Although he was addressing the audience at the Reserve Officers Association’s first National Security Symposium in Washington, D.C., the subject of Gen. Peter W. Chiarelli’s keynote speech was on the health and well-being of soldiers and their families – it is "absolutely critical to the security of our nation.""I recognize it may seem to be an unusual topic for a forum on national security, however I believe it’s absolutely very relevant," the Army vice chief said during his Jan. 30 speech.Soldiers and their families are under a tremendous amount of stress and strain after nearly a decade of what he calls a time of "persistent engagement."As operations wind down in Iraq and Afghanistan, more soldiers are going to be returning home – many dealing with physical or behavioral health injuries and other issues."I’m certain that many of you have heard me talk at length about the complexity of these injuries and how absolutely important it is that we do everything we possibly can to assist soldiers and families dealing with them now and into the future," he said.Adding, "The fact remains these wounds are not well understood, yet they affect a significant portion of the Army’s wounded warrior population."As of Jan. 1, 47 percent of wounded warriors are suffering from post-traumatic stress, and 16 percent from traumatic brain injuries – a "staggering" number of about 9,000 soldiers, Chiarelli said."Although the Army is taking a holistic approach in dealing with these injuries, the reality is the study of the brain is incredibly complex and rather immature," he said. "Most efforts aimed at diagnosing and treating these conditions are at their infancy."Chiarelli said he gets a number of e-mails a day claiming to have a cure, but he can sit on a panel with "14 different psychiatrists and psychologists" and still get conflicting information."It’s going to get harder before it gets easier, but we’re making significant progress," he said.The Army is working with researchers, doctors and medical professionals worldwide to better identify and diagnose head injuries as well as expand treatment options, he said.Unfortunately, this stress and strain has led to suicides and suicide attempts, but, there has been a slight reduction to those numbers recently for soldiers serving on active duty, and Chiarelli credits that to the new Comprehensive Soldier Fitness program and a Pain Management Task Force to instruct medical providers and soldiers on best practices for pain medication.Other programs that have been implemented include confidential alcohol-abuse treatment and education, and face-to-face post-deployment behavioral health screenings, he said.Guard and reserve soldiers are also spending more time at demobilization stations upon return from deployment to ensure they are thoroughly checked out.The vice chief is also looking forward to an upcoming joint Study To Assess Risk and Resilience in Servicemembers – STARS – that he anticipates will have an "unprecedented impact" on mental health, similar to the results of Framingham Heart Study on cardiovascular disease."We believe these and other efforts will take us from a leveling off of active-duty suicides to a reduction in suicides, suicide attempts and high-risk behavior," Chiarelli said.However he added, "We saw a substantial increase in the number of suicides of soldiers not serving on active duty, to include a doubling in the Army National Guard."So the issue is how to carry the successes from active duty to the reserve component, Chiarelli said. Once soldiers return to inactive status, it becomes more difficult to track the effects of stress. Those soldiers are usually geographically removed from support functions and even the oversight and camaraderie they would experience while around their fellow soldiers.However, focusing on the extreme outcome of suicide shouldn’t be the primary focus because the numbers are small in relation to the overall Army population. It’s the overall health and resiliency that is needed, which will ultimately affect suicide rates."These deaths, albeit tragic, represent the most extreme outcome, as such the smallest segment of our overall population," he said. "That’s not to say we can or should disregard them in order to focus on the largest segments of our population."The symptoms of stress are all the same, but soldiers may be experiencing it at different levels of severity or "have more or less resiliency in dealing with it," Chiarelli said. The goal is to increase soldier resiliency to get them further away from being at risk.Among the issues reservists and guardsmen face include challenges due to the economy and labor market upon returning to the civilian side, Chiarelli said."We are continuing to work closely with employers of the guard and reserve in the private sector to try and mitigate economic stress on both the individual and the employer," he said. "The reality is what they both desire is predictability, and we recognize we must do everything we can to provide that predictability and also as much stability as possible."The Army is also working to enhance the quality of health care as well as increase the availability of medical and counseling services for soldiers and families, he added.Chiarelli also called on the people in the room to get more involved with soldiers in their units."Start paying attention to things you may never have considered in the past," he said. "If you see something that doesn’t seem right, say something, ask questions, be nosy. It could be the difference between life and death. No individual should suffer in silence when there’s help available. Encourage them to seek help and follow up – ensure they get the help they need."But, what the Army can do that would help both active duty soldiers and citizen-soldiers is increase dwell time, he said. They all need time at home for rest and recovery."The truth is a lot of the issues we’re seeing with behavioral health and physical injuries are the result of people not having enough time between deployments to reintegrate with their families and communities, and recover from wounds and injuries," Chiarelli said.The Army is striving for one year deployed and three at home for active-duty soldiers, and one year deployed to four or five years at home for those in reserve components, he said."We’re making progress but still have a long way to go," he said.