Mr. Speaker, I thank my friend from Arizona for her dedication to helping veterans. It will be often cited that 20 veterans a day take their own lives. It is important that we take a deeper dive into why that is because, as a society, we…
Mr. Speaker, I thank my friend from Arizona for her dedication to helping veterans.
It will be often cited that 20 veterans a day take their own lives. It is important that we take a deeper dive into why that is because, as a society, we want to know.
There will be upwards of 40-some thousand suicides this year in our Nation. Even one is too many. And I know that organizations that deal with suicide prevention want to see that drop considerably. But there is some understanding that is important for us to know what we can do and what stands in the way.
I want to note that those who serve in the military are about 1 percent of the population. Those who have served in World War II, Korea, and Vietnam are dying off fast from natural causes. But a great many of those veterans who do take an act of suicide are above age 50. Many of them have never served in combat.
Characteristic groups, such as the Army National Guard and reservists are among those who do have some
higher rates. It has been interpreted that perhaps one of the reasons for that is that they do not stay with their cohorts after combat. They go back home, come back on weekends, but don't have that same day-to- day support.
We also know the military, very much so after Vietnam, when you were done with your time, when you got your points, you were gone.
You could be in the middle of a battle, and you would be picked up by helicopter and taken home with encrusted blood still on your uniform from your friends, but you were sent back to the States--no chance to recover, no chance to develop from that, no chance to even get a checkup from the neck up, and, as a matter of fact, that was not even done. So for those who did serve in Vietnam and Korea and World War II, you just went back to life.
We have learned it is important to do more for people, and we do try and understand what is it, the characteristics among those who have taken their own lives, or tried to, that causes that to happen.
First of all, it is worth noting that about 70 percent of those who have taken their own lives who were veterans have not been involved with the VA hospital system. That is extremely important to know. They are not involved.
Now, that could be a number of reasons. It could be veterans who were not eligible for involvement at the VA. Many reservists and guards are not unless they served Active-Duty time, and even that is a limited timeframe. They also may have not been early identified when they came out of the military that would make them eligible for services. And, quite frankly, in many cases, it just is not near their home.
A study that was done with people at Fort Carson, Colorado, of 70- some folks who had attempted suicide, found that the number one reason that they gave, out of a list of 33 possibilities, was they wanted to end emotional distress. They simply wanted the pain to stop, and they ran out of ways to make it stop.
I reflect on the life of my father, who is now gone for other reasons, but one day when I was at home from college--and he himself was a World War II veteran--I heard his soft voice calling from the bathroom, and to see him there with a lot of blood on him, because he had just attempted to cut his arms and kill himself. Luckily, he did not. We got him care. But I believe for him, he certainly would have been in this category. He just wanted the pain to stop.
I don't think it was PTSD or his old signs of war. I think it was, perhaps, other distress as he dealt with his own alcoholism, or did not deal with it very well at that time, and the financial distresses of raising a family, and we just didn't have money, but it was enough to affect me--lifetime--in terms of trying to understand and dedicate my life to helping those in psychological need.
I should mention, on September 11, I got my honorable discharge, so I am no longer in the Navy. I miss it every day, because I loved that time working with servicemembers who had traumatic brain injuries and post-traumatic stress and a wide range of other problems, but here are a few things that I learned from them that are very important.
One is, if you want care in mental health, you just can't get it, not only because there may not be a VA near you, but even if there was, many persons who are dealing with panic and anxiety and depression don't want to leave the house; many with post-traumatic stress disorders do not want to go onto a bus or into traffic or into congested areas, because that can bring back some terrible memories for them. The very thing they need is to get treatment, but the very problems they have prevent them from getting treatment.
Now, we have passed legislation here that deals with choice to allow veterans to get that care closer to home. But can they get it? Well, tragically--not just sadly but tragically--in the area of mental health services, half the counties in America have no psychiatrist, they have no psychologist, they have no clinical social worker, they have no psychiatric nurse practitioner, and they have no licensed drug treatment counselor. In other words, it is not available.
If you just look at those, for example, with a substance abuse disorder, of the 22 million, about 75 to 80 percent of them also have a mental health problem and they are at higher risk for suicide. And certainly if we have a veteran who has substance abuse and depression, they are at higher risk.
But look at this group. For every 1,000 people with a substance abuse disorder--for every 1,000 people--900 do not seek treatment. Out of the 100 who do seek treatment, 37 have got nothing available to them. Of the 63 who have something available, only six get evidence-based care.
So it is no wonder when we talk to veterans, and they say, ``I tried getting help, but this person didn't understand. I couldn't get help. It was a problem that was ongoing,'' at some point they reach that point where they want to just end their emotional distress.
I remember visiting the house of a veteran. The mother had called me and said: ``Can you help him? He won't go to the VA. He won't get help.''
I made a house call. The VA doesn't do that, but I made a house call. And without revealing too much, I will just say that it was pretty clear he had a lot of medication around his house. His apartment was pretty unkempt, food lying around, bottles, dozens and dozens of bottles of medication unopened, each one from the VA, because probably each time he went to the VA, they said: ``How are you doing?''
``I am not doing well.''
``Here. We will just increase your dosage,'' or, ``We will give you a different medication,'' but the system was not set up to say, ``How are you doing? What else can we do to care for you?'' It simply was not set up to go to his home and help him out when he missed his appointments, when he was no longer employed, when he had isolated himself from society, when, like so many people, covered the windows of their bedroom with camouflage or some other dark thing so the light doesn't get in, don't watch TV, just stay away from the world, this shrinking world that constricts you like a snake around the throat until they see no more reason to live.
I remember going to the VA hospital and mentioning, ``You know, I know the Marines are famous for not leaving anyone in the field. What do you do about some of these other folks with mental health problems?''
They said, ``We don't go out to their homes.''
I said, ``Why not?''
``We just don't do that.''
``Why not?''
``We just don't.''
I agonize over that as being a Navy healthcare provider to know this doesn't sound like the Marines. The Marines don't leave someone out there.
Are we so constricted and tied up by rules that we can't even go and reach out to them? But that is part of the problem, that we need easier access to local care, we need care that reaches out to veterans, and not just say, ``Hey, listen, if you really want to get help, why don't you suck it up, pull up your bootstraps and go out and get help,'' because some of them are not able to do that yet.
Many of them feel, as a veteran, ``I have faced tougher battles. I can't let people know I am weak or I am struggling.''
Many of them have addiction disorders, and they don't want people to know that they are weak and they are struggling.
To those veterans, I say this is not a sign of failure. It is like if you are in the battle and bullets are coming at you and grenades are coming at you and incoming fire is coming at you, the last thing you want to do is deny it is happening. You have to acknowledge it is happening. What do you do? You get on the radio and you call for help. That is what we have to make sure veterans understand, that that is what this is about, depression and panic and anxiety as well.
We need more providers. I have had legislation on a mental health bill to get more providers. We recently voted on some things in amendment to the Labor-H bill here to get a little bit more, but we need thousands of more providers, psychiatrists, psychologists, social workers, licensed drug treatment counselors. We don't have that.
If Congress really wants to help, we have to do more of that, but part of the
problem is this, too: they oftentimes, in the field, have such massive student loans. And relative to other areas of medicine and healthcare, they get paid so little, they may choose not to go into these areas of mental health care. So for those who are the most vulnerable, we make it the most difficult for them to get care.
Add to that the idea of, who among those who are mental health providers actually have training and understanding of military healthcare, understanding military medicine, understanding military life?
I was commissioned 8 years ago, and I know that when I went on to officer school, and I went to training, you have got to learn a lot. The Marines say, ``I learned to shoot a gun, and I can polish my shoes better than anybody,'' but there is more to it than that. It is understanding the words, the acronyms, the lifestyle, what a person goes through.
We could certainly do much better, if not just saying let's hire people at the VA, but have a program for civilian mental health professionals, one, to recruit more; two, to pay for more reimbursed student loans to get them in the workforce; but also, quite frankly, to give them more regular orientation of what it is like to be a member of the military. Let them observe boot camp. Let them understand this.
I will give you an example. Once a soldier who I was treating, he said he had given up getting care for a while. He said the third time he had to explain to his therapist what an MRAP was, he said, ``Give it up.'' The MRAP is a military vehicle, commonly known vehicle.
Now, every branch of the military has their own acronyms, and I don't pretend to know them all, but if a person doesn't even know the basics, you lose that sort of connection with the patient, and they give up.
The other issue here is that we need to be able to have a system that monitors the medication closely. It is very common that if someone is on medication, they are a polypharmacy event; that is, they are taking so many medications, and then they will take other medications that counteract the effects of those medications, and then they will take other medications to deal with the side effects of those medications.
It was not uncommon for us at Walter Reed to have a patient on 8 or 10 or 15 or more meds that they were on. We found that we reduced them down to one or two.
But with medication comes weight gains, comes increase for diabetes, comes other problems, comes stresses in the family, comes situations where they are estranged from their spouse, difficulties with children, episodes with anger. These aren't bad people, but they see their life deteriorating, they see questions with regard to what is happening through their employer, they wonder about their future, they may have taken poor medication, but sometimes they just give up.
There is a quote by author Steve Goodyear, who had quite an inspirational quote. I hope, Mr. Speaker, if there are veterans listening tonight, they take this to heed.
Mr. Goodyear said: My scars remind me that I did indeed survive my deepest wounds. That in itself is an accomplishment. And they bring to mind something else too: they remind me that the damage life has inflicted on me has, in many places, left me stronger and more resilient. What hurt me in the past has actually made me better equipped to face the present.
That is a message I want veterans to hear, that having moments of depression or anxiety or worry are as normal as feeling tired or hungry, but we know when you get in a downward spiral, it gets worse.
I don't want veterans to give up. I don't want veterans or members of the military feeling that they have so much emotional distress, this is the only way to end it.
I understand the feeling, but I also know that, as members of the community and members who are veterans, we wrap our arms of hope around those veterans to say there is help out there, and we as Congress Members have an obligation to make sure we are providing those services.
It pains me when I think that sometimes we can come up with funding for all sorts of programs, but for this 1 percent who say, ``I am willing to take a bullet for you, I am willing to die to defend my country, its Constitution, and its flag,'' we as Congress ought to be able to say we are willing to put some money in to help you get more services.
Also some advice for those veterans who may be listening: It is extremely important to follow a few guidelines in your own life, too, besides not giving up, but physical fitness that you were forced to do in the military and boot camp, and all those pushups and sit-ups and running and pullups we did, they had a reason; because when you stay physically fit, it affects your brain functioning and it improves it, and it is one of the things that is used to fight off depression and other problems.
Two, you have to have an attitude that is focused on positive things. You can make it. Many times, part of that attitude, an essential part, is a strong faith in God, a strong belief there, which gives you that attitude to say, ``I can do it.'' Navy SEALs talk about the way you eat an elephant is one bite at a time; the way you temper steel is with fire; that pain is weakness leaving the body; that courage is something that is built through experience and focus. It is not something that just comes, but you build that attitude. So you have fitness, you have attitude.
Another part is sleep. Many studies I have seen--I think it was Dr. Germain at the University of Pittsburgh who did studies that said perhaps sleep is a greater factor with post-traumatic stress, anxiety, and depression than anything else, and a big part of this is just getting enough sleep.
Members of Congress, we deal with this a lot in terms of our own hectic lifestyle, and we know many constituents, because of their workload, their anxiety in the family, they don't get enough.
It is essential. It doesn't necessarily mean you are crazy, you have problems, but that is an important part.
Further, training, knowing what you can do, whether it is in the workplace or the military, we know it is essential.
Making sure one eats right. It sounds obvious. I don't want to make this in any way sound small, but making sure one is actually eating a healthy diet is an important part of fighting off suicide, fighting off depression.
Then making sure that people are paying attention to relax, to rehabilitate themselves, to do their own personal checkup from the neck up to make sure they are dealing with these things.
None of those things I just mentioned require help from a doctor. All of those things are essential to healing and getting better.
When one reaches the point where you say, ``You know what, I need a little help here; I need to call in support on the radio; I need a quick response team; I need to pop some smoke; get some help in here,'' that is okay. I want veterans to know not only is that okay, that is what we are supposed to do.
You call in help. We don't need dead heroes on the battlefield. We certainly don't need them in the streets or the homes. We need people who are saying: Understand, that even though it may be tough to get help, there is help out there. There is help out there. People want to facilitate and help you get better.
I don't want anybody to feel that this is the way to end emotional distress. It is a permanent solution to a temporary problem, and even if that problem seems to have been going on for years, I know people can and do get better. I have seen it time and time again. The soldier or veterans that thought: I can't go on; I have to give up. They can turn that life around and become a contributor.
One has a few choices. One can be a victim and say: You know what? I am under this giant boulder. I will never get better. The weight is too great. I am too weak. I cannot move on. There's no hope.
Or you can move on to another stage and say: I am going to be a survivor.
On the first part, you say: I am helpless because of what is happening. When you are a survivor, you say: You know what? I am going to move on despite what is happening. I will pray more. I will engage more. I will do
more. But every day I will wake up and commit more to get through that day to do something that is important and meaningful. I don't need to set up a goal of 10 years from now, but let me get through that day. Let me find some things I can do and focus. It is extremely important.
But beyond that, beyond being a victim or a survivor, is a third stage, and that is being a thriver, someone who says: I am going to make sense out of what I have done, and it is going to make me a stronger person.
What I said here in the quote from Steve Goodier where he says, ``What hurt me in the past has actually made me better equipped to face the present,'' if I am in a tough situation, if I am in a situation where I, myself, look at it and I have despair and I lack hope for my own future and I turn towards someone, give me someone who has been there before. Give me a veteran. Give me a soldier who understands boot camp and what is it like to be yelled at and lack sleep. Give me a veteran who has been on the battlefield. Give me someone who has been out to sea and understands what it is like to be months without seeing your family. Give me someone who has been there and says: I made it; so can you.
I want veterans to have that sort of hope. We have our obligations in Congress: get more providers, make sure the VA is responsible. But since most people aren't near a VA, we can do a lot to help them.
I hope that this Veterans Suicide Recognition Month is something that sometime in the future we can put behind us and make it a thing of the past. We can do that if veterans themselves make those decisions to get help, and if we as the Congress make some decisions to get them that help, and society itself says: Stop having pity on them. Give them help out of affection and love and respect.
And, by the way, that respect also includes a lot of people who play professional sports, who have no idea what it is like to have someone shoot at you and try to kill you. Stand up. Have a backbone instead of a wishbone. A lot of veterans don't really want to hear that life is tough for you when you make more money in 15 minutes than they will make in a lifetime. Show some respect for those folks.
And then as we as a society recognize what they have given to the last full measure, we will be able to provide the kind of things they need and save some lives.
Too many times I have gone to a ceremony. You fold a flag 13 times and hand it to a grieving widow or widower. How much worse it is when they take their own life, because the stigma among the family is there was nothing else you could do, and all of us feel helpless when that happens. Let us make sure we are not part of that problem and, instead, we are part of the solution to celebrate and help our veterans so these things don't continue to happen.
