More progress needed in suicide prevention, Chiarelli tells committee 

9/1/2010 

The vice chief of staff of the Army said that Web-based health care services would go a long way to reducing the stigma of seeking and provide soldiers with multiple sessions with mental health professions.

Testifying June 22 before the Senate Armed Services Committee on a hearing to find ways to reduce the number of suicides in the armed forces, Gen. Peter Chiarelli said, "I really think this is something that will fix this now."

In his prepared testimony, he said, "Our long-term goal is to create a network of counselors and certified mental health care providers that encompasses the entire U.S. Then, when a brigade redeploys, for example, a gymnasium full of stations/computers could be put in place allowing every leader and soldier to participate in a behavioral health evaluation on-line upon redeploying."

Sen. Carl Levin, D-Mich., committee chairman, said, "The increase in suicides by military personnel in the last few years is alarming.

"In 2007, 115 Army soldiers committed suicide. In 2008, the number increased to 140 and to 162 in 2009. Similarly, 33 marines committed suicide in 2007; 42 in 2008 and 52 in 2009."

"We have seen a fairly significant reduction in suicides among active duty soldiers this year as compared to last year. However, we have seen an unexpected increase in suicides among our reserve component soldiers not on active duty, in particular the Army National Guard," Chiarelli said.

Adding, "We are down two with our reserve component soldiers not on active duty. We are up 21 in our National Guard soldiers who are not on active duty. And that concerns me greatly. I think there are three things. I think it’s multiple deployments for them. I don’t think we’re getting enough time with them at the de-mob station to give them the kind of checkouts they need, behavioral health checkouts that they need."

Chiarelli, in answer to a question, said, "I am able to wrap leaders around returning active component soldiers for the entire time that they’re back. We take a reserve component soldier today and within five to seven days, he’s back in his community on his own."

He told the committee that 1,200 soldiers have been through resiliency training at the University of Pennsylvania, and the Army’s goal is to have those trainers in each battalion. At the same time, about 780,000 soldiers have taken an online assessment of their resiliency.

"This [training and assessment] is something that finally starts to get us to the left and not waiting until we see soldiers with problems but try to attack resiliency as far to the left as we possibly can."

Chiarelli said it is important to recognize the connection between Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) and the high rate of "co-morbidity," or co-existing conditions in an individual. That, coupled with a lack of medical understanding about the disorders, and the differing drugs to treat them and problems like anxiety and depression, complicates diagnosis and treatment, he said.

"There is no doubt that you can go to any of our posts and find soldiers struggling because [doctors] can’t nail down and diagnose their conditions," he said. "But I promise you it is not from lack of trying. We are doing everything we can.

"Our science on the brain is just not as great as it is on other parts of the body," Chiarelli added, noting vast medical opinions about diagnosing and treating the disorders. "It’s not this well-developed science like you find with heart surgery."

Of the Army’s most severely wounded soldiers – those at least 30 percent disabled – at least 60 percent are diagnosed with PTSD or TBI, Chiarelli said.

There still is no conclusive test to diagnose TBI, Dr. Robert L. Jesse, a physician and acting principal deputy undersecretary of health for VA’s Veterans Health Administration, told the committee. "It may just be the complexity of this disease that it takes time to manifest in ways we can diagnose."