August 8, 2010

Army General Peter Chiarelli talked to Christiane Amanpour on 'This Week' today about the new task force charged with stopping the wave of army suicides. One of the ways he hopes will put an end to this epidemic of despair is by removing the stigma of asking for help:

AMANPOUR: General Chiarelli, thank you very much for joining us on THIS WEEK.
CHIARELLI: Well, it's great to be here.
AMANPOUR: One of the most extraordinary lines that I think I took away from the entire report was when it says, simply stated, we are often more dangerous to ourselves than the enemy. That is pretty stark.
CHIARELLI: Well, we have an army that's, for almost a decade, has been going very, very hard with our operational tempo; having our soldiers deployed for 12 months, home anywhere from 12 to 16 months, and back for another 12 or 15-month deployment.
AMANPOUR: It's too much.
CHIARELLI: Well -- and during that time, we've seen an increase with some soldiers, a very small number of soldiers, of high-risk behavior.
AMANPOUR: What do you mean by "high-risk behavior"?
CHIARELLI: Well the abuse of alcohol, drugs, getting in trouble with the law.
AMANPOUR: Is it just people who are predisposed to high-risk behavior or is it the -- the pressures of, as you said, these multiple deployments on such short turnaround?
CHIARELLI: Well, we definitely think, and we have some pretty good data to show, that deployment plays a role in the increase that we've seen. But at the same time, there's all kind of stressors in a soldier's life.
AMANPOUR: So let's talk about the particular problems. Let's talk about suicide-- so what did you notice about the suicide rate amongst the soldiers and those who are coming back?
CHIARELLI: Well, some of the things that we're seeing in suicides is 60 percent of our suicides take place(AUDIO GAP) with our soldiers who are in their first term of enlistment. Normally, it's six --
AMANPOUR: Sixty percent?
CHIARELLI: Sixty percent.
AMANPOUR: And most of those suicides are happening back home.
CHIARELLI: There are two-thirds that are occurring back home and about a third that are happening in theater.
AMANPOUR: Let me put up a statement that comes from the report. It says that there are instances where a leader's lack of soldier accountability resulted in suicide victims not being found until they have been dead for three or four weeks. And then it goes on to say that in an organization, the military, that prides itself on never leaving a soldier behind, this sobering example speaks to the leadership breakdown, the breakdown of leadership in a Garrison which appears to be worsening as the requirements of prolonged conflict slowly erode the essential attributes that have defined the Army for generations.
That's very serious language.
CHIARELLI: Well it is, and it needs to be serious cause we need to go back to doing things the way we used to do things.
AMANPOUR: But how does this happen? I mean, why aren't people looking at these young men? You've already mentioned that they are under extraordinary stress because of the redeployments in a much shorter period of time than is much generally called for.
CHIARELLI: Well, commanders --
AMANPOUR: So you know that they're at risk.
CHIARELLI: Commanders are getting ready to take their soldiers into harm's way. And let's say you have a soldier that has a minor problem with alcohol, gets stopped at a roadside spot check and blows just over the legal limit six weeks before deployment.
Now, this soldier has been downrange with you, done just a fantastic job in his last deployment and you're faced with either putting him into a drug and alcohol program or turning to the platoon sergeant and saying, listen, PFC. Chiarelli's a good soldier, let's do what we can. Let's forget this time.
AMANPOUR: So no accountability?
CHIARELLI: Well, I'm not saying no accountability --
AMANPOUR: Repeat offenders.
CHIARELLI: Well, that's how repeat offenders happen. He comes back from his next deployment, has a more serious issue with alcohol, no one knows about the first cause the leadership has changed out or he's moved to another unit, and we have this problem.
AMANPOUR: Can I ask you, because I want to sort of stop you when you say high-risk behavior. Obviously some of it is because of high-risk behavior, but there are parents who have told us that it's not just about high-risk behavior. Their children were absolutely fine until they went to the front over and over again. One mother said, that she's offended at how suicide victims are being stereotyped as reckless losers predisposed to engage high-risk behavior, her son didn't leave home that way.
You know, do you think that -- do you think that all of these people are simply predisposed to high-risk behavior?

CHIARELLI: Absolutely not. Absolutely not. What are soldiers are seeing downrange every day human beings shouldn't see at times, and we have problems with posttraumatic stress. We know we have soldiers who come back, and I like to call it a chemical injury that takes place because of the way their body reacts to some kind of event.
AMANPOUR: And yet, you know, I know, because I've reported on these soldiers, and you know because you've had to deal with them and take care of them that this still is an enormous stigma.
AMANPOUR: Let me put up something that President Obama said this week about this very issue. Listen.
(BEGIN CLIP)
OBAMA: To anyone who is struggling, don't suffer in silence. It's not a sign of weakness to reach out for support, it's a sign of strength. Your country needs you. We are here for you. We are here to help you stand tall. Don't give up.
(END CLIP)
AMANPOUR: So President Obama speaking to veterans earlier this week.
But the thing is, whose here? How many behavioral experts do you have? How many people do you need? How many do you actually have?
CHIARELLI: Well, I don't know if we know how many we need. We have a force that has been stressed after almost a decade of war. We're looking for new ways to be able to deliver behavior health, such as virtual behavior health where we literally bring up a network using the internet, using the network of doctors, say 200, from all over the United States who can, in fact, provide a good, good look at our soldiers when they return.
AMANPOUR: I've heard that perhaps you have a shortfall of hundreds of people who can actually provide this kind of help.
CHIARELLI: Well, we do have a shortage.
And if you want to get at stigma, you start with the brigade commander, brigade command sergeant major and work right down the chain of command so every soldier sees his leader going through the same checks that the soldier's going to go through.
AMANPOUR: I want to also have you listen to a young soldier in -- on the battlefield. Listen to this little clip for a moment.
(BEGIN CLIP)
MALE: You can't get a better high. It's like crack, you know? You can skydive or bungee jump or do kayak, what? Once you've been shot at, you really can't come down. There's nothing -- you can't top that.
QUESTION: Are you going to go back to the civilian world then?
MALE: I have no idea.
(END CLIP)

AMANPOUR: There it is.
CHIARELLI: Well, that's the kind of individual -- that individual needs that help that we've got to convince to get that help. And we've got to get leadership to be attuned to those kind of reactions.
AMANPOUR: What can leadership say to young soldiers, young servicemen and women who find themselves at the front and who have that reaction that there's no bigger high, that we cannot cope with civilian life once we come back.
CHIARELLI: Leaders need to lead, to know their soldiers, to look for those signs that they see that PFC. Chiarelli has changed. PFC. Chiarelli is going out and maybe drinking a little bit too much, showing up for work late, whatever it might be.
AMANPOUR: And just so that it's clear, it's not just suicides we're talking about, we're talking about crime, we're talking about rape, we're talking about addiction and dependence.
And for instance, one of the statements in the report, as we continue to wage war on several fronts, data would suggest we're becoming more dependent on pharmaceuticals to sustain the force. In fact, anecdotal information suggests that the force is becoming increasingly dependent on both legal and illegal drugs.
I mean, that's terrifying.

CHIARELLI: That's a concern. We know that we had over 10,600 soldiers last year who had a prescription of three weeks or more for some kind of antidepressant, anti-anxiety medicine.
AMANPOUR: Because I mean it sort of raises the specter of a significant number of people out there heavily armed, afraid, under fire, IEDs and drugs are sort of the motivating --
CHIARELLI: But but, we know that the drugs that we're talking about are cleared by the CENTCOM surgeon for soldiers to be taking when they're downrange. So we're not sending any soldier into harm's way who is taking a drug that we feel would somehow endanger him or others.
AMANPOUR: So now the big picture. Obviously, you've got this human drama. You mentioned already that they're being redeployed at much shorter intervals than many suggest are the correct intervals. For instance, some are saying that for a year in combat you have to have three years in Garrison, at home base. Are you able to do that?
CHIARELLI: That's our goal.
AMANPOUR: Are you able to?
CHIARELLI: No, we're not there yet, but we're going to see ourselves get further, what we call, into balance.
The first step for us is getting one year deployed, 24 months at home. That's our first step. We would like to get to one to three, which would be either nine months deployed, 27 months back home or 12 months deployed, 36 months back home.
We know when that happens many of the problems that we've seen will in fact meliorate themselves.
AMANPOUR: And how do you make sure you maintain your combat edge, as a military, as a force, and still have these appropriate cares for these people who are obviously coming back stressed and very fragile?
CHIARELLI: You need that time at home. A portion of those 106,000 soldiers that I told you are on some kind of pain medication, it has nothing to do with a behavior health issue.
There are soldiers who have been on two, three, four deployments, hucking a rucksack filled with equipment that may weigh 70 to 80 pounds at 8,000 feet and they've got a knee injury or a leg injury that is painful. Probably should stay home and get operated on, but they go back for the second deployment and they're on some kind of a pain medication. We have soldiers who suck it up all the time and hide from their leaders when they're hurt.
AMANPOUR: For their country.
CHIARELLI: That's exactly right. Who feel a tremendous need that we all do in the military -- to be with our buddies. That's what it's all about.
And that's one of the issues that we have to get through is we try to break down stigma. To get soldiers to understand that these hidden wounds of war are things that they've got to seek help for when they have problems.
AMANPOUR: General Peter Chiarelli, thank you very much indeed for joining us.
CHIARELLI: Thank you.

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