ADM. MICHAEL MULLEN: Well good morning. Before I get started, before we get started on the topic that is so important to all of us, I do want to express our thoughts and condolences for all of the citizens of Haiti and all of those who have been stuck by this very significant tragedy. And also certainly, from my perspective, the United States is going to do all we can to help. We’ve been working throughout the night to figure out how we can do that and how we can do it as rapidly as possible. We have an awful lot of people working in that direction right now. I know there are also significant international efforts and all of those will greatly appreciated. So we should just keep the Haitian people in our thoughts and in our hearts as they start to recover from this very, very tragic incident. (News Story I Video I Pictures)
It really is a great pleasure to be here. A Department of Defense and a VA conference and I think that alone says an awful lot about where we used to be and where we are right now, very much in this together. I know this subject, the subject of suicide, is one of tremendous difficulty and challenge and understanding. And there have been a lot of people who have worked on this diligently for many, many years and certainly in the services with the rise in the numbers in all of the services since these wars started to really look at the causes and get to a point where we can prevent this and understand it.
And I know there – at this point in time, there does not appear to be any scientific correlation between the number of deployments and those that are at risk, but I’m just hard pressed to believe that’s not the case. And I know we are and hope we continue to look there first to peel back the causes, if you will, to get to the root of this so that as these deployments continue and our dwell time particularly in the Army over the next couple of years is not going to go down significantly, as we come out of Iraq and send additional troops into Afghanistan.
Our dwell time in the Marine Corps, which is another service that has been very hard pressed by deployments will increase over the course of the next year or so to get to a point of about twice as long at home as you are deployed; and we think that’s a significant mark – and then sustaining that over time. We think that will relieve a lot of the pressure and the stress.
And, at the same time, we know we’ve got to continue in these missions. And we’ve got to focus on our members and their families to address this issue and other issues that are so important and so relevant to the force that we have today.
So what you’re doing this week is really, really important. And I hope – and I was talking to Gen. Sutton just walking in – I know that – I think there are twice as many people here this year as last; the problems that are identified in suicide are being widely discussed and I go back to where I started – between the DOD and the VA, I think sharing those practices, sharing those protocols, sharing that understanding and I’m sure reaching much further than that across the country and indeed around the world to centers of excellence in the suicide world will help.
I’m struck – one of the things that struck me in recent months is the Army kicked off this $50 million suicide study several months ago, in the fall. And it was a 5-year study. And one of the things I worried about was, we can’t wait 5 years. And these things have to – we need to be putting programs, intervention, building resilience, attacking the issues that we know affect our people right now.
And I was encouraged in talking with the leaders of that study that they were going to peel off results as they go; so it’s not going to be a 5-year wait. And I’m very hopeful that they will do that and start doing that in the very near future.
As I’ve talked with uniformed leadership about this, the uniformed leaders are attacking this and from the leadership perspective. The NCOs, in the case of the Marine Corps, really focusing on the NCOs. And when I was in Camp Lejeune not too long ago, I was struck by the commander’s comment that the NCOs had really started to not just get into it, but have an impact. And numbers of events, number of suicides that were taking place down in Lejeune were reduced over the previous few months that that had occurred.
And I don’t know how else to get at this except leadership – and figure out who’s at risk, understand it, train to it. Back to this study, I was also struck – and these were five of the leading individuals in our country on suicide from East Coast to West Coast who were leading this. And I was also struck at how from their perspective, how little national attention is paid to this issue and the tens of thousands of suicides every year; it doesn’t generate the kind of interest and effort to get at the causes across the board in America. And so this study is really part of what I would call really a landmark study upon which we are greatly dependent.
And these experts explained that they really hadn’t been able to do anything like this in the past. So I am encouraged by that as well. Like so many things, we’re trying to solve these very difficult problems while we’re in two conflicts. We’re trying to release the pressure, build resilience, understand how we identify at-risk people and then extend the web. Deb will comment here very shortly: We also find it extending into families and into children.
So how do you extend the web? How do we know as an institution? We don’t track suicides longer than 120 days after somebody is ETS. So how do we really know what’s happened to those who have served so well, who aren’t necessarily connected to the VA?
So our tracking mechanisms need to improve; we need to understand very early who the at-risk individuals are. And it’s oftentimes squad leaders and family members who know that; best friends who know that, who see the symptoms the earliest, who can look them in the eye or who can reach out and throw a life-ring of help towards someone who can help intervene in this very difficult area.
So I know there is an awful lot of leadership attention giving focus to this. And we focused a great deal on the Army. But Gen. Chandler is here, who is here, who is the vice – the number-two officer in the United States Air Force.
And as I look at the numbers for each service, the numbers have gone up; the rate has gone up per capita at about the same rate over the last four or 5 years for every service. So this isn’t just a ground-force problem. And it’s a growing problem that we as leaders have to commit to.
And then you in your fields of expertise have to figure out how to get it to us so that we can actually do something with it from an institution standpoint, so we understand what causes it as best we can, and then make those kinds of changes. I just want to reemphasize my commitment, Deborah’s commitment and the leadership and the senior family leadership commitment to getting at this problem.
DEBORAH MULLEN: Good morning. I really was – I was asked if I wanted to say a few words, which I appreciate the opportunity. And I know that a lot of the focus, as it should well be, is on our military service members who have been committing suicides. And I think that the Marines just in this month alone have already had several suicides, so the problem continues.
I know that we’re also looking how to assist family members who are survivors, who have had family members commit suicide, and I think that’s very important. But there’s another side to this and that’s family members who commit suicide.
I had a recent meeting with several of the leadership individuals from the Marines and the Army, and I asked about whether they track family member suicide. And the Army did say that they did; that they had nine family members last year who had committed suicide.
I did not get a response out of the Marines. I don’t think – my understanding is that they don’t generally track suicides because it tends to be left to the civilian investigators, and often, people don’t really want to talk about the fact that someone has committed suicide, so we really may not have our arms around that figure.
I asked about the number of suicide attempts by family members. And I was stunned when I was told that there are too many to track. So if you have a family, and let’s say it’s a spouse who has attempted suicide and her husband or the wife is serving overseas and we’re not tracking this, are there children in the home that we are not aware of that we may need to be doing interventions with?
I know that if that number is that large just in – this was the Army – we really don’t have an idea of the scope of the problem with attempts by spouses in any of the other services. So we don’t know how many children out there are at increased risk.
Also, just the fact of a family who has someone serving downrange, if the mother or father has attempted suicide here in the States, this is a crisis – this is a family in crisis – and it’s our responsibility; these are our family members. We have got to find a way to track them. I don’t know if they’re attempting this because this is the only way they feel they can get mental health, emotional health care. We don’t really have any answers and I think we need to understand the answers.
We know there’s a stigma. Spouses tell me all the time that they would like to get mental health assistance but they really do believe, as incorrect as this is, but they really do believe that if they seek help, that it will have a negative impact on their spouse’s military career. We have got to be – this stigma is not just with the service member getting help.
Recently, there was a spouse who – I think it’s been finalized that she did commit suicide. When I was reading about this, they believed it was suicide in Germany. And one of the things that the spouses talked about was there is no training for suicide prevention for spouses. There is suicide training but it’s focused specifically on – in the military, it’s on the service member. I think we need to start to recognize that we have families that are under such great stress.
This stress is only going to continue as we send these 30,000 troops in. We need to be able to give tools to family members who are left behind to recognize not only in themselves but in another spouse or a friend what – not just the usual, I’m feeling depressed or I’m down. We know that they feel this way, but how do we maybe go a little step further by providing training for these spouses to really understand what they should be looking for in another spouse or in a family member?
The other issue I just wanted to talk about was when you have a spouse living with someone – a service member who has PTSD from a combat experience, these spouses suffer from anxiety and depression and suicidal ideation.
And one of the big problems is – and psychologists and psychiatrists say, these folks need to see someone but this barrier to care, whether it’s an inside barrier to care that they’re afraid to go or they think the stigma is there or they think it’ll have a negative impact. Or the barrier to care, because they can’t get help, I think is something that we really need to address.
And I talked to Bonnie Carroll about if we had a family member that felt someone in the family, either the service member or a child or even themselves, was contemplating or they thought was looking – looked like maybe there was a suicidal situation that might happen.
You know, Bonnie’s organization, TAPS, has such a connected web across our country with first-responders that if we can use that resource, someone can call TAPS and TAPS can actually talk to them and also have a first-responder present very quickly. And those kinds of resources, we need to get to our families. It’s not just about families of the fallen, which is what TAPS does so beautifully, but it’s also, they have the resources to help people that are really struggling with the fact that there may be someone in their family that they are suspecting is suicidal.
So I appreciate the opportunity to just talk a little bit about the families and hope that that’s something that you will look at as you work through these really challenging problems. We do have family members that we need to be aware of. We need to be able to find out; we need to get our arms around the problem that we’re facing through this number of suicide attempts and actual suicides and the impact on the families. So thank you very much. (Applause.)
ADM. MULLEN: Let me just close with a couple of thoughts. First of all – and Deborah mentioned the PTS issue, the TBI issue, the stigma issue. Those are things that have been out there. We know how difficult they are. We’re not breaking through them quickly enough.
Now, I don’t know what the right answer is. I have actually, particularly on the stigma issue and the how-do-I-reach-for-help. But I have a real sense that we’ve got to create a much broader network of anonymous help that is effective so that individuals have a way to seek help, get help and not be consumed by this thought that it’s either my career or my spouse’s career that I’m putting in jeopardy until we break through it. And I’m not saying that that’s the answer; I just think that we’ve seen some success with that and I think we need to broaden that as rapidly as possible.
Part of the sea of goodwill in this country, there are individuals out there who want to help those who are in the military and their families. And until that well is dry, we should be figuring out ways to tap it – innovative ways to tap it.
And then lastly, in terms of suicide, specifically, when I lost one of my crew members in command, when I was a Navy captain, what I didn’t really understand – and it was at a time of real tension in our deployment cycle, in our readiness cycle, et cetera – what I really didn’t understand what sort of the pebble in the quiet water that a suicide was, and how far those circles radiate, how far they reach.
And I, as a line leader, wanted to solve this as rapidly as I could. But I couldn’t do it alone. And I didn’t really know that. I’m not necessarily geared to thinking there are problems I can’t solve, when I’m in command, but I couldn’t. And it wasn’t until – in the Navy, there is something called a sprint team that is available in the major hospitals. And it’s a 24/7 team that’s available with bags packed to respond to a crisis. And it’s a group of psychiatrists, psychologists, mental health professionals, and they’re on their way immediately.
And it wasn’t until I got them on the ship – and I had a crew of about 400 troops – that they understood the pebble in the quiet water piece. And they reached to places and to families that I wouldn’t even have thought, that were affected by this suicide. And these were friends, liberty buddies, families of families, family friends of family friends kinds of things.
And I would hope that, again, until we see relief here, that we are focused on this as the crisis that it is and have the kind of response that was very supportive of me many years ago and allowed me, quite frankly, as a commander, to work my way through these issues much more rapidly because of that assistance, and then get on with the mission.
And the last thing I’ll say, even though I’ve said that a couple times – (laughter) – the last thing I’ll say – and it is really the evolution of who we are, and it ties back to families – but it’s the readiness piece, literally from the day you join any of the services. And if you join with a family, it’s how ready is that family for this experience? And we have a tendency to cycle that, to get you ready before you deploy.
And I would argue that, with where we are right now, that we have to have a continuum of readiness that starts to educate families from day one. And I wouldn’t even just say spouses – I’m talking about moms and dads as well – about the challenges that lie ahead, the information that is available, the networks that are out there in these challenging times, so we hopefully can avoid crisis, but that when we get in them, as we are right now in this suicide area, we know who to reach for and we know how to get help.
And these young family members – these young soldiers, sailors, airmen, Marines, Coast Guardsmen – they have a lifeline and they also have leadership, which is supportive of throwing that lifeline out before it is a complete crisis and everybody’s looking back and saying, what happened. So again, thanks for all your work on this. As in all these conferences, there area lot of people here. You’re going to spend all week. I expect great outcomes – output – to impact on these challenges. And I appreciate all the work that you all are doing – both Deborah and I do. Thank you. (Applause.) We’ve got a few minutes for a couple questions, if there are those that want to ask. (Pause.) Or not. (Laughter.)
Q: Good morning. My name is Theresa Rankin. I’m the originator of the BrainLine project, which is funded by the Defense and Veterans Brain Injury Center. Good morning, Adm. and Mrs. Mullen. Have you had an opportunity to have any kind of feedback from the American Red Cross on working very specifically on the needs of the National Guard and reservists who are returning to rural America? I’m quite struck by the extensive networking and extraordinary capacity and competencies of the American Red Cross affiliates and state chapters.
ADM. MULLEN: I have not. But I’ll certainly take your recommendation and get that. I actually heard a great deal about what you do this week because Deb, I know, spent some time with you, and senior spouses, spent some time with you this week. The issues that surround the guard and reserve are particularly important and difficult, because they do – members who are in our guard and reserve live throughout our country.
And it’s a great strength of our country, and there have been – some guard units have been incredibly innovative in how they attack these very difficult challenges. But I will tell you, last year – 2009 – I was struck, as we really tried to – as we really dove into the suicide issue and the heavy focus was on the Army and we were tracking month to month on the Army. It wasn’t until almost two-thirds of the year that I asked the question, do these numbers include the guard? And in fact, the ones we were tracking did not.
Now, the guard was tracking it, but we weren’t tracking it macro, and we are now, very specifically. And the efforts amongst the services, across – you know, again, the senior leadership is working hard to understand what is working best, share those practices and then spin them out as rapidly as possible. But I’m not aware – I haven’t seen anything from the Red Cross, per se, and I’ll be happy to look into that. And certainly, from just to the tone – your question itself, obviously, they’re doing some great things, and we need to make sure we’re taking advantage of it.
Q: Can I just say something? Did you all have a brief on brainline.org? Because it’s actually the only comprehensive resource out there for traumatic brain injury. I visited their location – it’s through WETA, who has a history of some very successful Web sites. And this is not just a normal Web site.
One of the things that BrainLine wants do to is create sort of an online university, so as our veterans leave the DOD, the VA and then go out to rural communities, the doctors who may not have had training in traumatic brain injury, or maybe have only seen one or two over a period of a year, and all of a sudden, there may be a veteran in their area that has this – that suffers from this – and also, teachers who may have a child whose parent is suffering from this – they can go on BrainLine and literally go through a curriculum so that there’s some training and some understanding.
Because, you know, a child who may not be dong the work – it’s not because they don’t want to; it’s because they’ve got a parent at home who’s suffering through traumatic brain injury. Same thing for a person in their job – people don’t understand. And so this brainline.org, I think, if they get the funding, is going to be able to put this up online, which I think will be a wonderful resource for our country, but mostly for those more rural areas that don’t have, like, a level one trauma hospital in the area. So it’s well worth visiting.
ADM. MULLEN: Let me just comment, also, on the DOD/VA aspect of what you’re doing here. And I have come to believe, over the last couple of years, that we ought to very seriously look at evaluating people’s readiness to be discharged. And too often – and any military member knows this – when an individual gets within six months of their ETS or EAOS, it’s just how many days left. And they focus specifically on that number, that day, whether they’re ready to go or not.
And so for those who have been through these wars and been through so much, leaders need to ask the question, is Sgt. Jones ready to go. And if not – because in the long run, it’s going to be much better to ensure that he, and his family, or he, by himself, are actually ready to transition out into civilian society from this very structured environment, whether they loved it or hated it, into an environment that they left years ago, that is unstructured, and in which they may have no support whatsoever.
And I believe we need – the outfit that does this pretty well are Special Forces, because the deal is, you can’t leave until we’re ready to let you leave, if you want to be a Special Force soldier. And I think we need to think a lot more about that, and that’s a pretty steep hill, because you sign a contract, 4 years later your EAOS comes up, you’re supposed to leave, you get focused on it, the contract’s over, et cetera.
But in the long run, I believe if we can get that right, that the individual will be much better off. So will society. And we’ll be able to transition much more smoothly those individuals into the VA system. And one of the things I haven’t ask is the VA’s view of who we are sending them and what we could have done better in preparing them for this transition.
Q: Good morning. Master Sgt. Oher (ph) from Youngstown, Ohio. I’m a reservist. And my question is – because I’ve been on three deployments – and well, usually you come back and you might stay one day and then you’re gone off the base. Maybe there needs to be some kind of program where – I’m a deputy sheriff, so maybe the police force in the areas, fire department and also the hospital have some kind of DOD training regarding suicide prevention, with what we deal with in the military.
And then they can have a step-by-step concept of what to do for these people, and especially their people they work with. Because you go back to your regular job and there’s no one there that really understands what you’ve been through – maybe some, because we have more than myself that are also in the military. But I think there needs to be some kind of program like that around.
ADM. MULLEN: That’s a great suggestion. I understand exactly what you’re saying and you speak to an issue that’s been a challenge throughout these wars, is you deploy, you come back, you’re back at work in a week or two or however long it is, and you have very few individuals – maybe none – that have your experience.
And so that support mechanism isn’t there, and they don’t understand what you’ve been through. It goes to the Red Cross idea, the guard and reserve idea. And I’ll actually take that back with me and just ask the question, to see where we are on that.
MRS. MULLEN: You know, there’s – Michael and I have met with Marine infantry platoon that was getting ready to deploy and Michael asked – and I found out you asked the wrong question.
ADM. MULLEN: Thank you.
MRS. MULLEN: You’re welcome. (Laughter.) And he asked if anybody had emotional problems, and apparently that’s not – what you’re actually supposed to ask, you know, how are you sleeping, apparently. But anyway – (laughter) – he asked that and, of course, there was dead silence and Michael always just stands and waits. And finally, someone said that, well, actually, they had actually called to get some help.
And it took the person two sessions just to explain, you know, what their job was. And finally, he realized that he wasn’t really going – this particular therapist wasn’t going to be able to help. And so he basically turned to the guy next to him that was sitting on the deck and said, this is who I go to for help now. But I think that happens to a lot of our military folks. They go out, and if someone doesn’t understand what they’ve gone through, it’s pretty hard – they spend a lot of time just trying to explain the military and what it’s like in theater or what goes on with their families when they get back.
And I’m not saying that, you know, outside therapists can’t handle that, but not all of them can because they don’t have the training and they don’t have the experience. And so there’s a lot of frustration in finding someone that you don’t have to, you know, spend two, three sessions just trying to explain and then maybe get to the problem at some point.
ADM. MULLEN: Okay, thank you.