Aug 18, 2010

Insider: The DoD and Military Brass Don't Know and Don't Care about Suicide

- "[We understood the Iraq War] was going to be different, and that it was going to be house-to-house and urban combat. And that type of warfare requires a surge, if you will, and the ability to have mental- health-care treatment available, closer to the front, and also available when they come back home. The harder and uglier the war is, the more the psychological toll is on the human mind. In that meeting [in the spring of 2002], they [DoD staff and Dr. William Winkenwerder, then-Assistant Secretary of Defense for Health Affairs] looked at us as if we were people from outer space, wondering why we were there. They patted us on the back and told us they had everything under control, and they would be able to take care of any contingencies that might pop up. And that turned out not to be true.

"What does [Army Vice Chief of Staff Gen. Peter] Chiarelli not understand about combat? Soldiers engage in high-risk behavior on deployment. The report is written in such a way to blame the soldier, and not the leadership of the military for its part in not inculcating people so that they have resiliency and understand how to deal with stress; because there are not any real programs that train the force as a whole. Also, the leadership treats this problem as a lack of moral character, and a lack of intestinal fortitude, when it is really a medical issue. ...

"I had this conversation with a guy in the [Bush] White House, the liaison to the Department of Veterans Affairs. This was during the Bush Administration. He said, if we were to keep every promise that we made to the veterans, it would bankrupt us as a nation."
- Veterans' advocate, Steve Robinson, who has challenged the President and the Defense establishment face-to-face on their shameful neglect of the health problems, especially mental-health issues, faced by returning Iraq and Afghanistan War veterans. -

From EIR [Executive Intelligence Review]:

Aug. 12—On July 29, the Army released its “Health Promotion, Risk-Reduction and Suicide Prevention Report,” the result of a 15-month effort, directed by Army Vice Chief of Staff Gen. Peter Chiarelli. Chiarelli explained to reporters at the Pentagon that the investigation that produced the report was prompted by the fact that in January 2009, the suicide rate in the Army hit 20 per 100,000 population, exceeding the civilian rate of 19 per 100,000 for the first time.

In addition to suicide, the report addresses other indicators of stress on the force, including high-risk behaviors, such as substance abuse, and the number of soldiers who enter the mental-health system voluntarily as well as involuntarily. Then it lays out what Chiarelli described as a “campaign plan” to try to drive down the suicide rate, and includes more than 250 recommendations in an attempt to identify and mitigate the problems that stem from “nearly a decade of persistent conflict.”

To get an assessment of the report, EIR [Executive Intelligence Review] turned to veterans’ advocate Steve Robinson. Robinson retired from the Army in 2001, after a career serving in Ranger and Special Operations units. Upon retirement, he went into veterans advocacy, initially working on health issues arising from the 1991 Gulf War.1 He has since become a sought-after expert on the full range of veterans’ physical and mental-health issues that arise from exposure to combat, has testified numerous times before Congressional committees, and has advised the White House and the Department of Defense.

In the Spring of 2009, Robinson was told by the White House that they wanted him to take a position in the Department of Defense on the implementation of policy and programs for returning combat veterans and wounded warriors. Robinson waited nearly 18 months for the Senate to confirm retired Marine Maj. Gen. Clifford Stanley to be Undersecretary of Defense for Personnel and Readiness. After interviewing Robinson, Stanley said he wanted to hire him, but then Secretary of Defense Robert Gates issued a hiring freeze for all Office of the Secretary of Defense agencies, preventing Robinson from being hired. Robinson was interviewed by Carl Osgood, EIR’s Pentagon correspondent, on Aug. 4 and 12, 2010.

Carl Osgood: I want to start with the report that came out on July 29, the “Health Promotion, Risk-Reduction and Suicide-Prevention Report,” which General Chiarelli presented to reporters. Probably the best thing for me to do is just read a line from the introduction, and get your response to that.

You are, of course, well aware that the suicide rate and other symptoms of stress have been growing in the Army since 2004, and that there has always been an air of mystery about why this is happening—at least the way the Army talks about it. And they say in the introduction:
No one could have foreseen the impact of 9 years of war on our leaders and soldiers. As a result of the protracted and intense operational tempo, the Army has lost its former situational awareness, and understanding of good order and discipline within its ranks. This report’s comprehensive review exposes gaps in how we see, identify, engage, and mitigate high-risk soldiers.

Nobody Acted on What We Told Them

Robinson: Well, right off the bat, they are wrong, that no one could have foreseen it, or said anything about it, or even suspected that it might happen. Myself, and Rick Weidman [executive director of Vietnam Veterans of America], met with Dr. William Winkenwerder [then-Assistant Secretary of Defense for Health Affairs], I think in the Spring of 2002, as we knew that we were not only going to go to war, hunting down the guys that were responsible for 9/11, but that it also seemed like we were going to war in Iraq. And we understood that this war was going to be different, and that it was going to be house-to-house and urban combat. And that type of warfare requires a surge, if you will, and the ability to have mental- health-care treatment available, closer to the front, and also available when they come back home. The harder and uglier the war is, the more the psychological toll is on the human mind.

In that meeting, they looked at us as if we were people from outer space, wondering why we were there. They patted us on the back and told us they had everything under control, and they would be able to take care of any contingencies that might pop up. And that turned out not to be true.

So, we began to beat the drums at DoD [the Defense Department], the Secretary of the Army, and the Congress. On March 23, 2003, a few days after the invasion of Iraq, I testified to the House Armed Services Committee. In that hearing we brought up the issues of everything that eventually played out over
the years. . . .

At that time, we were concerned that . . . the stated reason we were going to war was biological warfare and chemical weapons, and during that hearing, I testified that 250,000 chemical warfare suits were known to be defective, and had been issued, and nobody could find them; and M8 chemicalagent alarms that were defective, and ridiculously false-alarmed in the first Gulf War, were the same M8 alarms that we were carrying into this war.

Everything just seemed wrong.

Everything that could be broke was still broke, and we laid out the issues all the way up through mental health. And even though both Rick and I, and others, felt like we were giving them what they needed to know to get ready, everybody looked at us like we were some kind of voodoo, crystal ball-gazing freaks, who didn’t know what we were talking about, and nobody acted on any of the information that we gave, not the Congress, not the Department of Defense. And everything that we said would happen, has happened.

Osgood: One of the things that Chiarelli talked about in his briefing to reporters was leadership in garrison. He said that one of the problems his task force had identified was that commanders were not addressing and responding to high-risk behavior by their soldiers, such as drunk driving, and this is one of the features of the report.

Robinson: What does Chiarelli not understand about combat? Soldiers engage in high-risk behavior on deployment. The report is written in such a way to blame the soldier, and not the leadership of the military for its part in not inculcating people so that they have resiliency and understand how to deal with stress; because there are not any real programs that train the force as a whole. Also, the leadership treats this problem as a lack of moral character, and a lack of intestinal fortitude, when it is really a medical issue.

If somebody lost their legs due to an IED [improvised explosive device], and the leader came, and said, “Get up! Get back to your job! Get back into the humvee!”: That is the same thing that they are actually doing to people with these mental-health injuries and traumatic brain injuries that you can’t see. They simply do not understand the medical side of what has happened to the human mind and body, and they are punishing people for having the symptoms of PTSD [posttraumatic
stress disorder] and traumatic brain injury. And when you do that, it’s the same as punishing an amputee for having lost his legs.

The military doesn’t even understand that the brain isn’t fully formed yet until people are about 24 years old. So, we are taking 18-year-olds, putting them through basic training, and giving them five, six years of combat; filling their brain with nothing but war and trauma and death and destruction, and then acting as if we are mystified when they have problems. Well, the science of the brain and body tells us that, during that time, the reasoning center of the brain isn’t fully formed, and so that means we have to be extra vigilant when veterans of that age come home, and make sure we can help them negotiate the experience of war, rather than leaving it up to them, or rolling the dice to figure who will and who won’t kill themselves.

That’s not speculation on my part. That is what we know about how the brain develops.

All I know is this: We don’t have any real programs that emphasize, in the same way that we emphasize, let’s say, for example, marksmanship, how the brain and body can be affected in war by witnessing people getting blown up. There is no military training that teaches you to be psychologically resilient to what happens in war.

They are just now beginning to think about it, eight, nine years after we’ve been telling them about it. But it does not surprise me. The suicide rate does not surprise me. We predicted it back in 2002, with Winkenwerder, that if we didn’t get some training before people went to war, that was reinforced while they were at war, and watch for red flags when they came home from war, that we were going to have a crisis on our hands. And we do. It’s here.

This War Is Different

Osgood: Now, the other thing that bothers me about this is the reluctance on the part of the Army to connect this to the war itself, to the demands of the war.

Robinson: [sarcastically] Well, it can’t be about the war, because war makes you stronger. The more you go to war, the stronger you get.

Let’s just take previous wars—the Gulf War, Panama, Somalia—the previous estimates—about 70% of people who serve are going to go [into combat], and it’s going to be a defining moment in their life... . Thirty some-odd percent come back and have problems—it owns them. They suffer from it.

This tour is different. We are already at a percentage rate where 45%, coming close to 50%, of the people who go to the VA [Department of Veterans Affairs health-care facilities], from Operation Iraq Freedom, Operation Enduring Freedom, are suffering from some form of mental-health-care issue. It could reach as high as 50%, or even higher. We don’t know. RAND did their report that estimated anywhere between 300,000 and 400,000 people, right now, are suffering from some form of mental-health issue, as a result of their service.

This war is different because there is no place to withdraw, to rest, refit, and recuperate. It is different because there is no defined enemy. It is different because of the use of the IED. It is different because the objectives, in many cases, are not clear and understandable, so you don’t know what you’re fighting for. If you take turf one day, and then give it back to the Taliban the next day, and five of your buddies died, you are going to have a problem with that.

Plus, we have been fighting it longer than any war in our history; and it is wearing down the less than 1% [of the population] that is doing all the fighting. So, of course, there is going to be a significant toll.

None of those things are revelations to me, but they appear to be revelations to General Chiarelli, where suddenly, he is having this epiphany, eight and a half years into the war, that we are having problems. We have been seeing these problems from the beginning; they are just getting worse.

Why did their report say that, basically, war wasn’t one of the factors in suicides? I don’t know. That is what bothers me the most about the report, which is one of the reasons why, when we heard they were forming this task force, I went to Sen. Kit Bond, and I said, “Look, Andrew Pogany [an Iraq War veteran, who was medically retired after a bad reaction to the malaria drug lariam, and who then became a strong veterans advocate] and myself have been very close to this issue.

If we don’t get somebody on to this task force to bring some truth to it; if all it is, is an internal DoD investigating DoD, then the summary that comes out of it is predictable, and they’re going to say that financial problems, relationship problems, lack of discipline, and soldiers not utilizing the services that are available, is the reason why people kill themselves.” And I’ll be goddamned if that isn’t exactly what they did!

And they blamed the soldier in their report. And it was an internal report, where no outside agencies, stakeholders, subject matter experts, or just plain old veteran advocates, like myself, were able to provide any input. And every time, over the course of the last four or five years, since Chiarelli has been in his position, and even before him, his predecessors, we have been sending cases to the Army, which demonstrate the Army’s failure, and almost the epidemiology of suicide in the making: showing them how failed leadership, lack of understanding of mental-health-care issues, lack of effective treatment programs, in essence, create a condition by which the service members kill themselves.

We are creating the problem! Because of the lack of training programs and emphasis on prevention. And they don’t want to hear that. And this report reflects it ... .

Osgood: In 2008, Barack Obama was running for President on the promise that all of this was going to change. In the beginning, after he took office, it even looked a little bit like it might, in part because of the appointment of General Shinseki to head the VA. Have things really begun to change? Or not?

Robinson: Well, there have been some improvements in the Department of Veterans Affairs. But there has also been a tremendous amount of missteps and political fumbling, because number one, the current Administration still, to this day, has unfilled vacancies, or they have left previous Administration officials in positions of responsibility and power, who have proved their incompetence—for example, Dr. Ira Katz [the VA’s top mental-health official]—and their lack of understanding of the issues that veterans face.

So, yes, there have been some improvements, some things that I am sure the veterans are appreciative of, but it baffles the mind to think that the Administration believes change will occur if they don’t clean house, and remove the entrenched bureaucrats, and policy wonks, who are gatekeepers to affecting that change. I don’t know why they haven’t moved them out, but they are still there, and they are, in fact, sabotaging Shinseki on several fronts. And there have been some political blunders that have occurred, because some of these entrenched bureaucrats—two and three levels below Shinseki—have made recommendations that
filtered their way up to the top; and because this Administration doesn’t have any historical perspective on the last 15 or 20 years of what happened in the VA—they ran with it. And those things have become political blunders.

The President Is Failing

Osgood: At the same time, the war policy, at least with regard to Afghanistan, continues. In fact, Obama has escalated the war.

Robinson: During the Bush Administration, when I started bringing these issues forward, and talking about what was and what was not happening for returning veterans, a couple of organizations, and even news outlets, tried to throw the label of anti-war veteran on me. And it didn’t stick because I have never been involved in the anti-war movement, and I have understood the nuance of the fact that there are real reasons to protect the interests of the United States, and sometimes those reasons cause us to send people with guns to go protect things that are important to us.

And certainly, the war in Iraq looked like a bad idea. It looked like, early on, that it was about oil; early on that it was about revenge; early on that it was about showing the Middle East that we could come kick somebody’s ass if we wanted to.

But the war in Afghanistan, hunting down bad guys and killing them, who plotted to do things against us, and had training camps, seemed like a good idea to me. However, with no clear objectivein mind, and the initial idea that, I think, we were nation-building and we were democracy-building, the mission in Afghanistan has turned into something else. And I am all about protecting America, and keeping bad guys from coming, and flying planes into buildings, but it appears to me that the mission of hunting al-Qaeda in Afghanistan is over. There ain’t that many of them there. And now, it’s not clear that we are democracy-building, because it doesn’t look like it’s going to look like anything that we want it to look like.

So, why is the President still fighting that war, and why is he continuing to support Afghanistan? Those are all questions that I can’t figure out. But I do know this:

If the President chooses to do it, and we are going to send people there, and we are going to surge into Afghanistan, then we have a responsibility to take care of those who come back from that war injured. And I’m not just talking about the amputees, and the people who get burned, and the people who get shot. I’m also talking about the psychological casualties of war, and on that front, we are failing. The President is failing. The Department of Defense is failing. The services individually are failing, and it’s harming not only the individual service member,

And for the first time, I believe he [Obama] said it—he said something that I’ve been saying for probably eight years: It harms our national defense. It harms our national security, in that, if we don’t keep our promises to the men and women that we send down range to go fight, at some point under the current system that we have, people will not sign up to protect the nation. And it becomes a national security issue.

Osgood: On this point, are veterans groups satisfied? They supported Obama for President, or many veterans groups did, but how do they view him now?

Robinson: Well, the veterans service organizations themselves are political creatures, for the most part. And they have political leanings. And those political
leanings are understood within the Beltway; and we know who the VFW is, we know who the American Legion is, and people don’t want to be put into those boxes.

But you can tell by the things that they do and don’t support, where they stand. I think veterans were frustrated with the Bush Administration, and when you looked at the possibility of getting more of the same with John McCain, and potentially his candidacy, veterans, and veteran services organizations, and others, I
think, chose Obama.

And Obama got elected because they believed that Obama was going to fix the things. He was talking about our issues. In fact, I, myself, and Paul Sullivan [executive director of Veterans for Common Sense], and others, some of our talking points that we sent to then-candidate Obama actually came out of his mouth on platform speeches around the United States: End homelessness. Zero tolerance for homelessness. Take care of the soldiers with PTSD and TBI [traumatic brain injury]. No inappropriately sending the guy with PTSD back into the war. A whole bunch of issues that we raised, and brought up to Obama, actually became platform issues that he ran his candidacy on.

So, the veterans service organizations liked that, and they sat back and watched. And now, we are 18-plus months into the Presidency of Barack Obama, and coming up on two years and something left to go, and people are starting to wonder, when are the campaign promises going to be kept?

Now there have been some improvements in the Department of Veterans Affairs, things that we can stand up and say, we’re glad that that was done. Many of them were initiatives that myself and Paul Sullivan and other people recommended, that actually came to fruition, like the lessening of the standards, the burden of requirement, to receive a PTSD diagnosis from the VA.

The GI bill, which was something that was accomplished by Iraq and Afghanistan Veterans of America, and others who fought for the GI bill for this generation. There have been some improvements. The suicide hotline we called for, and got.

What About the Veterans?

But, in the Department of Defense, the problems that we had in 2007, are the same problems that we have today—almost to a tee. In fact, I actually made a
list the other day: No oversight. No accountability in the Department of Defense as it relates to suicides, mental-health-care programs, and appropriate discharges. Bush appointees still in key positions of responsibility in the Department of Defense. Failed leaders, unfilled vacancies, and harmful policies in wounded warrior care. Service members being denied benefits. Service members with PTSD and TBI still being redeployed. Current models of mental-health care in DoD do not reflect state-of-the-art recovery models available. Suicide rate, continuing to climb. Lack of suicide prevention programs. No Congressional oversight. Multiple programs. No singular effort. No one person in charge. Wasteful spending. The DoD uses a system of care that ignores mental health, but applies the UCMJ [Uniform Code of Military Justice] to the symptoms of PTSD.

All those things were happening in 2007, and they are still happening today. And the veteran service organizations that sat on their hands for 18 months, are now
saying to themselves, okay, we gave you time; we’ve waited for you to address these issues. It doesn’t seem like you’re addressing them. The Congressional election cycle is coming up. You’re going to be calling on us and asking us for support.

What’s going on? How come these issues aren’t being addressed?

There was an emergency meeting just a couple of days ago, at the White House, a very hastily called-together veterans service organization meeting, in which they brought in 12 of the largest organizations, to basically reintroduce them to the people in the White House who are responsible for answering their questions. And the reason I believe this meeting came about, is because I made a phone call to a couple of people in the White House, saying that it’s my belief, and my sense, because of the circles that I walk in, that veterans service organizations, and veterans themselves, are going to start holding this Administration accountable for keeping its campaign promises. And that they are frustrated—it appears that veterans issues are not high on the priority list of things that the President has to deal with.

And listen: I get it. There is lots going on. There are oil wells spewing oil into the Gulf. There are two wars going on. There’s economic collapse. There is relationship-building between Palestinians and Israelis. There’s all kinds of stuff going on. But somehow, somewhere, somebody has made the calculation over the last 18 months, that veterans issues, and keeping those promises, aren’t as important as those other things. And it has agitated, I think, veterans, and the veterans service community, and I believe that we are going to see some rhetoric, which is already occurring, if you look at some of the different things that organizations are saying—we are going to see rhetoric, and pressure, to get the Administration to start answering the question of why these issues are not being solved.

I just saw it the other day. In the span of five days, the AFL-CIO raised hell about something that the Obama Administration was doing in reference to its ability to organize unions. And then, somebody made a phone call, to somebody, because, five days later, the AFL-CIO was announcing that it got $53 million to make sure that the Democrats get elected across the United States, and oh, by the way, today [Aug. 2] Obama is meeting with the AFL-CIO.

So, I don’t have $53 million to get the attention of this Administration. But apparently that’s how things work in this town. And so, the only thing we can do is make noise, and say that if you don’t keep your promises, we’re not going to vote for you.

Austerity: Everything Is on the Table

Osgood: There are a couple things going on in this Administration. The notion which underlies them is, a policy of austerity—that is, you had the health-care reform bill, which was passed earlier this year, which includes a panel called the Independent Payment Advisory Board, which will decide what kinds of health-care services will be paid for, and what kinds won’t. And you have the so-called Fiscal Deficit Commission, which is supposedly looking at the Federal deficit,
and discussing ways to slash government spending. I don’t believe that they have specifically mentioned veterans spending, but they say that everything is on the table.

And so, is there concern that this austerity drive will hit veterans, in the name of reducing costs, and reducing the deficit, and so forth?

Robinson: Well, it’s already happening in the Department of Defense. One of the reasons why I’m not working in the DoD today—according to the people that I have talked to in the White House—is because Secretary Gates announced a budget initiative, whereby offices would reduce their personal staff. I am not an economist, Carl, so I don’t know if what I’m going to say is right or wrong. But it seems to me that we are not going to be able to tackle all the problems we have in the DoD, if we simply cut budgets, reduce staff, reduce mental-health-care providers. It seems to me the problems are only going to get worse. And it bothers me that this Administration has suddenly become budget-conscious, at a time in which they are holding the purse string, but yet, on other issues, there are tremendous bailouts, and money being given to companies that have really gotten us into a lot of trouble.

So, the answer to your question is, I think it’s already happening. I think there are small, subtle signs that pay and benefits and health care, and all the things that we rely on, to get people to join the military, are up for grabs. And also how we honor them after they have served, looks to be in jeopardy.

But I had this conversation with a guy in the White House, the liaison to the Department of Veterans Affairs. This was during the Bush Administration. He said, if we were to keep every promise that we made to the veterans, it would bankrupt us as a nation.

And I said, if that’s true, if that’s why you’re not taking care of them now, and that’s why there are not enough mental-health-care providers, and that’s why you’re not addressing the suicide issue, and that’s why there are not effective treatment programs, then why don’t you tell the American people? Come out and say to the American people, guess what? It’s gotten so bad that we can’t keep our promises. And so if you join today, you may, or may not get programs and services to help you when you come back from war.

I would be much happier to have someone make that honest statement, than I am to hear you say, “Nothing’s too good for our veterans, and we will give them everything that they need,” and know that you won’t do it.

So, I believe those things are on the table. I have seen in the past, where veteran programs were exempt from across-the-board cuts, but I’m imagining that if
things are really as bad as everybody is saying they are, veterans, just like others, are going to be impacted. And if it does happen, then I would also like to hear from the Administration, that we can’t keep our promises. We are not going to be able to provide you the best health care. We are not going to be able to create these great rehabilitation programs, because of the cost of the war.

But, goddamn it, if that’s the reason behind it, if it’s never-ending war that’s creating the situation where we can’t take care of veterans, and keep our promises, then we ought to look at that too. And ask ourselves, what are we getting out of this deal? So, my rant on that.

Let me sum up. I think I’m not the only person out there who is articulating the sentiment that we are frustrated with the first 18 months of this Administration, and the pace at which it is tackling the issues that confront service members and veterans. And that there hasn’t been much change in the Department of Defense. It’s virtually the same as it was in 2005. And I think that there is a level of agitation among veterans service organizations, that is going to manifest into political action by those organizations, to hold leaders accountable—whether it be through the vote, or whether it be through activity on Capitol Hill, or activity in the press.

But that we can’t wait any longer.

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