[Congressional Record (Bound Edition), Volume 155 (2009), Part 6]
[Senate]
[Pages 8054-8056]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      SUICIDE IN THE ARMED FORCES

  Mr. FEINGOLD. Mr. President, today, on the sixth anniversary of the 
invasion of Iraq, I want to speak about an epidemic facing the Nation's 
Armed Forces; namely, the alarming rate of suicides in the services. 
Yesterday, the Personnel Subcommittee of the Armed Services Committee 
held an excellent hearing on this topic, and I would like to thank the 
chairman and ranking member for taking on this important issue. I would 
also like to discuss an issue that we have so far paid far too little 
attention to, and that is the way the strain on the force caused by the 
rate of deployment is compromising our ability to care for 
servicemembers struggling with mental health concerns.
  We have come a long way in addressing this issue. Only a generation 
ago, Vietnam veterans struggled to get care for the long-term 
consequences of the trauma they survived during the war. They were 
trailblazers, and thanks to them the VA has revolutionized the way it 
cares for veterans. We now have, among other things, counseling centers 
where combat veterans can go to speak with experienced counselors who 
are also combat veterans about their difficulties in readjusting to 
civilian life. I commend the President for emphasizing the need for 
additional centers and have been a strong advocate for just that in the 
State of Wisconsin. But more remains to be done.
  It is not sufficient to wait until a servicemember is discharged from 
the Services and transitioned to the VA to respond to the crisis. Let's 
be honest. There is a conflict between the responsibility to both 
maintain the readiness of the Armed Forces and adequately respond to 
the needs of servicemembers struggling with mental health issues. 
During this time of tremendous strain on the Armed Forces, our 
noncommissioned officer corps is under incredible pressure to ensure 
that the servicemembers under their command are ready to meet the 
demands of combat. We must create the space for them to identify those 
soldiers who are in need of extra assistance and provide a means for 
them to provide that assistance.
  We must begin by asking men and women in uniform about their 
experiences and what we can do to support them. I was disappointed that 
the hearing yesterday did not include the testimony of servicemembers 
about their personal experiences, so I would like to take this 
opportunity to talk about what I have been hearing from servicemembers 
and their family members from my home State of Wisconsin.
  Over 2 years ago, I was approached by a family whose son had taken 
his own life while serving in Afghanistan. After an investigation of 
the situation, I learned that the soldier was struggling to meet the 
grueling demands of his duties and had, perhaps as a result, become 
isolated from his unit. It was a tragedy for all involved.
  Last year, my office was contacted by a soldier who immediately 
thereafter took his own life. A subsequent investigation revealed that 
he, too, had become isolated from his own unit. Due to his ongoing 
struggle with mental illness, his leadership became understandably 
frustrated with him and repeatedly disciplined him. His doctors decided 
he was not fit to deploy with his unit which was headed to Iraq. This 
was a major blow for him. He desperately wanted to deploy with his 
unit. He became angry and isolated. He sought to be transferred to a 
wounded warrior transition unit where he could focus on his recovery. 
Unfortunately, his leadership failed to get him transferred in a timely 
manner. If they had, he might still be with us today.
  I was recently approached by a Wisconsin veteran who lost three of 
his peers to suicide during his time in the Army. He has informed me 
that in all three instances one of the main problems was a breakdown in 
leadership. He has given me a list of recommendations for the Armed 
Forces to train our noncommissioned officers in suicide prevention. I 
will ask to have these recommendations printed in the Record.
  Listening to the voices of these men and women serving in uniform, a 
consistent pattern has emerged. Our Armed Forces, which are under 
tremendous pressure due to two ongoing major contingency operations, 
are struggling to meet the needs of their members while completing 
their mission.
  I suspect that the single most important thing our country can due to 
address this epidemic is to redeploy from Iraq so that we can take the 
time to care for the psychologically wounded without putting additional 
strain on those who have already completed multiple tours. Redeploying 
would also serve our national security needs by allowing us to better 
focus on the global threat posed by al-Qaida and its affiliates.
  Secondly, we must review the strategy we embraced which has led us to 
rely so much on the continued sacrifice of so few. We must not make the 
same mistake again of engaging in a mistaken war of choice. We should 
not ask those who volunteer to serve their country to bear the burden 
of a 6-year war absent a compelling need. We, the civilian leadership 
of this country, owe it to the men and women in uniform to be more 
responsible stewards of our Armed Forces.
  It is far past time to redeploy U.S. troops from Iraq. I am pleased 
that the President has set a course for such a redeployment. Now, we 
can turn to the task of rebuilding our Armed Forces.
  Mr. President, I ask unanimous consent to have recommendations to 
which I referred printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                 U.S. Army Suicide Prevention Proposal


                                Abstract

       The following correspondence is a proposal consisting of 
     recommendations members of Congress should consider regarding 
     the high numbers of suicides occurring within the Army. Even 
     though this proposal is emphasized towards the structure of 
     the Army, other branches should be able to utilize this 
     proposal in order to improve suicide prevention tactics as 
     well. If measures within this proposal are already being 
     taken, I apologize for the redundancy. This proposal is also 
     not intended to interfere with other preventive measures 
     being considered by the Army. Its sole purpose is to 
     implement ideas, based on my experiences, that should improve 
     the health and welfare of soldiers, increase education for 
     leaders at all levels to utilize while counseling 
     subordinates, and to develop measures commanders should take 
     should leaders abuse their authority, or commit any other 
     acts of misconduct that may hinder health, morale, and 
     welfare of soldiers within the United States Army.


                              Introduction

       The high numbers of suicides within the United States Army 
     are extremely disturbing. Ever since combat operations 
     commenced in Afghanistan in October of 2001, the suicide 
     rates have been increasing. However, statistics from 2007 and 
     2008 reveal numbers of suicides that are the highest since 
     the Army began recording numbers of suicides in its history. 
     In January of 2009, 24 soldiers took their own lives. The 
     number of soldiers killed in action was lower than those who 
     committed suicide. In February of 2009, another 18 soldiers 
     committed suicide. Even though the Army has a very serious 
     problem pertaining to suicides by soldiers deployed overseas, 
     a high abundance of soldiers stationed within the United 
     States are committing suicide as well.
       I commend the Army's initial and recent efforts intended to 
     handle this serious problem. Increasing the numbers of mental 
     health experts, operating a suicide-prevention hotline, and 
     encouraging soldiers to seek help if symptomatic are steps in 
     the right direction. However, as a 13-year veteran who has 
     dealt with a significant number of soldier suicides in the 
     past, I am aware of other problems that require immediate 
     attention. If these problems are not assessed and corrected, 
     the aforementioned measures will make little difference in 
     the pursuit of suicide prevention. Based on my observations 
     and experiences, the primary core of problems involving 
     suicides by soldiers involve breakdowns of leadership at the 
     lower levels. Therefore, the following proposal will detail 
     recommended improvements of leadership training for younger 
     leaders.


                        Army Recruiting Command

       Army recruiters have perhaps the most arduous duty within 
     the enlisted ranks. They

[[Page 8055]]

     are required to meet specific standards in regards to 
     attracting individuals to contemplate enlisting into the 
     Army. They work very long hours each day, and often work six 
     days a week. They are under constant pressure to secure 
     enlistments so that the entire Army meets recruit quotas and 
     goals. Overall, the duties they perform are extremely 
     stressful. Recruiters either volunteer to perform recruit 
     duty, or are selected to do so by the Department of the Army. 
     Even though recruiters are noncommissioned officers who are 
     normally more responsible and mature, they too are human 
     beings who are subject to mental health problems due to the 
     nature of their duties. Weeks ago, four recruiters in Houston 
     committed suicide, most likely from extreme pressure from 
     their chains of command. Recruiters normally have no one to 
     turn to in times of stress. Their leaders want them to 
     produce, not complain. Therefore, if they are experiencing 
     any types of mental health problems, most are likely to keep 
     it within themselves. Fellow recruiters must look out for 
     each other, and pay attention to stress that appears beyond 
     the normal stresses associated with recruiting duty. Like 
     others, they should not be ridiculed or chastised should they 
     request treatment. Also, even though it would probably be a 
     difficult task, the Army needs to expand the recruiting 
     command. The more recruiters, the less stress will be placed 
     on recruiters performing their duties today. Also, 
     stigmatization shall not be tolerated if a recruiter feels 
     the need to seek mental health treatment. The fear of 
     stigmatization is a very potential reason for the four 
     suicides that occurred in Houston.


                         Drill Sergeant School

       Drill Sergeants are perhaps the ``elite'' of the 
     noncommissioned officers throughout the Army. Like 
     recruiters, they either volunteer to perform this duty, or 
     are selected to do so by the Department of the Army. They are 
     responsible for turning civilians into soldiers. Molding a 
     typical individual into a motivated, highly-disciplined 
     warrior is no walk in the park. Being a drill sergeant 
     requires high levels of dedication and commitment to their 
     duties. Drill Sergeant training is simply the same as going 
     through basic training all over again. They learn what they 
     are going to teach. Since they are the first true soldiers 
     recruits are going to follow, drill sergeants must set an 
     extremely high example at all times. Like recruiting, drill 
     sergeants work long hours. They receive a limited number of 
     days off. Drill sergeants are required to pay extra attention 
     to detail due to the ``culture shock'' new recruits receive 
     once entering initial-entry or one-station unit training. 
     Basic training is normally a recruit's true separation from 
     family and friends from home. Therefore, they are typically 
     prone to suffering home sickness while being pushed to their 
     limits. Drill sergeants must be adequately trained in 
     recognizing changes in behaviors of their recruits. They must 
     be proficient counselors, especially when recruits appear 
     more stressed than normal. In 1995, a recruit at Fort 
     Benning, Georgia shot himself to death after rifle training. 
     The recruit had apparently hid a round after the training, 
     and went to an isolated area with his weapon after cleaning 
     it. He then used the live round in his possession to commit 
     suicide. The incident was an example of dereliction that can 
     occur if drill sergeants do not perform their duties with 
     high levels of attention to detail.


     initial entry training (iet)/one-station unit training (osut)

       As mentioned earlier, entry into the Army is normally a 
     level of ``culture shock'' for a new Army recruit. Even 
     though they expect initial, or basic training to be a true 
     test, they do not know what to truly expect until they 
     initially experience the high levels of stress at the 
     commencement of training. Drill sergeants are tasked to mold 
     civilians into soldiers in a short period. Therefore, the 
     operational tempo is very high. The stress can be so high 
     that certain recruits may act out of normal character. 
     However, one positive aspect of this level of training is 
     that new recruits are treated the same way. They often turn 
     to each other for support and encouragement. However, 
     separation from loved ones is very difficult. If something 
     negative happens within a recruit's family while he or she is 
     in training, his or her behavior or mental state will most 
     likely change. One of the first blocks of instruction 
     recruits receive should involve the importance of the ``buddy 
     system.'' Drill sergeants must inform their recruits that it 
     is alright to report signs of problems. Even though drill 
     sergeants are hard on their recruits, the last thing they 
     want is for a recruit to feel alienated in any sort of way. 
     If a recruit is suffering from mental distress, immediate 
     intervention is a necessity. It is alright for drill 
     sergeants to demonstrate compassion towards the men and women 
     they are training. Recruits are taught how to pay attention 
     to detail just as much as drill sergeants are. Therefore, 
     unusual behavior, or warning signs of potential suicide must 
     be reported immediately. In the Army, all soldiers, 
     regardless of rank, are safety officers. Recruits must be 
     properly counseled by their cadre. If initial entry trainers 
     cannot solve problems, recruits demonstrating signs of mental 
     distress must be command-referred to mental health services 
     upon immediate signs of problems in order to prevent a 
     catastrophic event from happening.


       the army noncommissioned officer education system (ncoes)

       The initial phase of the NCOES involves the Warrior 
     Leadership Course (WLC), which is designed to prepare Army 
     specialists and corporals to become sergeants. Sergeants are 
     normally ``team leaders,'' who have a span of control 
     consisting of two or three subordinate soldiers. This four-
     week course is military occupation specialty (MOS) non-
     specific, and covers basic leadership skills. Students 
     receive enhanced proficiency on physical fitness training, 
     teaching skills, drill and ceremony, land navigation, field 
     and garrison leadership, and a written examination. It also 
     involves a situational training exercise (STX) designed to 
     teach hands-on leadership in a battlefield environment. My 
     recommendation is that a thorough block of instruction be 
     implemented that focuses on overall suicide prevention. 
     Students need to be taught what warning signs to look for, 
     and how to properly counsel troubled soldiers, as well as 
     carrying concerns up the NCO support channel and chain of 
     command in order to prevent a crisis from occurring. The 
     block of instruction should consist of classroom instruction 
     and role-playing activities. The role-playing training would 
     be the most beneficial part of the training. It must be as 
     realistic as possible and should give students hands-on 
     experience on listening to soldiers, demonstrating compassion 
     and caring towards a subordinate's problem(s), and providing 
     reassurances that problems can be resolved.
       The next phase of the NCOES is the Basic Noncommissioned 
     Officer Course (BNCOC), which is specific to a sergeant's 
     MOS. The course is mandated for current or future staff 
     sergeants. The length of BNCOC varies by MOS, and is a live-
     in learning environment conducted in two phases: Phase I, 
     which is a review of blocks of instruction learned in the 
     WLC, and Phase II, which is MOS-specific. This course 
     provides opportunities to acquire the leader, technical, 
     tactical, values, attributes, skills, actions, and knowledge 
     required to lead a squad-sized element of nine soldiers. Like 
     the WLC, a thorough block of instruction should be 
     implemented regarding mental health and suicide prevention. 
     It should involve the same classroom instruction and role-
     playing activities learned in the WLC. Once again, proactive 
     and realistic role-playing would provide enhanced skills 
     designed to identify warning signs of suicide, tactics to 
     provide compassion towards the troubled soldier, and 
     necessary measures to immediately inform the squad leader's 
     NCO support channel and chain of command.
       Promotable staff sergeants or newly-promoted sergeants 
     first class must complete the Advanced Noncommissioned 
     Officer Course (ANCOC) in order to lead a platoon-sized 
     element. The course builds on the experiences gained in 
     previous operational assignments and training. It emphasizes 
     skills complementing commissioned officer counterparts. By 
     the time NCOs reach this level of education, they should have 
     adequate knowledge of mental health, soldier human nature, 
     warning signs of suicide, and tactics required to ensure 
     prevention measures are taken.
       The final phase of the NCOES is the Sergeants Major Academy 
     (USASMA). Noncommissioned officers (normally master 
     sergeants) attending the academy, are instructed on how to 
     implement policies, procedures, and training techniques and 
     tactics. They are the primary NCOs who would be responsible 
     for the oversight of suicide prevention training within the 
     NCOES. Sergeants major are instructed to oversee operations 
     within a battalion, brigade, division, or other element. 
     Command sergeants major oversee the training and operations 
     of all companies, battalions, brigades, divisions or other 
     higher elements, and serve as the enlisted advisor to 
     commanders of the aforementioned elements. Command sergeants 
     major are the NCOs most responsible for ensuring NCOs are 
     performing their duties properly and professionally. They 
     should mandate suicide prevention training be a part of 
     subordinate unit's training schedules. Suicide prevention 
     training should be conducted by chaplains, and/or 
     installation psychiatrists or psychologists. The same blocks 
     of instruction should be utilized during these training 
     sessions. My recommendation is that command sergeants major 
     mandate one day of training be conducted by each unit 
     quarterly during a fiscal year.


                west point and officer candidate school

       Specific curriculums pertaining to mental health and 
     suicide prevention must be implemented if they do not already 
     exist. Suicide prevention training for officers is extremely 
     important since they make final decisions as to how to handle 
     soldiers who are demonstrating warning signs of committing 
     suicide. More importantly, they must be prepared to initiate 
     investigations within their units that should reveal why a 
     soldier is contemplating suicide. Every unit has a safety 
     officer designated by the unit commander. Safety officers 
     must conduct thorough investigations as to why potential 
     crises arise, who may be responsible for misconduct, and

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     what measures must be taken in order to rectify the situation 
     without any harm done to anyone.


              the medic school at fort sam houston, texas

       On average, most Army companies have one medic per platoon. 
     Medics, MOS 91W, are enlisted soldiers normally supervised by 
     a medic NCO. Medics can be excellent counselors because many 
     soldiers potentially having a crisis situation often do not 
     feel comfortable talking about their problem(s) with their 
     leadership for fear of stigma. Therefore, any suicide 
     prevention training conducted at the Medical School at Fort 
     Sam Houston must be very thorough and specific. It should 
     involve the same blocks of instruction recommended within the 
     NCOES. It would be of great surprise to me if a thorough 
     block of instruction pertaining to crisis counseling and 
     suicide prevention did not exist at the Army Medical School. 
     Therefore, the United States Army Training and Doctrine 
     Command (TRADOC) should take any potential immediate action 
     to implement more crisis and suicide prevention training if 
     necessary.


              the uniform code of military justice (ucmj)

       I am very aware of some of the potential reasons as to why 
     soldiers resort to suicide. Whether they are experiencing 
     personal problems, are unable to tolerate military stress and 
     operational tempos, or are suffering from depression or any 
     other type of mental illness, soldiers caring for each other 
     are the best preventive measures. Based on my own personal 
     experiences while serving in the Army, I have seen several 
     young NCOs abuse their authority for their own personal 
     satisfaction. I have seen newly-promoted sergeants embarrass 
     subordinates in front of other soldiers just to demonstrate 
     they are in charge, and that any defiance will result in 
     repercussions. In my opinion, the failure to control 
     ``rogue,'' or immature and inexperienced leaders is a 
     significant and contributing factor in soldier suicides. 
     Therefore, more senior NCOs must closely supervise newly-
     promoted NCOs to ensure soldiers are being cared for and not 
     humiliated. As mentioned earlier, commanders should order 
     investigations be conducted if soldiers are being mistreated. 
     Not only can mistreatment of soldiers increase likelihoods of 
     suicides, they will most likely affect the overall morale and 
     cohesion of an entire unit. Therefore, I recommend commanders 
     adopt and enforce ``no tolerance policies'' for acts of 
     cruelty or maltreatment of subordinate soldiers by superior 
     NCOs. Such actions violate Article 93 of the UCMJ (Appendix 
     A). If complaints are made, and investigations reveal 
     misconduct has occurred, commanders should either exercise 
     their authority to discipline under Article 15 of the UCMJ 
     (non-judicial punishment), or to order discipline under 
     Article 32 for more serious offenses. However, soldiers must 
     also know and understand their right to file a complaint 
     against their commanding officer if he or she is performing 
     wrongful actions against a soldier. Article 138 of the UCMJ 
     (Appendix B) protects soldiers from wrongful disciplinary 
     action being exercised by a commanding officer. If a soldier 
     believes his or her commander is in violation of Article 138, 
     a soldier should have full right to consult with the next 
     highest commander within his or her chain of command. If no 
     action is taken by that individual, the soldier should seek 
     assistance from the post Inspector General (IG), or the post 
     Staff Judge Advocate. For example, many soldiers are being 
     separated under Chapter 14 of Army Regulation 635-200 
     (Appendix C) for acts of misconduct. However, these acts of 
     misconduct may stem from mental health problems such as PTSD. 
     Therefore, soldiers should exercise their rights under 
     Article 138 to request medical separations. Chapter 14 
     separations normally result in ``other than honorable 
     discharges.'' Such discharges often hinder a veteran's VA 
     health benefits upon separation. Soldiers who served in a 
     combat zone do not deserve such an act of injustice. Appendix 
     D outlines examples of service members separated for 
     misconduct. Another problem involves service members 
     separated for personality disorders. According to Army 
     Regulation 635-200, only a psychiatrist, or any other mental 
     health professional may make such a diagnosis. Based on my 
     experiences, commanders take such action to simply separate a 
     soldier as soon as possible. Separations under Army 
     Regulation 635-200 are performed much quicker than medical 
     evaluation board (MEB) proceedings. While stationed at Fort 
     Stewart, Georgia, I observed an NCO harass a subordinate on 
     several occasions. However, even though the NCO was not 
     properly performing his duties and abusing his authority, the 
     commander declared the soldier as ``substandard,'' and had 
     him transferred to another unit, alienating him from his 
     friends and his overall support network. He eventually 
     committed suicide shortly after the transfer. Such 
     aforementioned abuses by NCOs are examples of abuses of 
     authority. They cannot be tolerated. Even though an 
     individual committing suicide is committing a selfish act 
     that cannot be rectified, improper treatment of soldiers does 
     nothing to help the situation. A new clause must be added to 
     Article 93 of the UCMJ. Since females do not deserve to be 
     harassed sexually, or in any other manner, soldiers, 
     regardless of sex, do not deserve to be harassed or chastised 
     for being mentally ill. They deserve treatment. Therefore, I 
     recommend Article 93 be amended to emphasize that any forms 
     of stigma towards soldiers, regardless of rank, be a 
     violation of the article.


                    medical evaluation boards (meb)

       Medical evaluation board (MEB) proceedings should be 
     commenced for all soldiers demonstrating symptoms of mental 
     illness, regardless of the symptoms or the illness. An MEB 
     establishes a disability rating, and the soldier is separated 
     under honorably. Subsequently, he or she is able to obtain VA 
     medical care for a service-connected disability, and may 
     request disability percentage increases if his or her 
     condition worsens. If a psychiatrist diagnoses a soldier with 
     a ``personality disorder,'' the soldier should not be 
     separated under the provisions of Army Regulation 635-200 
     governing personality disorders. He or she shall be medically 
     separated with a disability rating.


                               conclusion

       As mentioned in the abstract, this correspondence involves 
     recommendations and proposals that may already have been 
     taken into consideration, or implemented within the Army. 
     This correspondence is not intended in any way to insult the 
     Army in any way. Its primary purpose is to attempt to assist 
     with the prevention of suicides within the Army, regardless 
     of whether soldiers are deployed or not. Too many soldiers 
     have taken their lives over the past few years for unknown 
     reasons. However, I have seen first hand soldiers take their 
     own lives due to failed leadership. It is time to be 
     proactive, and ensure more preventive measures are taken. 
     Soldiers are human beings, not super heroes. Hence, missions 
     cannot be completed without healthy soldiers on the front 
     lines.

                          ____________________