Lawmakers hope to use an annual defense bill as a vehicle for mental-health screenings.
Jacob Sexton, a 21-year-old member of the National Guard, fatally shot himself inside an Indiana movie theater during a two-week leave from Afghanistan in 2009.
Sen. Joe Donnelly will unveil legislation Wednesday named after Sexton that would require service members to get an annual in-person mental-health assessment. Donnelly hopes it helps stop others from taking their own lives.
“This is about working nonstop with Jacob’s parents to prevent other families from experiencing that same pain,” the Indiana Democrat said in a video obtained by National Journal that will be released Wednesday.
Donnelly’s legislation, formally called the Jacob Sexton Military Suicide Prevention Act, follows the Pentagon’s latest suicide numbers released late last month. The report found a decrease in the number of reported suicides among active-duty troops, but an increase in reserve and Guard members killing themselves.
There were 319 suicides reported among active members in 2012, compared with 261 in 2013, according to preliminary data. But suicide within the ranks of reserves and National Guard members increased from 203 in 2012 to 213 last year.
And while suicide is historically underreported, the Pentagon says a total of 841 service members attempted suicide at least once in 2012.
Meanwhile, the number of service members who kill themselves after they leave the military has increased dramatically. The VA estimates that 22 veterans commit suicide each day, totaling about 8,030 veterans every year.
Many service members already have an annual mental-health screening, but Donnelly’s bill is aimed at closing the gaps for in-person assessments. For example, Air National Guard members currently have an annual online assessment, but face-to-face examinations take place only every five years.
Lawmakers and service organizations worry that the stigma attached to mental-health issues keeps service members—both past and present—from asking for help or reporting mental-health problems. Attempting suicide is currently considered a crime under the military’s rules.
“Right now, the best and most consistent screening is happening only for those within the deployment cycle, and it leaves reservists and Guardsmen like Jacob underserved,” Donnelly said.
In addition to the mental-health screenings, Donnelly wants an annual report from the Pentagon to the Armed Services committees detailing the screenings and what care or follow-up was recommended. The Defense Department would also have to submit a report on how to improve its response on mental-health issues. And a committee to improve mental-health services for National Guard and reserve troops would be formed with the Department of Health and Human Services.
Donnelly isn’t alone in his search for solutions. Lawmakers have introduced a handful of other proposals to address mental-health issues in the military. Some argue such measures could help prevent a shooting like the one at Fort Hood last month, when Ivan Lopez, a 34-year-old Army specialist, fatally shot three people and injured 16 others before turning the gun on himself.
Republican Rep. Glenn Thompson of Pennsylvania, Democratic Rep. Tim Ryan of Ohio, Republican Sen. Rob Portman of Ohio, and Democratic Sen. Jay Rockefeller of West Virginia have introduced the Medical Evaluation Parity for Service Members Act in their respective chambers. Instead of requiring annual in-person mental health screenings, the legislation would require screenings for military recruits and for reserve and National Guard forces that transfer to active duty.
Donnelly and other lawmakers hope to get their proposals included in the annual defense bill, the National Defense Authorization Act. The bill has been passed for the last 52 years, and it’s likely the best vehicle for avoiding partisan fighting. And Donnelly’s legislation will get early bipartisan support, with Mississippi Republican Sen. Roger Wicker expected to endorse the proposal.
Donnelly originally introduced a version of the bill last year, with a pilot program on mental health screenings instead of annual in-person screenings for all servicemembers. The Pentagon was required to submit a report with feedback on screening tools included in the program, as part of the last year’s defense bill.
The report—part of a bipartisan push spearheaded by Donnelly—also asked for an assessment of new tools that could be used to improve mental-health screenings and better identify suicide-risk factors for service members. Donnelly received the report in March, and used it to help craft his new legislation.
“There is not one solution, there’s no cure-all to prevent suicide. But this problem is not too big to solve. We can start by improving our methods of identifying risk factors before it is too late,” he said.
(Reuters) – Suicides among U.S. special operations forces, including elite Navy SEALs and Army Rangers, are at record levels, a U.S. military official said on Thursday, citing the effects of more than a decade of “hard combat.”
The number of special operations forces committing suicide has held at record highs for the past two years, said Admiral William McRaven, who leads the Special Operations Command.
“And this year, I am afraid, we are on path to break that,” he told a conference in Tampa. “My soldiers have been fighting now for 12, 13 years in hard combat. Hard combat. And anybody that has spent any time in this war has been changed by it. It’s that simple.”
It may take a year or more, he said, to assess the effects of sustained combat on special operations units, whose missions range from strikes on militants such as the 2011 SEAL raid that killed al Qaeda chief Osama bin Laden to assisting in humanitarian disasters.
He did not provide data on the suicide rate, which the U.S. military has been battling to lower. In 2012, for example, more active duty servicemen and servicewomen across the U.S. armed forces died by suicide – an estimated 350 – than died in combat, a U.S. defense official said.
That trend appears to have held in 2013 although preliminary data is showing a slight improvement, with 284 suicides among active duty forces in the year to December 15, the official added.
McRaven’s command, headquartered at MacDill Air Force Base in Tampa, oversees elite commandos operating in 84 countries.
The Army, Navy, Air Force and Marine Corps special operations commands comprise about 59,000 people, according to Pentagon documents.
Special operations forces have been lionized in popular culture in recent years, in movies such as “Zero Dark Thirty,” about the hunt for bin Laden, and “Act of Valor,” as well as a National Geographic special.
Kim Ruocco, who assists the survivors of military members who commit suicide, said members of the closely knit special operations community often fear that disclosing their symptoms will end their careers.
Additionally, the shrinking size of the U.S. armed forces has put additional pressure on soldiers, whose sense of community and self-identity is often closely tied to their military service, said Ruocco, director of suicide prevention programs for the Tragedy Assistance Program for Survivors, an advocacy group for military families.
near Patrol Base Boldak, Afghanistan, on July 30, 2013. BOBBY J. YARBROUGH/U.S. MARINES” src=”http://www.hiddenwounds.org/wp-content/uploads/2014/04/image-1-300×199.jpg” width=”300″ height=”199″ /> Staff Sgt. Javier Jimenez interacts with local Afghans as he tries to gather information about the movement of insurgents near Patrol Base Boldak, Afghanistan, on July 30, 2013. BOBBY J. YARBROUGH/U.S. MARINES
By Thomas Brennan
The Daily News, Jacksonville, N.C.
Published: April 8, 2014
It was a sensation that Marine Staff Sgt. Javier Jimenez could physically feel: the weight of life was literally crushing him.
“You start running out of air, the room starts getting smaller around you and your heart starts pounding,” Jimenez said, describing the “horrible” feeling that overwhelmed him. “You’re more hopeless than you have ever been before. You start worrying about the next day, wondering if you are going to make it there because all you want to do is die.”
For years, 34-year-old Jimenez, an infantry Marine who is currently transitioning to Wounded Warrior Battalion East, has dealt with thoughts of suicide as a means to escape his overwhelming anxiety. Diagnosed with psychosis, a mood disorder, post-traumatic stress disorder and an anxiety disorder, Jimenez said he is constantly battling the urge to end his own life. It won’t be by his own hand though, he said, and he’s never physically hurt himself. Instead, Jimenez engages in risky behavior that he said he hopes will result in an accident that kills him.
“Even in Afghanistan, I would walk in the open trying to get shot at,” he said. “I was putting myself in risky situations because I wouldn’t kill myself, but the whole time I wanted to die. I just want to be put out of my misery.”
His risky behavior in combat carried over to daily life, he said. Feeling as though he has no control over his life, Jimenez said living for tomorrow has become increasingly difficult with each passing day, especially now that he is not actively participating in infantry training.
“Fighting with yourself to live to the next day isn’t a way to live your life,” he said. “Sometimes you spend the whole day thinking about suicide — every single second. When you get out and put yourself in that risky situation, you feel a rush. It’s the only time you feel alive. Cutting it close is the only time you don’t want to die because you finally feel alive. Not wanting to die is a good feeling, and I try to feel it as much as possible.”
But he’s not without hope — or help.
He said the treatment he has received from mental health providers at Naval Hospital Camp Lejeune has been “outstanding” and helps him understand that things will get better with time and effort on his part. The infantry unit he is attached to, 2nd Battalion, 2nd Marines, has been fully supportive, recommending him for Wounded Warrior Battalion East so he can focus fully on his treatment.
“There’s a lot of help available when you’re debating suicide,” Jimenez said. “I know it feels like you’re stuck in a horrible place with no way out; but there is hope, and that’s one thing the groups and the doctors are showing me.”
Opening lines of communication
At the School of Infantry aboard Camp Geiger, both Marine and Navy leadership encourage Marines and sailors to attend an anonymous group where they can discuss the stresses of life, marriage, military service and more. The group, which meets weekly, is a safe haven for dozens of Marines aboard the installation to vent and discover they are not alone. Because the Marine or sailor’s leadership is not notified of their involvement in the group, many servicemembers have turned to the group, which also advocates for one-on-one treatment if the servicemember is interested.
“The program … was spearheaded about a year and a half ago when a need among our (Marines) was identified,” said Marine Col. Jeffrey Conner, the commanding officer of the School of Infantry. “Marines being Marines, they want to come to work and put their best foot forward and have their game face on … but when they have difficulty with that we give them the resources and support they need to do just that.”
The program is discussed both monthly and quarterly to identify trends and, if needed, request more resources for the Marines and sailors, he said. In conjunction with the program, he said, the unit’s Family Readiness Officer and chaplain help identify at-risk Marines and sailors and refer them to the program. The group, he said, allows for open communication among Marines and their leaders and also builds awareness on how to be cognizant of what your peers may be going through.
As the sergeant major of the Advanced Infantry Training Battalion, Daniel Wilson, 40, of Jacksonville said that some of the Marines within his battalion are stepping forward and asking for help, noting there is a receptive environment that allows for personal development through therapy without judgment or reprisal. Because AITB trains senior enlisted Marines, Wilson feels as though the open-door policy toward mental health will have a trickle-down effect within the Marine Corps and make others more accepting of those who ask for help.
“The reason they seek treatment may not even be combat related, it could just be stress,” Wilson said. “The Marine Corps has not written the book on managing post-traumatic stress … but we are doing everything we can to wrap our heads around it. … This is just one of the ways we are doing that.”
At both Marine Combat Training Battalion and Headquarters and Support Battalion, Sergeants Major Therester Cox and Christopher Garza said the message to Marines afraid of seeking treatment is that there is no stigma at the School of Infantry and they will not see any backlash for getting help.
“Get out, get help and don’t be afraid,” said Cox, 39, of Jacksonville. “To me, No. 1, everybody is a man or woman first. You’re important to somebody. … Now add to the fact that you are a United States Marine. It’s very important that Marines understand they need to get help because the Marine Corps is counting on you. You aren’t able to do anything for the Marine Corps if you aren’t taking care of yourself as an individual.”
The group is led by Navy Lt. Crystal Shelton, a clinical social worker who devotes her time between clinical appointments to interacting with the Marines and sailors as they train students, hoping to build awareness of resources and to minimize any stigma associated with mental health treatment, she said. The program is designed to be used for early intervention, she said, and it is also used to help people determine whether or not they are having a problem; but in order to help, someone needs to ask for it.
“Right here, what is happening is what other places are trying to model themselves on,” said Shelton, 38, of Jacksonville. “We’re trying to send the message that waiting (to get treatment) doesn’t help the situation. By waiting it usually makes things worse in their life. It you think there is an issue, come in and talk to someone. You don’t have to wait until you can’t do your job anymore.”
Navy chaplains, who are embedded within Marine units, often find Marines and sailors confiding in them when things in life aren’t going as planned. Trained to non-clinically identify symptoms of suicide, post-traumatic stress and other ailments, chaplains have access to resources they can make available to Marines such as counseling, retreats and more.
For Navy Cmdr. Marc Massie, 43, of Camp Lejeune, the best part of being a chaplain is that he can assist servicemembers with any problem and it will be kept 100-percent confidential. Chaplains are bound by law to maintain confidentiality regardless of the topic discussed even if the servicemember confesses homicidal, suicidal or fratricidal intents.
“Confidentiality means that it doesn’t matter what a servicemember says to a chaplain, it will not be repeated to anyone else,” said Massie, the station command chaplain for New River Air Station. “The reason the military does this is because it gives the servicemembers a safe place to go. The doctors, nurses and MCCS are great, but they are not 100-percent confidential.”
Whether real or imaginary, many Marines and sailors have fears that asking for help will ruin their career, he said, and part of what chaplains do is try to break down those walls and make it OK to talk. If someone were to walk in his office and confess that they were suicidal, which has happened in the past, Massie said that a chaplain will do whatever it takes to get the servicemember whatever assistance they need before they leave their office and even offer to go with them.
Sometimes, according to Massie, going to talk to a counselor can be a scary thing, especially when a Marine or sailor must tell their command they will be attending therapy. Massie said he has assisted many servicemembers in telling their command that they will be attending therapy and doesn’t allow the command to poke and prod, which often times makes the servicemember uncomfortable.
“I’ve counseled atheists, Wiccans and every other denomination,” Massie said. “It doesn’t matter if you even believe in a religion. We come at things with a human approach and just talk to people. We become a friend with them and check in on them from time to time to make sure they’re doing OK.”
It’s one more example of letting troops know that they’re not alone.
“I think most Marines would be surprised if they knew how many of their peers has asked for help,” Massie said. “It’s not as uncommon as people may think.”
Just ask Jimenez, the staff sergeant working to find his way back.
“There are people going through the same thing,” he said. “I feel alone but I know I’m not alone. That really helps when you’re fighting your own battle.”
By SARAH A. M. FORD
Kutztown University of Pennsylvania
Did soldiers of the American Civil War suffer from post-traumatic stress disorder and other psychological disorders? It has only been several decades since mental illness attributed to war conditions was clinically recognized. Recent research has shown a strong positive correlation between war time events such as witnessing the death of comrades, friendly fire or IED explosions and post-traumatic stress disorder.1 With a conflict as devastating as the American Civil War, it would be logical to hypothesize that Civil War soldiers were subjected to events that put them at risk similar to today’s soldiers. There is a strong relationship between attributing events during the Civil War and psychological affects; for instance revolutionary weaponry developments, medical procedures, psychological warfare, and hand to hand combat could have invoked psychological ailments. Data compiled from diaries and letters will affirm the presence of psychological disorders in soldiers who fought in the war. From this body of evidence, it is clear that soldiers of the American Civil War did indeed suffer from post-traumatic stress disorder and other psychological disorders.
Soldiers facing death, 1861
Photo: Library of Congress
The most common disorder that results from exposure to combat is called post-traumatic stress disorder or more commonly known as PTSD. According to the Diagnostic and Statistical Manual of Mental Disorders, there are several categories of symptoms for PTSD. The symptoms include the experience of actual harm or threats to be harmed physically and or emotionally, intrusive symptoms that include flashbacks, disturbing dreams or memories, negative changes in cognition, the avoidance of stimuli associated with the event and changes in arousal levels. In order for there to be a diagnosis, symptoms must be present for over a month and the level of stress has to be significant enough where everyday activities are negatively affected.2
Another common and relatively novel disorder is Traumatic Brain Injury (TBI). This is a neurological disorder that inhibits cognitive functioning as a result of an injury to the head. Symptoms include moderate to severe amnesia, headaches, changes in personality and accumulating more sleep than normal.3 This disorder is becoming widely recognized and diagnosed more frequently in veterans today. Over 30 percent of all casualties in Operation Iraqi Freedom (OIF) and Enduring Freedom (EF) were associated with the head or neck area.4 As many as ten to twenty percent of OIF/EF veterans have been diagnosed with TBI.5 It is plausible to assume that Civil War soldiers, who were not provided helmets, would have suffered from TBI if they experienced in injury to the head or neck region. General Anxiety Disorder and Depression are both common psychological disorders that plague many veterans today. Soldiers who experience traumatic events, such as the death of a comrade or innocent civilians, may experience depression as a result. It is logical that countless men of the Civil War era may have suffered from depression or general anxiety disorder.
The first mentions of symptoms correlated with PTSD dates back three thousand years ago; four thousand years before it would be clinically recognized. Ancient Egyptian Hieroglyphics depicted the emotions and fears soldiers felt while in combat. The Greek historian Herodotus wrote, in 480 B.C, of a Spartan soldier who was taken off the front lines due to his trembling and later took his own life in shame.6 In the seventeenth century any disorder associated with depression or changes in personality was termed melancholy or nostalgia. Symptoms similar to PTSD were called Soldier’s Heart and Da Costa Syndrome during the mid and late nineteenth century.7 The catalyst for the recognition of PTSD was the outbreak of World War One. The Great War had some of the worst casualties in human history as a result of revolutionary weaponry that redefined warfare. The psychological effects of this war were often seen in the returning veterans as many experienced involuntary ticks and shook unaccountably.8 This later would be termed Shell Shock.
While not to the extent of the First World War, The Civil War had revolutionary weapon and technological developments that negatively affected soldiers physically and mentally. This included the Minie Ball, a cylinder shape bullet that was more aerodynamic, making it more precise and effective. Instead of a round bullet that would break the bone, the Minie Ball would completely shatter it.9 Another technological development that changed the world as well as warfare was the railroad. For the first time in human history, mankind would not have to rely on horses or their own two feet to transport them. This drastically changed warfare by allowing supplies and troops to move into the most remote areas at record speeds. This meant that more soldiers were exposed to significantly more carnage than past wars. A soldier was no longer confined to a specific geographical location allowing them to fight in more battles. Witnessing this novel amount of gore would have been a severe trauma that could have produced anxiety and other psychological symptoms associated with PTSD.
Wounded soldiers in a Union hospital
Photo of Library of Congress
The Civil War is unique in that it took place during a time of great weaponry and technological developments but it was only decades shy of medical advancements that could have saved countless lives. Disease rather than bullets proved to be a significant factor in the death toll of the Civil War. For every one death in combat, there were two deaths caused by disease. The lifesaving technique of sterilization was a foreign concept to Civil War physicians and as a result thousands of soldiers succumbed to infections.10 The omnipresence of decay and death of thousands of sick men only added to the carnage witnessed not only by soldiers but nurses and doctors. On a daily basis, medical teams witnessed horrific wounds, ghastly amputations and men succumbing to their injuries and illnesses. Procedures and surgeries performed by army surgeons and physicians also left Civil War veterans literally scarred for life. The survival rate for a man going into surgery was roughly eighty percent depending on the location of the wound. The fatality rate was directly related to the proximity of the injury to the core of the body.11 Anesthetics, like ether and chloroform, were used for many surgeries which made the procedures much more humane.Though the fear of having to endure surgery invoked great anxiety, the fear of life after surgery was an even greater anxiety to face.
In a society that relied on physical labor for maintaining a livelihood, living without a limb meant a lifetime of unemployment. Farmers, mill workers, railroad workers or dock workers were all required to be physically able to complete the tasks required of them. An amputee could not continue working in the physical labor market. To make matters worse, majority of the men who fought in the Civil War were from lower economic classes. The socioeconomic status of an amputee would have been lowest amongst the ranks partly because there would be very few jobs that could accommodate their special needs. The anticipation of failure to provide for themselves and their families conjured major stress and anxiety.
The biological needs of humans are crucial for both physical and mental health. If humans are bereaved of biological necessities then they are at greater risk of psychological ailments. In war, especially the American Civil War, even the most basic of human essentials, such as food, water and shelter, are unavailable to soldiers putting them at an elevated risk of psychological danger.
Food supplies were frequently limited and insufficient for the amount of calories a soldier would expel. The water was often contaminated with germs making soldiers sick. Septic water is especially dangerous because it carries many diseases like cholera and dysentery. A diary entry by Union soldier Henry Tisdale implies that he got sick from drinking the water at his camp “Unwell today for diarrhea, causing me to feel weak. Think it caused by drinking too much of the aqueduct water we have here.”12 Not only were the soldiers on alert for enemy attacks but also had to worry if their next drink or meal was going to make them ill. Due to the insufficient and inadequate food and water, many soldiers did not have the caloric intake needed to support straining activities. Union soldier Cornelius Platter wrote “3 mile to our right and went into camp 8 mile South East of Jonesboro at 8 oclock — This has been the hardest days march we have had. Distance marched 22 mile.”13 A malnourished soldier would have had difficulties executing long endurance orders like this and would have been pushed to the brink of exhaustion. On top of malnutrition, each soldier was subjected to the weather and its unforgiving nature. Evolutionary instinct would be to seek shelter from the elements, but this cannot be done in war. Joseph Waddell from the Indiana Volunteer Division wrote “Off early and marched to Black River a hard rain late in the evening two men killed on the road with lightning.”14 Soldiers had very little protection, which would have affected their sense of safety. With unavailable resources and basic needs going unmet, these men were at an elevated risk of developing psychological disorders.
Arguably one of the most intense contributing factors to psychological effects and disorders were the prisoner of war (P.O.W) camps. Some of the most detestable incidences in the war occurred inside these camps. Psychologically, people are put in situations with numerous traumas, such as ubiquitous death, fighting and abuse, making P.O.W camps a minefield for psychological disorders. Camps like Salisbury, Libby, Douglas and the most notorious Andersonville were overpopulated and did not have proper supplies for the number of prisoners it contained. At one point, Andersonville detained thirty-two thousand men but the original capacity was for only ten thousand men. When Sherman’s soldiers liberated Andersonville, they found some prisoners completely emaciated. At the end of the war when supplies were scarce, rations were withheld. “No rations issued yesterday to any of the prisoners and a third of all here are on the very point of starvation…” Prisoners would fight, even kill, other prisoners for whatever they might have in their possession that could aid in their survival. “Have just seen a big fight among the prisoners; just like so many snarly dogs, cross and peevish.” The fight to survive in hellish places like Andersonville, Libby, Salisbury and Douglas was exceedingly stressful. Witnessing the intense trauma of death on a daily basis was more than enough to produce PTSD.
A unique factor of the Civil War was that units were very often created by geographical location. A town’s entire male population, brothers, friends and neighbors, would fight together. A Union soldier from Michigan found the body of his best friend who was shot and killed. During the chaos of battle, the soldier kneeled down to clear the blood off his friend’s face, while bullets and shells exploded around him. He had lost his sense of urgency and experienced heightened arousal level, which put him in physical danger. This is an example of a soldier’s psychological state putting them at physical risk. This psychological state would be even more compromised when a soldier fought their own kin. The famous motto of the Civil War was Brothers Fighting Brothers. Families were torn apart by this war as brothers would often fight on opposing sides. James and Alex Campbell were two brothers who fought on opposing side. When war broke out, James went to the Confederate Army with the Union Light Infantry also called the 42nd Highlanders and Alex went to the Union 79th Highlander Regiment. At the Battle of Secessionville in eighteen sixty-two, the two brothers were fighting against each other. Not only would losing the support system of a family member be stressful but the thought of intentionally killing a relative would be a severe psychological trauma that could generate PTSD.
Psychological warfare has been a vital part of combat for thousands of years. Biblical writings of Gideon portrayed of soldiers blowing horns, let out a fierce cry and breaking objects as a result the Mindianite soldiers were so beside themselves with fear that they committed suicide. (Judges 7:1-22) The Civil War was no stranger to these psychological tactics. The phrase “Rebel Yell” originates from the Civil War and was a weapon used to instill fear in the Union soldiers. Similar to the battle cries of the Native Americans, Confederate soldiers would yell, shout or chant certain phrases or noises to invoke fear in their enemies and many times it did its job. The sounds were described anywhere from Indian wooping noises to the shrieks of a wild animal and these yells implored great fear into the Federal soldiers. “….the Union troops were startled by the most hideous of modern war cries, known as the ‘rebel yell’…This was the first time the Vermont boys had heard that fiendish sound, and it is not too much to say that they were appalled by it for a moment, and thought their time had come to be ‘wiped out.” Fear is a great weapon in combat; unfortunately this great weapon is lethal to a soldier’s psyche.
Witnessing an event is just as catastrophic to the psyche as being a victim of a trauma. Many soldiers did not have to experience combat to receive the full effect of war. Thomas Smiley, a confederate soldier, described the horrifying event that he witnessed at the Battle of Chancellorsville to his aunt. “The large brick house at Chancellorsville took fire and burnt up with about two hundred wounded Yankees who were so badly hurt that they could not move and their own soldiers did not help them any. Later in the day the woods took fire and a great many more helpless men perished.”15 At the battle of Seven Pines, a Confederate soldier was horrified not by fighting but from what he heard on that day. The soldier, lying wounded on the ground, described the cries and screams for help from the Union soldiers as they lay in the ditches too wounded to move. A heavy rain came and the water had accumulated in the ditches and the wounded men were slowly starting to drown.16 Stories like this would find their way back to the small towns and cities, terrifying the men who were eligible for enlistment or conscription. Joseph Waddell wrote of a young man who was sobbing because he was called up by the draft. “I heard a sound of lamentation…. A negro woman informed me that it was a soldier crying because he had to go to the war!… Several men and women stood in the street, some laughing and others denouncing the recruit”.17 Severe anxiety plagued the prospective soldiers as the news of the bloodshed and atrocious fighting trickled from the battlefield to home.
The amount of hand to hand combat in the Civil War left soldiers particularly vulnerable to PTSD, depression or any battery of psychological illnesses. This is the last major American war and one of the last major wars in the world to significantly utilize hand to hand combat. After the twentieth century, the technologies gained in World War One, such as planes, bombs and machine guns, did most of the heavy labor. While linear warfare was the fighting style of choice in the Civil War, almost every battle had some form of hand to hand combat . Union Naval Officer William Ferguson testified to Major-General Hurlbut as to what he witnessed when he arrived at Fort Pillow after the massacre “[There were] Bodies with gaping wounds, some bayoneted through the eyes, some with skulls beaten through, others with hideous wounds as if their bowels had been ripped open with bowie-knives…”18 This archaic style of fighting is tremendously personal and has exceedingly negative effects on a person’s psyche. To defeat the enemy, one must look into their eyes and take their life. Hand to hand combat is arguably one of the leading causes in the development of PTSD.
The evidence of psychological effects and disorders as a result of combat is clearly illustrated in the suicides of the soldiers. Numerous soldiers took their own lives rather than live to see another fight. Many men wrote home telling their loved ones about the unfortunate souls that would rather die by their own hand then fight for a chance of survival. Jacob Stouffer wrote about his friend Absolam Shetter saying, “he had been in trouble and at times in a State of despondency-this with the troubles and Excitements around us-deranged his mind and on yesterday morning ended his existence by hanging.” Newell Gleason, a lieutenant colonel, was described as a fearless leader but had experienced nervousness and anxiety after the Atlanta Campaign. Gleason had difficulty sleeping and battled with depression. In eighteen eighty-six, Gleason committed suicide as a result of his time spent in the Union Army. A majority of the suicide victims were Confederate veterans. Besides the fact that they lost the war, the South lost twenty percent of its population. Families were torn apart by this war. Fathers and mothers lost sons, brothers lost brothers and wives lost husbands. The men that were lucky enough returned from war found their homes and lands destroyed. They lost everything. The war and its surrounding events could have thrown the soldiers into a depressive state leading to psychological ailments.
Understanding events and conditions that contribute to PTSD and psychological disorders help to create a mental picture of the soldier’s experiences. These events are correlated to psychological disorders but neither confirm or deny a conclusion. Examining individual soldiers provides insight into the effects of the war. It also makes the connection personal and the event feel real instead of words on a paper. The next three case studies are the smoking gun evidence that there were indeed psychological disorders as a result of the Civil War. More importantly, they were all real people who were once very much alive and they were all victims of something far greater than themselves.
Albert Frank was a soldier in the Union Army. At the Battle of Bermuda Hundred near Richmond, Frank was off the front line and sitting on top of a trench. He offered a drink from his canteen to a fellow soldier sitting next to him. While the soldier was taking his drink, a shell exploded and decapitated the man, covering Frank with blood and pieces of brain. Frank experienced a complete loss of cognitive functioning being unable to speak, communicate or understand his fellow soldiers. He was later found on the floor shaking and making bomb noises. The only thing he would say was “Frank is killed.”19 He was taken to the Government Hospital for the Insane in Washington D.C and declared mentally insane. Witnessing such an intense trauma had affected Frank greatly. He was re-experiencing and reenacting the event and he associated himself to the trauma in a negative way saying he was the one killed. These are indicators of post-traumatic stress disorder.
Angelo Crapsey from Potter County, Pennsylvania eagerly enlisted in the Union army in 1861. Early in his military career, a sergeant in his unit committed suicide by placing his rifle between his knees and putting the muzzle in his mouth. This event would have a profound impact on Crapsey. As Crapsey started to engage in combat, his glorified perception of war began to fade away. “Rebels charged on us & we had to run, run for [our] lives…through an open field & we had showers of bullets sent after us.”
Crapsey became more withdrawn and the radiant spirit he possessed prior to the war disappeared. At the Battle of Fredericksburg Crapsey was taken prisoner and he spent time in at Libby Prison. While contained, Crapsey developed a case of lice infestation and frequently tried to rid himself of the pest even after they had subsided. After his release he fought at the bloodiest battle of the Civil War, Gettysburg. Upon his discharged, he returned back home to Pennsylvania were he experienced illusions, involuntary ticks and violent fits. On August 4, 1864, Crapsey said he was going out to hunt but instead stuck a gun in his mouth and shot himself; the same way the sergeant had done three years prior. Major General Thomas Kane said that he “loved no one of his men more than Angelo. He came up to his ideal of the youthful patriot, a heroic American soldier.” Crapsey embodied the image of the ideal soldier and possessed a luminous spirit that was contagious. Unfortunately, he lost himself in the tremendous force that was the Civil War.
Just like the soldiers in the Great War, Angelo had experienced involuntary ticks and violent fits. World War One soldier’s ticks and fit were attributed to constant bombardment at battles like Verdun and Somme. Angelo fought at Gettysburg, the sight of the largest artillery bombardment in North American History. While the bombs never physically harmed him, they drove him to insanity. Angelo experienced a change in personality, diminished personal relationships, a loss of previous interest, flashbacks, disturbing memories, negative emotions and he associated the negative trauma to himself which created a sense of self hatred. It got to the point where Angelo could not find a way out of his own prison and the only solution was death. Angelo displayed numerous symptoms of post-traumatic stress disorder.
Did soldiers in the American Civil War suffer from psychological effects and disorders? Through revolutionary weaponry developments, horrific medical procedures, psychological warfare, and the great deal of ferocious hand to hand combat, there appears to be a great deal of evidence for psychological effects in civil war soldiers. The Crapsey, Minor and Frank case studies provide significant evidence of psychological disorders as a result of Civil War combat. With this body of evidence the question can be definitively answered; psychological disorders are present in soldiers of the Civil War as a result of combat and or its attributing factors. Without a shadow of a doubt the Civil War psychologically scarred and damaged its soldiers. Those brave men put their “sacrifices upon the altar of freedom” and endured a fate worse than death by living their lives in silent suffering. The presence of psychological effects and disorders are evident in the soldiers of the American Civil War.
Sgt. Martin Scahill and his wife Genevieve Scahill are pictured in this family photograph. (Courtesy of Genevieve Scahill)
By: Brett Kelman and Drew Schmenner
The (Palm Springs, Calif.) Desert Sun
As the sun rose over the sleepy desert town of Yucca Valley, Sgt. Martin Francis Scahill stood in his backyard, a black 12-gauge shotgun pressed against his chin, a single shell in the chamber.
After contemplating suicide for months, Scahill pulled the trigger. His body fell backwards onto the ground, the shotgun landing between his legs.
It was 6:30 a.m., April 5, 2010, the day after Easter Sunday. Blood seeped into the sand.
Forty-five minutes later, two deputies from the San Bernardino County Sheriff’s Department rang the doorbell at the Scahill home, waking his wife, who was asleep on the couch. Together, they found the body in the backyard. Scahill’s belongings were scattered around his bedroom.
A laptop was left open, lingering on an image of his infant daughter, Emma. A gun box was open with a revolver inside, unloaded. A box of shotgun shells sat on a nightstand, one shell missing. A notepad rested on the bed, covered with messages his wife scribbled during an argument the night before.
“I loved you.”
“I want to separate.”
Scahill, 25, was a man desperate for help he could not find. Alcohol abuse had strained his marriage and threatened his job, but he continued to drink, bragging about downing 18 beers or a half-gallon of whiskey every night. Scahill’s family had a history of suicide, but when he threatened to take his own life he was never taken seriously.
Five weeks after Scahill shot himself, a military investigation of his suicide would contradict itself, reporting that the Marine’s death was both unsurprising and yet impossible to foresee.
The investigation report, which was partially redacted by the military, said Scahill did not demonstrate any suicidal warning signs before his death, and that any indications of his intentions were either “too subtle” or “masked by his morose sense of humor.”
However, the same report said that Scahill’s suicide did not come as a shock to his immediate family. To them, suicide was “not a matter of if, but when,” the report said.
Scahill is one of at least 16 service members — 15 Marines, and one sailor — who committed suicide from 2007 to 2012 while at the Marine Corps Air Ground Combat Center in Twentynine Palms. That tally does not include one Marine from the Combat Center who killed himself while deployed to Iraq in 2008.
The military has not yet released base-specific suicide data from 2013. A Combat Center spokesman said he could not confirm how many Marines had killed themselves at the base last year because he could not speak for the multiple battalions that operate at the base.
Even with incomplete statistics, suicide is the second leading cause of death for Marines in this desert, with a death toll surpassed only by vehicle deaths, according to a yearlong investigation by The Desert Sun. The dual crises of crashes and suicide are compounded by alcohol abuse, and together, speed, depression and booze make the peaceful deserts of Southern California as dangerous as a war zone.
Since 2007, there have been 60 combat deaths of Twentynine Palms service members. During the same time period, at least 64 Marines and sailors have died non-hostile deaths while either stationed or training at the Twentynine Palms base.
The Desert Sun investigation found that, although Marines at Twentynine Palms are no more likely to take their own lives than Marines at other bases, they are twice as likely to be under the influence of alcohol at the time of their suicide. About half of the Marines who killed themselves while at the Twentynine Palms Combat Center had used alcohol, according to a review of reports from police, coroners and the military. Throughout the entire Marine Corps, only about one-quarter of suicides are confirmed to be alcohol-related.
From 2007 to 2012, both the Twentynine Palms Combat Center and the Marine Corps as a whole averaged an annual suicide rate of 19 deaths per 100,000 troops. According to the American Association of Suicidology, the overall U.S. suicide rate is about 12 deaths per 100,000 people. This rate doesn’t statistically compare to the Marine Corps because 95 percent of Marines are men, who are four times more likely to commit suicide than women. The Marine Corps argues that if the civilian suicide rate is adjusted for Marine demographics, it would equal 22 deaths per 100,000.
Pvt. Kythe Yund is pictured with his wife, Stephanie, in this family photo. (Courtesy of Karin Varner)
A growing crisis
The military first recognized its suicide crisis in the mid- to late 1990s, when each military branch launched its own prevention programs. In 1999, the U.S. Department of Defense created the Suicide Prevention and Risk Reduction Committee, which formalized how suicides and suicide attempts were reported.
Despite the creation of prevention programs, the rate of military suicide rose over the next decade, climbing from 10.3 suicides per 100,000 military members in 2001 to 18.03 suicides per 100,000 military members in 2011.
In 2010, suicide supplanted transportation accidents as the leading cause of non-combat death in the military, according to a 2012 Armed Forces Health Surveillance Center report.
In 2012, military suicides reached a record 351, surpassing the number of troops who died in Afghanistan that year. Forty-eight of those deaths were Marines.
Another 45 Marines killed themselves in 2013.
Both former Secretary of Defense Leon Panetta and current Secretary of Defense Chuck Hagel have said that military suicides are among the most frustrating problems they’ve encountered. Panetta said in 2012 that military suicides were on the rise “despite increased efforts and attention” from both the defense department and the Department of Veterans Affairs. Last year, Hagel stressed that suicide prevention programs are so critical that they should be immune to wide-sweeping military budget cuts.
The Marine Corps operates a host of initiatives as part of its suicide prevention program, and base services include counselors, medical personnel and a 24-hour suicide helpline. In 2009, the Marines started annual suicide prevention training for non-commissioned officers, called “Never Leave a Marine Behind.” In 2011, the training expanded to include all Marines. In 2012, a new order required every battalion and squadron to appoint a suicide prevention officer.
But the existing efforts aren’t enough, according to the Department of Defense Suicide Prevention Task Force, a group of experts that spent two years studying suicide in the military. In 2010, a task force report found suicide prevention efforts were hampered by a troubling lack of communication on military bases. Commanders, clinicians and counselors weren’t talking about Marines who were at risk of suicide, and when they did talk, their conversations were stymied by medical privacy laws, which were often “misunderstood and over-interpreted,” the report said.
A year after the task force report was released, the Marine Corps launched its Force Preservation Council program on every base, encouraging battalion leaders and social support officials to share information about Marines who may be suicidal. In Twentynine Palms, the councils meet monthly.
“If there are Marines who are facing challenges in their lives, there are people that may have pockets of information,” said Lt. Col. Michael A. Bowers, commanding officer of the base’s headquarters battalion. “We want to make sure that everyone does have that information … and there are no gaps in what we know.”
One year after the council formed, the Marine Corps expanded its reach, launching a mandatory mentoring program at all bases, including in Twentynine Palms. Under this program, each Marine is required to meet monthly with a mentor — like a platoon commander or sergeant — to discuss life in the Marine Corps. Mentors use these meetings to look for six signs of trouble: disciplinary problems, relationship turmoil, substance abuse, money problems, mental health and social withdrawal.
If a mentor decides that one of his Marines is struggling, he can send the case up the chain of command, where battalion commanders use the council to connect with support services. Bowers believes the program is effective if Marines know the aim of the council and mentors is preventive, not punitive.
“They know they’re not going to the principal’s office to get scolded,” he said. “They actually know there are a lot of professional people caring about them and trying to get them back on track.”
The Marine Corps launched an in-depth study of suicide victims after the task force in 2010 said the military makes an admirable effort to record deaths, but not enough to understand suicide. Currently, suicide data is compiled into the Department of Defense Suicide Event Report (DoDSER), but the report offers only a superficial understanding of the suicide crisis.
“It’s inadequate on a whole bunch of levels,” said Dr. Alan Berman, a member of the suicide prevention task force. “Most profoundly, methodologically, (the DoDSER) relies on a single interview, oftentimes with somebody who didn’t observe the decedent in the days prior to death.”
Berman is executive director of the American Association of Suicidology, the organization hired to examine how Marines who committed suicide acted during their final days and weeks. They hope to discover a common “trajectory toward death” and early warning signs that could save others, Berman said.
The organization has begun psychological autopsies of Marines who died of suicide from 2010 to 2012. The results of the study should be out in May or June, Berman said.
Tragic end to the spiral
One of the Marines in the study is Pvt. Kythe K. Yund, a Twentynine Palms Marine who shot himself in Joshua Tree on June 17, 2011, the day before his 22nd birthday. Researchers from the American Association of Suicidology interviewed Yund’s mother, Karin Varner, for 90 minutes, starting the examination with Yund’s childhood.
“If it helps save another parent from losing their child,” Varner said, “I will do whatever it takes to even just help one family not have to go through it.”
Yund was a quiet child whose parents divorced when he was 3. There was a history of suicide on his father’s side of the family, and when Yund was in high school, he attempted to kill himself by overdosing on painkillers at his father’s home in Washington, his mother said.
This suicide attempt should have disqualified Yund from military enlistment, so it is unclear how he managed to join the Marines. A recent Harvard University study suggests that recruitment screening is far from perfect. About half of Army soldiers who attempt suicide while in the service admit to prior attempts before they enlisted, the study said.
Yund enlisted in the Marines Corps in November 2007, then was assigned to the 1st Battalion, 7th Marine Regiment in Twentynine Palms as a rifleman. While deployed to Iraq in 2009, Yund witnessed one of his friends die from a gunshot to the head. He returned home early from Iraq because his wife, Stephanie, almost died after giving birth to their daughter, Kyndel.
Stephanie lapsed into a coma and suffered short-term memory loss after gaining consciousness.
Back home, Yund drank heavily and abused drugs. He was punished for using cocaine, demoted from lance corporal to private. Unnerved by Yund’s behavior, his wife returned to her home in Illinois with Kyndel. The couple eventually started divorce proceedings.
On the day Yund killed himself, he was scheduled to meet with his superiors about another disciplinary matter, which could have led to another demotion. Varner believes the shame of another punishment, and the embarrassment it may have caused his wife and daughter, triggered her son’s suicide.
On a Friday about 5:42 a.m., Yund shot himself with a 12-gauge shotgun in his bedroom.
His roommates told police that Yund had spent the night before at home, drinking a little, but did not seem upset. At the time of his death, Yund’s blood-alcohol content was .03.
Varner spoke to her son for the last time five days beforehand. He called her on the phone, sounding more relaxed and hopeful. He was leaving the Marine Corps in about a month, and was anxious to move to Illinois to try to reconcile with his wife.
Yund also asked his mother to research counseling options in Illinois. He wanted help, but had avoided counseling in the Marine Corps after his fellow Marines mocked him.
“Some of the other mothers I’ve talked to have gone through the same thing with their child,” Varner said. “They would go ask for help through the Army, Marine Corps, whatever, and their child would be ostracized later because of it, so that’s why a lot of them didn’t go seek help.”
This refrain is common for family members of suicide victims, said Kim Ruocco, manager of suicide outreach for the Tragedy Assistance Program For Survivors (TAPS), a Virginia group that helps the family members of deceased military members.
If the military truly wants to combat suicide within its ranks, it must destigmatize counseling and prioritize the importance of mental health, Ruocco said.
“If you were sprayed by poisonous gas, you wouldn’t expect to just suck it up,” Ruocco said. “If you broke your leg … you wouldn’t expect to just keep going until it was infected. You’d get immediate, comprehensive care and get back on the battlefield. That’s the way we’ve got to start thinking about behavioral health.”
Ruocco said it is especially hard to reach out to Marines, a proud group tied close to the rough and tough identity of the Marine Corps. She speaks from experience — her husband, Maj. John Ruocco, an accomplished Marine helicopter pilot, killed himself in 2005.
John Ruocco had battled depression since the mid-1990s, when two helicopters collided during a training exercise, killing several of his friends. A memorial service was held for the fallen men, but within Ruocco’s squadron, discussion of the crash was taboo. He suffered in silence for a decade, eventually hanging himself in a hotel room near Camp Pendleton, a Marine base in San Diego County.
“When it happened to me, when my husband died by suicide, I remember saying: ‘I didn’t even see it coming,’ ” Ruocco said. “But then as I got over the shock and the grief, and I looked back, I thought ‘Wow there were many times within his life span and his career where he had trauma or loss. … We should have gotten help way back when. I think pretty much every survivor I’ve talked to says that.”
A rattled mind
After five months together, Cpl. Richard McShan and his girlfriend were struggling with trust. It was the evening of March 29, 2009, and they had each had a few drinks at a bowling alley in Twentynine Palms. Sometime after midnight, when they returned to her apartment on Bagley Street, she caught him snooping through her text messages.
McShan apologized, but she demanded he leave. The Marine went outside to load his clothes into his car, prepared to leave, at least for the night.
“You can’t forgive me, can you?” McShan asked.
“Not right now,” his girlfriend said.
Furious, she stormed back inside, leaving the Marine alone in the driveway, standing between their cars.
Seconds later, she heard the gunshots.
McShan had pressed a 40-caliber handgun against the right-rear of his skull, squeezing the trigger twice. He fell backwards, somehow still alive, the gun clattering onto the ground near his feet.
An ambulance rushed McShan to the Hi-Desert Medical Center in Joshua Tree, where he was hooked to a ventilator. Two hours later, as the sun rose, a helicopter flew the comatose Marine to Desert Regional Medical Center in Palm Springs. Doctors there said McShan had no hope of recovery.
Two days later, at the request of his family, medical staff turned off McShan’s ventilator, letting him slip away. He was pronounced dead at 2 a.m. on April 1, 2009.
McShan, 23, the son of a 20-year Army veteran, was born in Germany but grew up in Colorado Springs, playing trumpet and football at his high school. He joined the Marine Corps shortly after graduation, Sept. 11, 2005. He was stationed in Twentynine Palms with the 2nd Battalion, 7th Marine Regiment, deploying once each to Iraq and Afghanistan.
McShan came back from those deployments haunted by nightmares, his girlfriend told authorities. She also said that McShan had told her he had attempted to shoot himself once before, but was saved when the gun misfired.
But to Paul McShan, the father of yet another dead Marine, this suicide didn’t compute. His son Ricky had been a happy young man, brimming with competitive spirit, who loved being a Marine.
There had to be more to this story, the grieving father thought.
“I started digging and digging and digging, trying to find out why,” Paul McShan said. “We discovered that he had at least four concussions and one where he was blown out the top of a Humvee. His shoulder was dislocated and he was knocked out for three or four minutes. So my conclusion after all that digging was that his brain short-circuited.”
This theory is backed up by a growing body of evidence. In recent years, scientists have discovered a strong link between concussions and suicide, a possible explanation for the disconcertingly high suicide rate in the military.
In 2013, a study released by the National Center for Veterans Studies at the University of Utah said that military personnel were significantly more likely to report suicidal thoughts if they had suffered at least one traumatic brain injury. The study surveyed 161 service members, many of whom had been injured in Iraq.
Of the service members who had not suffered brain injuries, zero percent reported suicidal thoughts, the study said. Of those who suffered one, 7 percent reported suicidal thoughts. Of those who suffered more than one brain injury, 22 percent reported suicidal thoughts.
“Up to now, no one has been able to say if multiple (traumatic brain injuries), which are common among combat veterans, are associated with higher suicide risk or not,” said Craig J. Bryan, assistant professor of psychology at the University of Utah, who led the study. “This study suggests they are …”
Researchers believe that concussions and brain injury increase the likelihood of suicide through a neurodegenerative disease called chronic traumatic encephalopathy, or “CTE.” Symptoms of CTE include irritability, memory loss, dementia and suicidal tendencies.
In 2012, a study from the Boston University found evidence of CTE in the brains of four military veterans, each with a history of traumatic brain disorder. Three of the veterans had been exposed to explosions during deployment. The fourth, a 28-year-old with post traumatic stress disorder, had suffered four concussions caused by a bicycle accident, a football collision, a military incident and a vehicle accident. Two years after his last concussion, the veteran committed suicide by shooting himself.
According to the study, the veterans’ brains were indistinguishable from those of many professional football players, a group that has been studied more extensively, showing a strong link between head injuries, CTE and suicide. The Boston researchers have found CTE in the brains of dozens of football players, both at the college and professional levels, including some that have killed themselves.
Brain injuries also double the odds that military service members will develop post traumatic stress disorder, which further increases the risk of suicide. A new study, published in December, examined 1,648 Marines and sailors that had recently returned from deployment. About half of them were stationed in Twentynine Palms, said Dr. Dewleen Baker, a psychiatrist at a Veterans Affairs center in San Diego who co-authored the study.
Baker said the study has established a strong link between brain injuries and PTSD, but researchers still don’t understand how one causes the other. It is possible that both brain injuries and PTSD spring from similar traumatic events, like bomb blasts, but also possible that concussive injuries make it more difficult for the brain to recover from emotional hardship, Baker said.
Either way, links to PTSD and CTE have uncovered the true long-term danger of brain injuries, a field of study that was once ignored. High-tech imaging can be used to visualize brain injuries better than ever before, and with the right tools, researchers can even “see” PTSD, a once-hidden condition now revealed as over-activity of the amygdala, a portion of the brain that deals with excitement and fear.
Today, brain injuries stand on a precipice where other conditions have stood before, ready and waiting to be better understood, Baker said.
“My analogy is that in the ’40s and ’50s, we didn’t really understand heart attacks,” Baker said. “Nobody understood the details, and so there was a lot of treatment that didn’t happen when someone had a heart attack. They would put people in a room and have them rest and hope they got better. But when we began to research and image the heart, and find ways to test the heart, we found many ways to fix and prevent the damage. And now we are in the early stage of this kind of understanding in regard to head injuries.”
Alcohol abuse in the ranks
Of the 15 Marines who killed themselves while at Twentynine Palms from 2007 to 2012, seven, or 46 percent, had alcohol in their system. That’s nearly double the percentage reported throughout the Marine Corps, according to a four-year average compiled from DoDSER statistics.
As suicide rates have climbed in the military, so has drinking. From 1998 to 2008, the share of service members who were binge drinkers increased from 35 to 47 percent, and the number of heavy drinkers rose from 15 to 20 percent, according to a 2012 report from the Institute of Medicine, a nongovernmental agency under the National Academy of Sciences. Binge drinking and heavy drinking were more prevalent in the Marine Corps than other military branches.
In December 2012, the Marine Corps launched a random alcohol screening program, becoming the first military branch to do so. The rules were also the strictest: Twice a year, Marines must be given Breathalyzer tests while on duty, and they can be referred to substance abuse counseling at even the slightest hint of alcohol. Commanders can send a Marine to counseling if they have a blood-alcohol content of .01 — which could be triggered by a single beer. If the Marine has a blood alcohol content of .04, their fitness for duty can be challenged.
Since October, more than 1,000 Marines from the Twentynine Palms Combat Center’s headquarters battalion have been screened for alcohol while on duty. Only one was sent to substance abuse counseling after testing positive, said Capt. Justin Smith, a base spokesman. Smith said he could not release results for the other battalions at the base.
If an alcohol screening program like this had existed just two years earlier, it might have saved Sgt. Scahill, the Marine who shot himself in his backyard in Yucca Valley.
At the time of his death, Scahill had a blood alcohol content of .08. It is unclear if he drank that morning or was still drunk from the night before, but neither would have been out of character for Scahill, whose long battle with alcohol predated his job and his marriage.
Back in 2007, after returning from his second deployment to Iraq, Scahill confessed to drinking 18 beers a night during a post-deployment health assessment. Scahill repeated this admission to medical personnel at least four more times over the next year, according to a military investigation.
Although Scahill had reported “excessive drinking,” he was never required to go to substance abuse counseling. Because he had not been involved in an “alcohol-related incident” during his service, he was never obligated to get help for his problem, according to the investigation.
Scahill’s drinking continued after he married his wife in November 2008, immediately after returning from his third deployment to Iraq. In 2009, Scahill joined the tank battalion at Twentynine Palms, where his alcohol abuse was no secret. According to interviews with fellow Marines, included in the military investigation, Scahill would drink excessively during his off-duty hours, drinking exclusively for the purpose of getting blackout drunk. He frequently came to work hung over or smelling of alcohol, and showed up for work drunk at least twice, according to the report. His fellow Marines hid his abuse from his superiors, trying to protect his career while ultimately enabling his addiction.
Scahill’s drinking was a problem at home, too. On the day before his suicide, Scahill got in a drunken argument with his wife, Genevieve, who accused him of texting an ex-girlfriend. By the evening, Scahill was so drunk that his wife refused to allow him to hold their 11-month old daughter. Furious, Genevieve slept on the couch.
Early the following morning, she woke up her husband, sending him to physical training at the Marine base. Before he left, she told him she was tired of his drinking and wanted to go to her mother’s house in Los Angeles. It was an empty threat.
Scahill left for training but returned soon after, insisting that physical training had been canceled. As he walked into their daughter’s room, Genevieve fell back asleep.
The gunshot didn’t wake her.
“I still blame myself a little bit. I wish I had seen the signs,” Genevieve said during an interview with The Desert Sun. “I wish I would have gotten off of that couch and followed him.”
Although Scahill didn’t leave a suicide note, he did send a text message to some of his fellow Marines, perhaps a final cry for help.
“Hey man, I’m not coming to work today,” the text said, according to a military investigation report. “I’m going to blow my f—ing brains out.”
Another Marine, who assumed Scahill was joking, wrote back: “GTG,” military slang for “good to go.”
The message prompted a commanding officer to call police, sending the deputies to Scahill’s door.
Genevieve said her husband’s suicide first came as a shock, but in hindsight, the clues of his looming death were everywhere.
Both Scahill’s father and grandmother had killed themselves. Scahill had once told his wife that his father told him the only good way to commit suicide was to shoot yourself in the head.
One night, when Genevieve was pregnant, a drunken Scahill said he sometimes heard a voice that told him he was no good and that people would be better off without him. He denied it the following morning.
Later, only a few weeks before he died, Scahill showed off two guns to some of his friends. Upset at their rowdy behavior, Genevieve confronted them, telling her husband to put the guns away. He responded by pulling the trigger on an unloaded shotgun, saying, “You don’t care what I do?”
Scahill bought that shotgun — which he would later use to kill himself — about two months before his death. According to the military investigation report, Scahill would joke to his fellow Marines that he might accidentally shoot himself while cleaning the gun.
In January 2010, while attending a suicide prevention course at the Marine base, Scahill protested, insisting that “if someone is going to do it, they’re going to do it.”
Scahill had the numbers “5150” tattooed on his right forearm — a reference to the section of California law that deals with people with mental health issues who are a threat to themselves or others. Scahill had confirmed the meaning of the tattoo during chats with other Marines.
Finally, the most terrifying clue was also the most cryptic. After Scahill was gone, his wife found one of his books, arrows drawn in the corners of the pages. At first, the scribbling seemed undecipherable. However, when she flipped through the pages with her thumb, she discovered the drawings were a flip book, a rudimentary cartoon where stick figures played out a gruesome suicide scene.
Genevieve had seen this before. It was the same scene she and deputies had found in the backyard.
“The stick figure man was him waving goodbye to everybody. He took a gun, he put it under his chin,” Genevieve said. “The cartoon was everything exactly what I saw. He followed the cartoon.”
Out on a mission one day in northern Iraq in 2009, a convoy of gun trucks grinds through rising dust. In the turret of the lead truck, Spc. Andrew O’Brien, 21, crouches behind his .50-caliber machine gun. His job: to watch for IEDs, improvised explosive devices. He swivels anxiously to watch the passing landscape for the deadly bombs hidden in trash bags, squashed cartons, dog carcasses, maybe that discarded truck tire.
From up ahead, another convoy approaches: U.S. military police in heavily armored vehicles known as MRAPS, supposedly invulnerable to bomb blasts. As they squeeze past, O’Brien and the gunner in the lead MRAP rotate their guns away from each other. Anonymous under their helmets, goggles and dust scarves, they nod to each other in a silent salute.
Not long after, they hear a ka-rump and there goes the slow-rising column of black smoke. O’Brien knows that other convoy got hit.
Back at Forward Operating Base Summerall that evening, O’Brien and his crew are lined up for formation. They cast sideways glances at a wrecked MRAP, the one whose gunner had nodded to O’Brien. A bomb dangling from a tree had detonated into the gunner’s hatch. What’s left of the MRAP is partially covered with a tarpaulin, and the sergeant is telling O’Brien and his guys not to look under that tarp; it’s off-limits.
He couldn’t help himself. Until then, the war had seemed almost distant. He wanted to know the worst. That could have been his truck, his guys. He thought seeing the worst would make him hyper-aware, help him spot IEDs and keep his own crew safe. After formation, he snuck around and lifted the tarp and peered inside. The wreckage hadn’t yet been cleaned of human remains.
O’Brien, now 25, is a lean, good-looking young man; his chiseled features and quick grin give little hint of the torment that moment created, of the nightmares that crushed his spirit and drove him toward suicide. “It was the worst thing I’d ever seen in my life,” he told me.
Andrew O’Brien, second from right, seen here with his fellow soldiers in Iraq.
His outfit, the 3rd Brigade Combat Team, 25th Infantry Division, went home to Schofield Barracks in Hawaii that spring and the nightmares that had begun in Iraq followed him. Inside the wrecked MRAP he would see the bodies of his crew, guys he’d grown as close to as brothers. “It was like the worst thing you experienced in your whole life, happening over and over again, every night,” he said. “It became exhausting.”
Guilt, shame and anger boiled inside him. He felt guilty for disobeying his sergeant’s order not to look at the wrecked MRAP, ashamed that he had damaged himself and ended up diagnosed with post-traumatic stress disorder. “I hated civilians because they didn’t know what I’d been through and … you just come back angry at the whole world,” he said.
Back then, he felt he couldn’t talk to anyone about what was going on, not even to an Army psychiatrist. “I felt I was alone,” he said. “I thought everybody else was fine and I was just the weak guy who couldn’t handle it.”
So in November 2010, just over a year after returning from Iraq, he went home, scooped up four bottles of prescription pills and washed them all down with a few beers. Then he went around punching holes in the walls with his fists. “All of a sudden I felt the pills kicking in and felt myself dying and quickly realized I had made a mistake,” he wrote later in a post online. His consciousness fading, he shakily dialed 911.
When he woke up in intensive care, his older brother, a soldier who’d served in Afghanistan for 15 months, was on the phone. “He told me how much he loved me. He said, ‘Why didn’t you tell me?’ I said, ‘You’ve seen much worse, I don’t have a right to feel this way.'”
His brother’s answer, O’Brien said, “changed my whole life. I was hearing it from another veteran. He said that the worst thing you saw was the worst thing you saw, you don’t need to compare that to anybody else. You should be proud of what you did.”
After he was released, O’Brien felt he had an entirely new perspective on PTSD, suicide and how to handle emotional turmoil. He asked the base chaplain if he could brief soldiers, in order to pass on what he’d learned. “The suicide briefings we had were a joke — guys would just be laughing,” he explained. “I wanted to show them like it really was.” But the answer was no.
O’Brien soon left the Army when his contract ran out on Feb. 13, 2011, and for two years he bounced around, working at this and that, unsure of what he wanted to do with his life. Then he happened to see the latest statistics on military suicides, and his idea of briefings hardened into resolve, and then a plan.
Unofficially, on his own, he began arranging to speak with groups of soldiers, parents, veterans — anybody — about PTSD and suicide, telling them what he’d learned about navigating the tricky and sometimes dangerous transition from the battlefield to civilian America. These talks turned into a national campaign to spread his message: If you are suffering from war trauma, you are not alone. And it’s not a sign of weakness to get help.
In his brother’s words, the worst thing you saw was the worst thing you saw.
“I am a suicide survivor from PTSD and I am not embarrassed by it,” O’Brien says in a video posted on his website. Suicide “is hard to talk about. But it needs to be talked about. By me not being embarrassed by it and sharing my suicide attempt, I am helping other servicemen and women understand that it’s okay to be affected by the war. It is war and it comes with being in war.”
He backs up to explain. “Soldiers go through three transformations: The first is becoming a soldier, which is easy — they break you down and build you back up. The second is coming back from war and trying to become the person you were before.” That’s where people can get stuck, he said, short of the third transformation: “Realizing that’s not gonna happen and you have to be the person you are now.”
Everywhere he speaks with troops — most recently in August at Hawaii’s Schofield Barracks, where he attempted suicide almost three years ago — he says he meets people who admit that they, too, have gotten stuck and considered or even attempted suicide but were reluctant to get help.
“This stigma, this thought that if you have PTSD you are weak, the thought if you have issues you are weak,” O’Brien says, “that is what is killing our troops.”
This article is part of a special Huffington Post series, “Invisible Casualties,” in which we shine a spotlight on suicide-prevention efforts within the military. As part of the series, The Huffington Post contacted military service members and veterans who have considered suicide to learn what saved them from that irrevocable step.
Times photographer Luis Sinco made James Blake Miller an emblem of the war. The image would change both of their lives and connect them in ways neither imagined.
The young marine lighted a cigarette and let it dangle. White smoke wafted around his helmet. His face was smeared with war paint. Blood trickled from his right ear and the bridge of his nose.
Momentarily deafened by cannon blasts, he didn’t know the shooting had stopped. He stared at the sunrise.
His expression caught my eye. To me, it said: terrified, exhausted and glad just to be alive. I recognized that look because that’s how I felt too.
I raised my camera and snapped a few shots.
With the click of a shutter, Marine Lance Cpl. James Blake Miller, a country boy from Kentucky, became an emblem of the war in Iraq. The resulting image would change two lives — his and mine.
I was embedded with Charlie Company of the 1st Battalion, 8th Marine Regiment, as it entered Fallouja, an insurgent stronghold in Iraq’s Sunni Triangle, on Nov. 8, 2004. We encountered heavy fire almost immediately. We were pinned down all night at a traffic circle, where a 6-inch curb offered the only protection.
I hunkered down in the gutter that endless night, praying for daylight, trying hard to make myself small. A cold rain came down. I cursed the Marines’ illumination flares that wafted slowly earthward, making us wait an eternity for darkness to return.
At dawn, the gunfire and explosions subsided. A white phosphorus artillery round burst overhead, showering blazing-hot tendrils. We came across three insurgents lying in the street, two of them dead, their blood mixing with rainwater.
The third, a wiry Arab youth, tried to mouth a few words. All I could think was: “Buddy, you’re already dead.”
We rounded a corner and again came under heavy fire, forcing us to scramble for cover. I ran behind a Marine as we crossed the street, the bullets ricocheting at our feet.
Gunfire poured down, and it seemed incredible that no one was hit. A pair of tanks rumbled down the road to shield us. The Marines kicked open the door of a house, and we all piled in.
Miller and other Marines took positions on the rooftop; I set up my satellite phone to transmit photos. But as I worked downstairs in the kitchen, a deep rumble almost blew the room apart.
Two cannon rounds had slammed into a nearby house. Miller, the platoon’s radioman, had called in the tanks, pinpointed the targets and shouted “Fire!”
I ran to the roof and saw smoldering ruins across a large vacant lot. Beneath a heap of bricks, men lay dead or dying. I sat down and collected my wits. Miller propped himself against a wall and lighted his cigarette. I transmitted the picture that night. Power in Fallouja had been cut in advance of the assault, forcing me to be judicious with my batteries. I considered not even sending Miller’s picture, thinking my editors would prefer images of fierce combat.
The photo of Miller was the last of 11 that I sent that day.
On the second day of the battle, I called my wife by satellite phone to tell her I was OK. She told me my photo had ended up on the front page of more than 150 newspapers. Dan Rather had gushed over it on the evening news. Friends and family had called her to say they had seen the photo — my photo.
Soon, my editors called and asked me to find the “Marlboro Marine” for a follow-up story. Who was this brave young hero? Women wanted to marry him. Mothers wanted to know whether he was their son.
I didn’t even know his name. Shell-shocked and exhausted, I had simply identified Miller as “A Marine” and clicked “send.”
I found Miller four days later in an auditorium after a dangerous dash across an open parade ground in the city’s civic center. Miller’s unit was taking a break, eating military rations.
Clean-shaven and without war paint, Miller, 20, looked much younger than the battle-stressed warrior in the picture — young enough to be my son.
He was cooperative, but he was embarrassed about the photo’s impact back home.
Once our story identified him, the national fascination grew stronger. People shipped care packages, making sure Miller had more than enough smokes. President Bush sent cigars, candy and memorabilia from the White House.
Then Maj. Gen. Richard F. Natonski, head of the 1st Marine Division, made a special trip to see the Marlboro Marine.
I was in the forward command center, which by then featured a large blowup of the photo. “You might want to see this,” an officer said, nudging me to follow.
To talk to Miller, Natonski had to weave between earthen berms, run through bombed-out buildings and make a mad sprint across a wide street to avoid sniper fire before diving into a shattered storefront.
“Miller, get your ass up here,” a first sergeant barked on the radio.
Miller had no idea what was going on as he ran through the rubble. He snapped to attention when he saw the general.
Natonski shook Miller’s hand. Americans had “connected” with his photo, the general said, and nobody wanted to see him wounded or dead.
“We can have you home tomorrow,” he said.
Miller hesitated, then shook his head. He did not want to leave his buddies behind. “It just wasn’t right,” he told me later.
The tall, lanky general towered over the grunt. “Your father raised one hell of a young man,” he said, looking Miller in the eye. They said goodbye, and Natonski scrambled back to the command post.
For his loyalty, Miller was rewarded with horror. The assault on Fallouja raged on, leaving nearly 100 Americans dead and 450 wounded. The bodies of some 1,200 insurgents littered the streets.
As the fighting dragged on for a month, the story fell off the front page. I joined the exodus of journalists heading home or moving to the next story.
More than a year and a half would pass before I saw Miller again.
Back home, I immersed myself in other assignments, trying to put Fallouja behind me. Yet not a day went by that I didn’t think about Miller and what we experienced in Iraq.
National Public Radio interviewed me. Much to my embarrassment, the Los Angeles City Council adopted a resolution in my honor. I became a finalist for the Pulitzer Prize. Bloggers riffed on the photo’s meaning. Requests for prints kept coming.
In January 2006, I was on assignment along the U.S.-Mexico border when my wife called. “Your boy is on TV. He has PTSD,” she said. “They kicked him out of the Marines.”
I’d spoken with Miller by phone twice, but the conversations were short and superficial. I knew post-traumatic stress disorder was a complicated diagnosis. So once again, I dug up his number. Again, I offered simple words: Life is sweet. We survived. Everything else is gravy.
As the third anniversary of the U.S.-led invasion approached, my editors wanted another follow-up story.
So in spring 2006, I traveled to Miller’s hometown of Jonancy, Ky., in the hollows of Appalachia. I drove east from Lexington along Interstate 64, part of the nationwide Purple Heart Trail honoring dead and wounded veterans, before turning south.
Mobile homes and battered cars dot the rugged ranges. Marijuana is a major cash crop. Addiction to methamphetamine and prescription drugs is rampant.
Kids marry young, and boys go to work mining the black seams of coal. Heavy trucks rumble day and night.
Miller showed me around. At an abandoned mine, he walked carefully around a large, shallow pool of standing water that mirrored the green wilderness and springtime sky. He picked up a chunk of coal.
“Around here, this is what it’s all about,” he said. “Nothing else.
“It was this or the Marines.”
Often brooding and sullen, Miller joked about being “21 going on 70,” the result, he said, of humping heavy armor and gear on a 6-foot, 160-pound frame.
Before he was allowed to leave Iraq, he attended a mandatory “warrior transitioning” session about PTSD and adjusting to home life.
Each Marine received a questionnaire. Were they having trouble sleeping? Did they have thoughts of suicide? Did they feel guilt about their actions?
Everybody knew the drill. Answer yes and be evaluated further. Say no and go home.
Miller said he didn’t want to miss his flight. He answered no to every question.
He returned to Camp Lejeune, N.C. His high school sweetheart, Jessica Holbrooks, joined him there, and they were married in a civil ceremony.
Then came the nightmares and hallucinations. He imagined shadowy figures outside the windows. Faces of the dead haunted his sleep.
Once, while cleaning a shotgun, he blacked out. He regained consciousness when Jessica screamed out his name. Snapping back to reality, he realized he was pointing the gun at her.
He reported the problems to superiors, who promised to get him help.
Then came a single violent episode, which put an end to his days as a Marine.
It happened in the storm-tossed Gulf of Mexico in September 2005. His unit had been sent to New Orleans to assist with Hurricane Katrina relief efforts. Now a second giant storm, Hurricane Rita, was moving in, and the Marines were ordered to seek safety out at sea.
In the claustrophobic innards of a rolling Navy ship, someone whistled. The sound reminded Miller of a rocket- propelled grenade. He attacked the sailor who had whistled. He came to in the boat’s brig. He was medically discharged with a “personality disorder” on Nov. 10, 2005 — exactly one year after his picture made worldwide news.
Back home in Kentucky, the Millers settled into a sparsely furnished second-story apartment. Four small windows afforded little light. The TV was always on.
Miller bought a motorcycle and went for long rides. He and Jessica drank all night and slept all day. He started collecting a monthly disability benefit of about $2,500. The couple spent hours watching movies on DVD, Coronas and bourbon cocktails in hand. Friends and family gave them space.
Miller had hoped to pursue a career in law enforcement. But the PTSD and abrupt discharge killed that dream. No one would trust him with a weapon.
But at least he didn’t have to go back to Iraq. He started to realize he wasn’t the only one traumatized by war.
“There’s a word for it around here,” Jessica said. “It’s called ‘vets.’ ” She talked of Miller’s grandfather, forever changed by the Korean War and dead by age 35. Her Uncle Hargis, a Vietnam veteran, had it too. He experienced mood swings for years.
Sometimes, Miller’s stories about Iraq unnerved his young bride. He sensed it and talked less. Nobody really understands, he said, unless they’ve been there.
On June 3, 2006, the Millers renewed their vows at a hilltop clubhouse overlooking the forests and strip mines. It was a lavish ceremony paid for by donors from across the country who had read about Miller’s travails or seen him on television. Local businesses pitched in as well.
His father and two younger brothers were supposed to be groomsmen but didn’t show up. His estranged mother wasn’t invited.
Miller looked sharp in his Marine Corps dress uniform of dark-blue cloth and red piping. Jessica was lovely in white, her long hair gathered high.
Instead of a honeymoon, the young couple traveled to Washington, D.C., at the invitation of the National Mental Health Assn. The group wanted to honor Miller for his courage in going public about his PTSD. Its leaders also wanted him to visit key lawmakers to share his experience.
As a boy, Miller confided, he had embraced religion, even going so far as to become an ordained minister by mail order. He knew the Bible verses, felt the passion for preaching.
That’s how he found his new mission: to tell people what it was like to come home from war with a broken mind.
Three days after their wedding, I tagged along as the young couple flew to the nation’s capital. Easily distracted by the offer of free drinks for an all-American hero, Miller stayed out until 3 a.m. He was hung over when he met with House members a few hours later.
Miller chatted up GOP Rep. Harold Rogers, the congressman from his district. He smoked and frequently cursed while recounting his combat experiences. I cringed but stayed on the sidelines, snapping photos.
Miller shuffled from one congressional office to the next, passing displays filled with photos of Marines killed in Iraq. As he told his story over and again, the politicians listened politely and thanked Miller for his service. One congressman sent an aide to tell Miller he was too busy to meet. No one promised to take up his cause.
After Miller picked up his award, he took a whirlwind tour past the White House and Lincoln Memorial, but his mind was elsewhere. At a bar the night before, free booze had flowed in honor of the Marlboro Marine. Miller wanted more.
“Let’s get drunk,” he said.
I returned to Los Angeles the next morning, thinking I would catch up with Miller in a couple of months.
A week later, Jessica called. After they got home, Miller’s mood had become volatile. He was OK one minute and in a deep funk the next, she told me. Then he’d disappeared. She hadn’t seen him for days.
Could I come to Kentucky and help?
Why me? I thought. I am not Miller’s brother. Or his father. I could feel the line between journalist and subject blurring. Was I covering the story or becoming part of it?
I traveled all night to get to Pikeville, Ky., and soon found myself with Jessica, making the rounds of all the places Miller might have gone. I wanted to be somewhere else — anywhere else.
Finally, the next morning, Jessica saw her husband driving in the opposite direction. She did a U-turn, hit the gas and caught up with him down the road.
He got out of his truck. A woman sat in the passenger seat.
“Who is that, Blake?” Jessica demanded. “Who is she?”
He said her name was Sherry. They had just met, and he was helping her move. Jessica didn’t believe him.
I thought: Didn’t I attend this young couple’s fairy tale wedding just 10 days ago? Now, here they were, in a gas station parking lot, creating a spectacle.
Jessica grilled Miller. He bobbed and weaved. He appeared sober and sullen. Then he dropped a bomb. He didn’t want her anymore and had filed for divorce.
“You guys might want to go home and talk,” I suggested.
There, the tortured dialogue escalated.
Jessica pleaded with Blake to stop and think. They could quit drinking, she said. They’d get help for him and as a couple. Maybe they could move away — anything to work it out.
Miller slumped on the couch. I sensed his unease and feared he would become violent, so I stayed for a while even though I felt intrusive. But he remained strangely calm, albeit brooding and distant.
I returned the next morning. He called his attorney and put the phone on speaker. If uncontested, the lawyer said, the divorce would become final in 60 days. Jessica went to the fire escape to gather herself.
Miller remained unmoved, chain-smoking. The local newspaper had been calling him about rumors that he was getting divorced. It was a major local story. Finally, he wrote a statement. He asked for compassion and respect for their privacy.
The next day, I found Miller in a back bedroom at his uncle’s house. He told me that he had come close to committing suicide the night before. He had thought about driving his motorcycle off the edge of a mountain road.
He showed me the morning newspaper. His divorce was the lead story.
I felt torn. I didn’t want to get involved. I desperately wanted to close the book on Iraq. But if I hadn’t taken Miller’s picture, this very personal drama wouldn’t be front-page news. I felt responsible.
Sometimes, when things get hard to witness, I use my camera as a shield. It creates a space for me to work — and distance to keep my eyes open and my feelings in check. But Miller had no use for a photojournalist. He needed a helping hand.
I flashed back to the chaos of combat in Fallouja. In the rattle and thunder, brick walls separated me from the world coming to an end. In the tight spaces, we were scared mindless. Everybody dragged deeply on cigarettes.
Above the din, I heard what everybody was thinking: This is the end.
I’ve never felt so completely alone.
I snapped back to the present, and before I knew it, the words spilled out.
“I have to ask you something, Blake,” I said. “If I’d gone down in Fallouja, would you have carried me out?”
“Damn straight,” he said, without hesitation.
“OK then,” I said. “I think you’re wounded pretty badly. I want to help you.”
He looked at me for a moment. “All right,” he said.