Just retired after 21 years in the Medical Corps...

I see this as so multifactorial its difficult to wrap our brains around.

The correlation between military suicide and alcohol, drugs, problems with the law, adverse actions is very tight. However, this is a chicken or egg debate.

Were the suicides from lowering recruiting requirements and the "waiver culture" which has evolved in the military? Which begs the bigger question of who hold those "assuming risk" accountable? I was on the admissions committee at USMA and the number of times I was over ruled on medical waivers by the 3-star was insane. I was told that he has the authority to assume risk for the Army, but no one ever told me who holds him accountable for these disasters 5-6 years later when he is long and retired. We are more eager to get bodies in boxes than the right bodies.

Op Tempo is definitely a factor. Company level leadership being whipped by the BN and BN being whipped by the BDEs. Soldiers cannot get access to mental health care because it takes a man away from the motor pool, or weed whacking or whatever ridiculousness is being put upon them. This is just more work for the soldiers around them. ***If I were king for a day I would require enlisted E5 and below to be paid hourly and with overtime. The BN and CO commanders being held accountable for the budgets.**** This would fundamentally change and get rid of the vast amount of stupid, and pointless tasks. It would make leaders actually care about how they spend the time of their soldiers.

We are also first line to see the rampant hypocrisy within our government. Reference the Afghanistan withdrawal, funding billions to Ukraine while under-funding our own military, just to name a couple.

After numerous deployments I have learned that its the dopamine hit that replaces the adrenaline surge from combat. Many soldiers medicate with alcohol, drugs, and risky behaviors that result in legal issues and actions.

Military mental health is overwhelmed, good people, but the leadership is again troubled. At least in mil med, DEI has hurt us big time. It is clear that if you are not the right gender, race and sexual orientation you have no future in the upper echelons. The most competent leaders are fleeing because they would rather bail than have incompetent leaders constantly telling them to do more with less. Because these incompetent leaders want to keep "control" soldiers are gatekept from seeking mental health care. Your families can self refer, why can't a soldier? As an example: When I went to seek mental health care, I was told that I could not be referred off post, even though it meant that I had to go and seek mental health care from the providers that I senior rated.... no thanks, I will internalize, and self medicate in my own way a bit more....

I haven't event begun to discuss the DHA and milmed debacle. To summarize: Imagine your parents getting divorced. Mom has the kids and Dad has and controls all of the money. The kids are their only real resource and both are competing for relevance. The hold hands in front of the judge (Congress) and talk about their partnership in raising the kids, but its a bloody ass fight when the lights go off.

This crisis is not just a military crisis. There is a terrible shortage of mental health providers in the US. Psychiatrists, psychologists, LCSWs are in terrible short demand. We have to change the training paradigm for mental health providers. Standardize, and improve reimbursement. Recognize this is a crisis, fund training programs for civilians through the VA. All of which takes money that our government would rather throw at other problems.

I have several physician friends and colleagues (high functioning surgeons, O6s etc) who have taken their lives. Some AD some retired.

Just catching up here, will drop some thoughts/responses below. Sorry for the long post.


I know some military psychiatrists/psychologists that say a combat deployment should be a requirement for getting a military PTSD diagnosis. However, you can have PTSD from anything - a house fire, a loved one's death, a car accident, etc., just by the definition/diagnostic criteria.

PTSD isn't the only thing that is a risk factor for suicide. Depression is another big one we see going around right now. Anxiety to a lesser extent. As well as just inability to handle stress. Depression is pretty rampant in the military (and in society as a whole).



I agree that line officers/NCOs should not be taking on the role of counselor/mental health provider. It has gotta be tough for them to walk the line between being approachable and caring about "little" problems, but also pushing those under them to perform, and to develop resilience. Often times their default answer is "Go to medical." And they expect medical to be the bad guy and tell the service member to suck it up, or to just fix them and get them back in the fight.

Also, sometimes leaders get upset when medical gives quarters/a profile. It is entirely within the officer's/SNCO's authority to tell a service member going through something tough - "hey man, take the rest of the day off, get your stuff taken care of, and come back tomorrow." Instead, it either boils over, or you get sick call warriors that come and say they want to kill themselves because they know that's the only way they'll get time off.

I was out getting food somewhere when I heard a group of sailors talking. One was telling the others "yeah, anytime I feel stressed or don't want to work, I just go to the Naval hospital and tell them I want to kill myself and I don't feel safe going home. They admit me and I get a couple days off." People like this bog down the system. There is a lot of malingering in the military health system.

Commanders sometimes get upset at medical for believing the malingerers, but if anything does happen, they're going to point the finger at medical and say "but doc said he was good to go."

Zulu has an interesting thought about "budgeting" the time of junior enlisted. At my old squadron, one of my COs would reward a higher optempo and overtime with a 72 (3 day weekend) if we did a good job for an inspection or something.

Military mental health is significantly overwhelmed. A lot of people are getting referred out to civilian mental health (who hand out PTSD diagnoses like candy). Nationwide there is a huge shortage of mental health workers. And so the military is going to have to pay a lot to attract more. Just in the past 7-8 years though, I have seen a huge increase in access to more embedded providers. But many are very limited in what they can do.



The special operations communities (Who have ulimited budgets) do have embedded mental health providers, and an excellent provider to patient ratio. My understanding is that they see them frequently, as preventative maintenance almost, and can see them essentially as needed whenever. The Marines have embedded providers in some units, but the ratios are pretty bad, waits are long, and training/the mission often takes priority over letting a marine take off, find a ride 15 minutes on the other side of base, talk for 30 minutes, and come back. And then of course, your buddy has do to your work while you're gone. The Marines currently have the the OSCARs (Operational Stress Control and Readiness provders) that vary from LCSW, to PA, to pyshologist/psychiatrist. So big variance on what they can do and what they feel comfortable with. There are also the MFLCs (military family life counselors) that are generally basic therapists. Both tend to be understaffed/overworked.



There is certainly something going on in society regarding young people having less resiliency/mental fortitude. I'm not sure what it is. I think some may be work-life balance becoming more important, and essentially an expectation. I think some of it has to do with social media and being connected to the world or work 24/7. And I think some of it has to do with how you're raised, and how much resiliency you developed growing up (either taught or learned on your own).

I think a fewer and fewer percentage of Americans are serving, or have served. There is also a smaller percentage of those that serve that get deployed/see combat. And there are thus fewer people that "get it."
Fewer people to talk to, as OldArmyCT put it. I think some vets go from being in charge of others, having a sense of purpose to something bigger, to working a basic job with no real purpose and potentially being out ranked by someone younger, and having no one around you that gets it. Do service members that go into law enforcement or firefighting do better than those that do other stuff? Does that structure help? I don't know.



One of the reasons I started this thread, besides seeing the article I posted, was because I saw a youtube ad for an organization helping Afghan refugees. And it was a veteran, employing veterans, and saying how not only it helps the Afghans, but it helps them (the vets). And it just got me thinking about having a sense of purpose. Does that active duty radio operator that wanted to be a trigger puller feel as though he has no purpose? Or that he doesnt matter as much as the infantry (have seen several radio operators that were suicidal the past few days). If you give a young man a sense of purpose, and he believes that he can legimitely be successful in life, will he do better?

Retired Marine Grunt here-
I have thought of this often. It seems like we did not have the widespread PTSD / Suicides w/ the WWII Vets. They were gone for years and endured unbearable conditions, however, when they came home the seemed to assimilate back into society. There was PTSD (I think they called it Shell Shock) and suicides, and possibly it was not reported or under reported.

Vietnam seemed to see an increase. This could be due to the draft, the purpose of the war and liberal society that was emerging and increased drug use. My father was a Combat Viet Nam Vet and didn't show signs of PTSD / Depression / Suicidal Tendencies. Now, later in life he has mentioned that he feels like he had some of the symptoms: hard to sleep, drinking too much, agitation, but he says he just dealt with it.

Now, we move onto Desert Storm / OEF / OIF and it seems like it is a more prevalent and common.

What causes it? It has to be societal. For lack of a better term, I think it is the Wussification of America. I just don't think that we are as tough (both mentally and physically) as our predecessors were. "Modern day conveniences have made us soft. Old Army has Gone to Hell.

I think about how my father raised me and how I raised my son. He was so much tougher on me than I was my son. My son never wanted for anything and was given all kinds of opportunities that I was never given. He has turned out to be a fine young man, however, he is not near as tough as I was. I notice it in my buddy's sons, his friends and nephews also. They are good young men, but prone to whine and complain when things get tough (both mentally and physically). I guess I should blame myself for being part of the problem and not the solution.

But, it seems like it happened so fast.... in less than a generation, we have turned into a bunch of pansies.

Here endeth the Rant !