted suicide prior to joining the Armed Forces (Friedman, 2015).

U.S. Civilian Suicides

Another statistic of interest is the similar trend for the civilian side of the US population,

which also showed a sharp uptick in suicide rates from 34,598 in 2007 increasing to 36,035 in

2008 and continuing upward to 42,773 in 2014 (Curtin, Warner, & Hedegaard, 2016; CDC,

2015). Unlike our veterans, the civilian suicide rate is still on the rise.

Armed Forces Trends

Manpower Crisis

During the initial phases of Operation Iraqi Freedom/Operation Enduring Freedom,

(OIF/OEF) 2002-2003, the Marine Corps initiated an aggressive recruiting campaign that sought

to expand the USMC from approximately 174,000 to 202,000 (Eckardt, 2017). This expansion

was unsustainable as funding cuts took ahold following the 2008 U.S. economic collapse. As a

result the operating budgets began to diminish significantly. The Marine Corps was reduced to a

force of around 174,000, a number not seen since 2002 (Eckardt, 2017). Units were shuttered,

budgets were cut while unprecedented actions such as Staff Sergeant Retention Boards,

Voluntary Enlisted Early Release Program (VEERP) and Temporary Early Retirement Authority

(TERA) programs were initiated (Eckardt, 2017) to meet the cost reduction requirements from

these cuts. Additionally, this downsizing created unanticipated second-order effects (Gertz,

2015). This is a vital observation as it provides a timeline correlating the U.S. economy with

reduction of forces size and the uptick in suicide trends.


Veteran Suicide Epidemic: What Really Caused it? 4

In early January, 2015 retired General and current Secretary of Defense, James Mattis,

provided a succinct articulation of the impact of budget cuts on both force readiness and troop

morale during a Senate Armed Services Committee meeting stating that no foe in the field

can wreak such havoc on our security that mindless sequestration has done. Going

further by stating that the cuts in spending are costing military readiness and long-

term capability, while sapping our troops morale. (Gertz, 2015)

More recently, Mattis exclaimed that we are not giving our troops the funding, training or

equipment they need to accomplish missions safely and effectively. Moreover, that the United

States military, as currently structured and funded, is not ready to defend the nation against the

threats that face her (Venable, 2016).

Base Living Conditions

Reductions in funding has impacted every component of the Armed Forces, but what the

troops see in this regard is an unwillingness to provide them even the most modest

accommodations that are up to date and serviceable. Building and renovation contracts that were

approved and scheduled too often become victims of shrinking budgets when promised funds are

ultimately not delivered (Eckardt, 2017). This compounds the problem as maintenance issues in

current facilities accumulate, creating a backlog that facility-maintenance then claims is too large

for them to rectify in a timely manner. Additional problems are encountered when facilitys

maintenance is reluctant, or even refuses, to address current issues due to lack of funding. Yet

operational units are still required to house their Marines in these unacceptable conditions

(Eckardt, 2017).

Outsourcing
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With the budget cuts, decision-making capacity on what gets fixed and what does not has

been outsourced to civilians who are not even stakeholders in ensuring the welfare of our troops.

Budget reductions and unaccountable facilities maintenance supervisory staff have been primary

contributors to the negative perceptions and opinions shared by Marines of all ranks (Eckardt,

2017).

Equipment Overuse

Overuse leads to accelerated degradation. Constant demand means that equipment often

cannot be taken out of service for modifications mandated by technical directives. It also hastens

the life cycle of equipment that then requires substantial maintenance to be ready for service

(Eckardt, 2017). A good example of this can be observed in the USMC aviation community,

which struggles to maintain readiness levels. Despite shrinking operational budgets, the demand

for units to deploy has not stopped. Compounding the issue is the fact that the aviation industry

is transitioning their production and maintenance efforts to support anticipated new aircraft for

the future (Eckardt, 2017). Fewer companies are making parts for older designs, the demand for

spare parts has increased and needed parts have become scarce. With greater demand and fewer

suppliers the price increases exponentially. In an era of decreasing budgets this does not bode

well for readiness (Eckardt, 2017), simultaneously adding downwards pressure on the troops

tasked with mission accomplishment.

Troop Burnout

Since the onset of OIF/OEF there has been significant discourse on the impacts of

continual deployments on military personnel. These concerns are myriad, difficult to mitigate

and require nonstandard thinking to address sufficiently (Eckardt, 2017). General Mattis has

recently stated that we continue to ask our troops to do more while giving them less (Venable,
Veteran Suicide Epidemic: What Really Caused it? 6

2016). Such demands in light of funding cuts have had noticeable impacts on both readiness and

morale. Such impacts have been reported by both, officer and enlisted senior leadership (Eckardt,

2017; Venable, 2016; Gertz, 2015).

Stress. We know that repeated and long duration stress has very real and measurable

consequences which impact each of us across biopsychosocial spheres impacting our health,

brain, development and behavior (Applegate & Shapiro, 2005; Badenoch, 2008; Cozolino,

2010). Often times the result of sustained stress manifests itself in very predictable behavioral

outcomes including but not limited to depleted immune functions, rage, recklessness, substance

abuse, anger, anxiety, and depression (Cozolino, 2010; Applegate & Shapiro, 2005; Badenoch,

2008). Such behavioral outcomes often lead to domestic violence, alcohol and or drug related

incidents, and measurable reductions in individual conduct quality and job proficiency. The

result in many cases leads to Non-Judicial or Court Marshall administrative processes, which can

lead to early separation from service ahead of contractual terms. Such administrative procedures

often times result in separation status of less than honorable.

Discharge Status. In the cases of these types of less than honorable separations, newly

discharged veterans lose access to benefits and resources. Benefits like the GI Bill, VA healthcare

benefits, and disability compensation for injuries incurred while in service. The impact of a less

than honorable discharge determination leads to a destructive vortex of ramifications.

To begin with, the veteran is shamefully severed from his unit and command, loses a

steady paycheck, medical care, housing and food subsidies as well as access to mental health

treatment for the underlying symptoms that were arguably the root cause of his or her behavior.

Simultaneously, the underlying symptoms remain present and untreated. Further, worsened by

the loss of camaraderie coupled with disgrace, embarrassment and a loss of sense of purpose and
Veteran Suicide Epidemic: What Really Caused it? 7

self-efficacy. All of which are primary elements, which contribute to the choice of suicide over

life.

Evidence. Interestingly, this is also closely correlated with the data (Reger, et al., 2015),

which shows the highest rates of suicide are amongst veterans that served less than four years

and who did not receive an honorable discharge. Furthermore, additional data demonstrates that

70% of veteran suicides were carried out by those that did not use VA services. Moreover, those

that utilized the VA were less likely to commit suicide (VA, 2016; Thompson, 2016). However,

due to discharge status, many veterans that needed resources were not eligible for them. This

phenomenon is worthy of immediate attention, further research, and policy consideration as it

appears to place focus on both the root cause and avenues for a solution to the suicide epidemic.

US Economic Trends

On September 29th, 2008 the Down Jones Industrial Average fell 777.68 points marking

the largest single day drop in history. The United States economy began crumbling in what

became known as the great recession. Much research and reflection specific to the

precipitating factors and consequences have been published (Archarya & Matthew, 2009;

Obstfeld & Rogoff, 2009; Crotty, 2009; Kotz, 2009) detailing the many mechanisms that are

briefly touched on below.

Ingredients of the collapse

A convergence of information has manifested placing the fault upon a myriad of factors

which include: sub-prime lending, a housing bubble, easy credit conditions, fraudulent loan

underwriting practices, predatory lending, deregulation, increased debt burden, financial

innovation and complexity, incorrect pricing of risk, a shadow banking system, commodities
Veteran Suicide Epidemic: What Really Caused it? 8

boom, faulty economic forecasting, and systemic crisis (Archarya & Matthew, 2009; Obstfeld &

Rogoff, 2009; Crotty, 2009; Kotz, 2009).

Each of the factors listed above have their own respective dissertations. But they are not

the focus of this work. However, one component, which binds them all, is money. The

perversion of money, wealth, and greed, throughout millennia has formulated the underpinnings

of humanitys greatest sins and suffering at the moral, social, and spiritual realms regardless of

political, religious or spiritual affiliation.

Consequences

Housing. As a result, the housing sector of the economy was crushed, housing values

were decimated and foreclosures spiked across the country. Tens of millions of Americans lost

their homes. (Archarya & Matthew, 2009; Obstfeld & Rogoff, 2009; Crotty, 2009; Kotz, 2009).

Unemployment. The United States seasonally adjusted unemployment rate soared from

6.1% in September 2008 to a high of 10% a year later. This figure would not return to the pre-

crisis level until June of 2015 (BLS, 2017).

Labor force. Additionally, the U.S. Labor Force Participation rate, which had been at

66% in September of 2008, has never recovered and remains below 63%. To put that in

perspective, the current U.S. labor force participation rate is as low now as it was in the late

1970s (BLS, 2017).

Depression. Rates of depression in the United States rose from 5.4% in 2006 to 7.6%

between 2009-2012 (Pratt & Brody 2014).

Hypertension. Rates of hypertension among adults aged 20 and over that had been on

the decline leading up to the economic collapse began to rise (United States, 2015).
Veteran Suicide Epidemic: What Really Caused it? 9

Suicide. As discussed earlier, the rise in suicide rates for both veteran and civilian

populations also correlates to the timing and repercussions of the economic collapse.

The Problem

The totality of information above appear to demonstrate a correlation between the factors

surrounding the 2008 economic crisis, the ramifications of the crisis across the Armed Forces

and the epidemic incidence of suicide amongst both veterans and civilians. Furthermore the data

provided in the cited studies appears to disconnect both combat trauma and deployments from

the list of predictive factors impacting probability of suicide. Moreover, the studies have

demonstrated that combat and deployment have the opposite impact based on the rates observed

in each of the data sets. Specifically, those who have served in combat were less likely to kill

themselves even though they had a higher probability of PTSD diagnosis. On the basis of these

repeated observations, it is feasible that war, moral injury and PTSD are not to blame, but rather

greed and political gamesmanship are the real culprits.

What our society has endured is the consequence of revulsive and obscene desire for

money. It has created disgust, and hostility towards the institutions that propagated the disgrace

of politicians, hypocrites, thieves and corporate executives while leaving families outraged and

in horror. The manifestation of the consequences resulted in a state of emptiness and destruction.

The anguish, misery and loneliness which followed has left its indelible mark on our society

(Matthew 24:15; Daniel 9:5-11, King James Version), none more visible than the lives lost and

touched through the epidemic of suicide.

The Solution
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Ironically, as we have learned from the many studies and research detailed throughout

this work, combat is not the primary cause of veteran suicide. Having presented this argument, it

becomes plausible to consider that combat veterans may actually hold the secret to ending

veteran suicide.

Neurobiology

Perhaps the solution to this epidemic rest in our brains resilient and inherent ability to

heal. Research demonstrates that stress also builds resilience (Cozolino, 2010; Applegate &

Shapiro, 2005; Badenoch, 2008). It is due to our brains neuroplasticity whereby Neurogenesis

occurs within the regions of the brain associated with ongoing learning (amygdala, hippocampus

and frontal cortex) enabling them to continue to branch out, expand and grow in reaction to new

experiences and associations. (Cozolino, 2010; Eriksson, Perfileva, Bjork-Eriksson, Alborn,

Nordbog et. al., 1998; Gould, Reeves, Graziano, & Gross, 1999; Gould, Tanapat, Hastings &

Shors, 1999; Gross, 2000; Purves & Voyvodic, 1987). It is precisely this type of change in neural

coding that may enable our war fighters to thrive upon their return home while simultaneously

inspiring their fellow veterans to also excel.

Post Traumatic Growth

With so much research being directed toward the understanding and treatment of PTSD,

another phenomenon has been occurring, Post Traumatic Growth (PTG). While giving a recent

speech General James Mattis articulated both the phenomenon and our societies exaltation of

victimhood:

If you assume that there is something wrong with people, if you do it long

enough, expectations are very strong. There is also something called


Veteran Suicide Epidemic: What Really Caused it? 11

posttraumatic growth, where you come out of a situation like that (combat) and

you actually feel kinder toward your fellow man, fellow women; that youre

actually a better husband, father; you actually have a closer relationship with your

God. You do not have to go around apologizing as if there is some rage in you.

Although if we tell our veterans enough that this is whats wrong with them, they

may actually start believing it. I would just say there is one misperception of our

veterans, and that is they are somehow damaged goods. I dont buy it and I think

that that kind of self-pity while victimhood in America is exalted; I dont think

our veterans should join those ranks (Mattis, 2017).

Modern theorists articulate PTG as the positive psychological change experienced as a

result of struggle with highly challenging life circumstances (Jayawickreme, & Blackie, 2014).

Broad research is now available to support the theory that traumatic life events function as

catalysts for positive life change (Tedeschi & Calhoun, 1995; Jayawickreme, & Blackie, 2014 ).

Access

Veterans that have been discharged under less than honorable conditions should

automatically be mandated to initiate pre discharge mental health interventions and or VA based

mental health services. While this would result in a larger than current budget expenditure, it

would assist those that have lost access to other resources through corrective evidenced based

mental health modalities that have been shown to reduce suicide rates through the VA.

Where the situation dictates, based on initial evaluation, further consideration for other

VA based resources should be made available for veterans discharged for reasons that can be
Veteran Suicide Epidemic: What Really Caused it? 12

linked to the aforementioned domino effect caused by funding cuts that were imposed following

the 2008 collapse of the US economy.

As of March 8th, 2017, VA Secretary Dr. David J. Shulkin announced the intention of the

VA to expand mental health care access to former service members with other-than-honorable

(OTH) discharges and in crisis. In his testimony he reiterated the recent data that suicide among

veterans who do not use VA care is occurring at a greater rate than veterans who use VA care

(VA, 2017).

Discharge Determination Upgrades

Through the above mentioned mandatory mental health screenings, other mitigating

circumstances may be discovered that would make the veteran eligible for consideration of a

discharge upgrade to honorable status making him or her again eligible for the variety of

resources that have been shown to be successful. Resources such as health care, education and

disability compensation benefits that provide avenues for educational, financial and personal

success, which in turn have positive impacts on an individuals overall sense of self-worth.

Conclusion

This work has sought to provide both critical analysis of recent data and research as well

as the inclusion of potentially correlated factors that appear to have been ignored respective to

veteran suicide. It is the hope of this work that future generations may avoid repeating the same

apparent errors of social discipline. Further, that the pain and suffering caused throughout and

following the 2008 economic crisis may serve to redirect our collective moral and ethical

compass towards more fruitful endeavors, which seek to improve humanity for all. Especially

those willing to die protecting others.


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