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More deadly than combat? In a way, yes

'Suicide epidemic'affects many state soldiers returning from Middle East with depression
by: JIM CLARK, 
Iraq war veteran Joseph Holness, shown here with his wife Carolina in their Gresham home, spent six months in the United Arab Emirates in support of Afganistan before spending 10 months in Iraq. He suffers from numerous emotional issues including post traumatic stress disorder.

Nobody seems surprised. Not the physicians and therapists who treat returning veterans. Not the veterans themselves.

When told of recent data that appears to show that Oregon troops serving in Iraq and Afghanistan are more likely to die of suicide than in combat, they nod their heads, as if saying they've known all along.

And they have.

Joseph Holness, 48, of Gresham, served in the Iraq war and knows too well the hard reality of the war's aftermath. A soldier he served with in the Air Force Reserves - a friend - shot himself in the head after his return.

'People just don't know,' Holness says. 'It can be hard coming home.'

He says he's lucky he has a supportive family to help him deal with the anger and stress, but he wonders sometimes, 'Could I have been one of those statistics?'

And those statistics are staggering:

n In 2005, the last year for which complete Oregon data has been compiled, 19 Oregon soldiers died in combat in Iraq and Afghanistan. That same year, 153 Oregon veterans of all ages, serving in various wars, committed suicide.

n The rate of suicide among Oregon men who are veterans is more than double that of Oregon men in general - 46 suicides out of every 100,000 compared to 22 out of 100,000 - according to the Oregon Department of Human Services Center for Health Statistics.

n Nearly one in three Oregon suicides is a veteran, says Mark Kaplan, a Portland State University professor and suicide researcher.

Iraq War veteran Sean Davis, 35, Portland, who suffers from post-traumatic stress syndrome and a variety of physical injuries, volunteers at the Portland Vet Center. Despite his own issues, Davis says has never thought of killing himself.

He served with the Oregon National Guard in Iraq in 2003 and 2004. Currently, he is a student and writer.

He remembers that his squad went on 35 combat missions by truck and helicopter in its first 30 days in Iraq.

He recalls the horrible smell of civilians burning in cars set afire by roadside bombs and remembers a friend in full uniform in the barracks shower, trying to wash the day's blood off himself.

A roadside bomb hit Davis' truck in June 2004.

'There's something in your brain that's going to be changed after picking up bits and pieces of your best friend.'

He says he learned of a combat buddy who tried to kill himself after a Christmas party to which Davis was invited.

Medford resident Stacy Bannerman, whose husband, Lorin, is expecting to be deployed soon for a second tour of duty in Iraq, has become an outspoken advocate for military families. She says she has heard from more than 100 families whose veterans have attempted suicide.

'Based on what we're seeing already, this country hasn't seen anything yet in terms of the severity of combat trauma and veteran suicide rates,' Bannerman says.

One surprising trend that some are beginning to see: Kaplan and other experts are noticing a rising trend of suicide among aging Vietnam veterans, possibly influenced by what they've seen in recent years about Iraq and Afghanistan.

Still, the age group that shows the greatest differential between veteran and non-veteran suicides, by far, are those between ages 18 and 24. Veterans between 35 and 44 have the next highest suicide rate relative to nonveterans of the same age. Twenty-one Oregon veterans under the age of 45 committed suicide in 2005.

Kaplan says even those numbers might be underreported as much as 25 percent. Nationally, reports of high suicide rates among veterans began to gain attention in April, when a series of e-mails from Veterans Affairs officials came to light during a class-action lawsuit brought by a veterans group in San Francisco.

The e-mails say that 12,000 veterans under VA treatment attempt suicide each year, and that more than 6,000 veterans succeed in killing themselves each year, most not while under VA care. There are about 25 million veterans.

'A lot of these people are not being recognized as casualties of the war. They're given this label of disgrace, and it's a shame,' Holness says.

'Suicide epidemic'

'There is clearly a suicide epidemic,' says Paul Sullivan, executive director of Washington, D.C.-based Veterans For Common Sense, which brought the lawsuit. Sullivan says the VA's own data on calls made to its suicide hot line might be the best indicator of the depth of the problem.

According to the VA, in July there were 250 calls a day to the suicide hot line. And veterans have made more than 22,000 calls since the hot line started in July 2007. Portland VA officials say 864 calls to the suicide hot line have come from Oregon veterans in the last year.

Linda Rotering, a social worker who counsels veterans at the Portland Vet Center on Northeast Sandy Boulevard, says she is seeing an increase in the number of Vietnam veterans coming in to see her with post-traumatic stress disorder.

Rotering and others say many Vietnam veterans may have been able to keep the symptoms of their stress disorder at bay while they busied themselves with jobs and families after the war. Now, she says, many are retiring and their children are out of the house, and they may be that much more susceptible to the images from the war in Iraq.

'There's nothing to block out the memories,' Rotering says. 'I hear over and over again, if I have a 19-year-old sitting in my office or a 60-year-old from Vietnam, the exact same things are coming out of their mouths.'

Corvallis mother Adele Kubein, regional representative of Military Families Speak Out, which supports withdrawing troops from Iraq and Afghanistan, says her daughter returned from Iraq in 2004 with a shattered leg and a shattered psyche.

'The first time was when she called from Iraq weeping and weeping and saying, 'Oh, mom, I can never come home. I just killed a 12-year-old boy.' I knew from that point on she was suicidal.'

Risk factors

While nobody is sure what leads a veteran to attempt suicide, a recent report from the Rand Corp., a nonprofit research organization, looked at the risk factors for post-traumatic stress disorder, which many believe serves as a precursor to suicide among those who do not get help.

The Rand study found that one in five veterans from the wars in Iraq and Afghanistan - more than 300,000 people - suffer from either post-traumatic stress or depression. But just more than half sought help and only one in four received acceptable care.

The No. 1 major risk factor for PTSD, according to the Rand report, is the amount of combat trauma soldiers experience. About half of those returning from Iraq and Afghanistan say they had a friend killed in action, says Lisa Jaycox, who headed the Rand Corp. research team.

Length of deployment is another risk factor, Jaycox says - the longer a soldier is deployed in combat the higher the risk for post-traumatic stress. And soldiers in Iraq and Afghanistan have served much longer tours than American soldiers in any modern wars, experts say, with some tours extended as long as 15 months and some troops being sent back for second and third tours.

Jaycox says that reserve and National Guard troops are at higher suicide risk than regular active-duty forces. That last has particular relevance in Oregon, where Guard troops have been sent to battle on a scale never seen before. About a third of the Oregon soldiers who have died in Iraq and Afghanistan were in the reserve or National Guard.

Many National Guard and reserve troops enlisted thinking they would never find themselves in combat, so they may be less prepared for the horrors of battle, experts say.

Also, Guard and reserve troops often have less help than regular army solders in transitioning back to civilian life, says Rob Tell, suicide prevention coordinator at the Portland VA Medical Center.

'An army guy comes back to the base and there is a whole social structure on the base,' Tell says. 'The guard guy comes back to Canby and 48 hours after he's come back, he's walking on the street in Canby with his buddies.'