DoD/VA Suicide Prevention Conference
As Delivered by Secretary of Defense Leon E. Panetta, Washington, D.C., Friday, June 22, 2012
Thank you, Dr. Woodson for the kind introduction, and thank you all for your leadership, for your wise counsel, and for your commitment to ensuring that our service members and their families receive the kind of treatment and support that they so richly deserve.
I’d like to express my appreciation to all of you in this audience, appreciation for coming together, appreciation for the work that you’ve been doing at this three-day conference, appreciation for the focus that all of you are making to try to give attention and energy on one of the most complex and urgent problems facing our military families, the problem of suicide.
There are a lot of people here who have been working with this issue day in and day out and I have tremendous respect for your capabilities – you’re the experts in trying to deal with a very difficult issue. I’m reminded of the story of a Nobel Prize winner who was going throughout the state of California. He had won the Nobel Prize in a very complex area of physics and he was going throughout the state of California giving a very complex address on the area that he had got in the Nobel Prize. As he was heading toward Fresno one day, his chauffer leaned back and said, “You know professor, I’ve heard that same speech so many times. I think I could give it by memory myself.” And the professor said, “Well why don’t we do that? Why don’t I put on your uniform and you put on my suit and you give the speech?” And they did that, and the chauffer got up dressed as the professor, spoke for an hour on a very complex area of physics and got a standing ovation at the end of the address. And the professor dressed as the chauffer sat in the audience, couldn’t believe what had just happened. But then somebody raised their hand, said “Professor, that’s an outstanding address, but I have a question.” And he went into a three-paragraph question and included some mathematical equations, some formulas, and basically said, “Now professor, what do you think about that?” And there was a long pause. And the chauffer said, “You know, that’s the stupidest question I’ve ever gotten. And just to show you how stupid it is I’m going to have my chauffer answer it out in the audience.”
So there are a hell of a lot of chauffeurs in this audience when it comes to this complicated issue, this difficult issue. And I really appreciate the devotion and the dedication that all of you are making to try to deal with this issue. I’m particularly pleased that this conference is run jointly by the Department of Defense and the Department of Veterans Affairs.
Building a stronger collaboration between our two Departments is absolutely essential, it’s essential to meeting the needs of our service members and veterans. And I am proud of the strong working relationship that I’ve built with Secretary Shinseki, and I agree with what he told this audience on Wednesday – that our two Departments are now working more closely together than ever before. It’s essential and important that we build that kind of partnership if we’re going to address issues like suicide.
This issue, suicides, is perhaps the most frustrating challenge that I have come across since becoming Secretary of Defense last year. Despite the increased efforts, the increased attention, the trends continue to move in a troubling and tragic direction.
All of us gathered here share a very deep concern about this issue and about the trends that we are seeing. We also share a commitment to take action – to do everything possible to prevent these horrible tragedies, and to support those who have served our country with honor and with distinction.
The greatest frustration, the greatest frustration, is that there are no easy answers here…there are no quick fixes…there are no simple solutions to the problem of suicide. But that doesn’t mean that we can’t do more to prevent it from happening. We can do more. We must do more. And together, we will do more to prevent suicides.
But first, it’s important for all of us to recognize the nature of the challenges that we face in our military and veterans community.
For more than ten years, we have been a nation at war. Repeated deployments, sustained exposure to combat, the tragedies of war, have brought stresses and strains on our troops and on their families back home. Thanks to advances in protective technologies and battlefield medicine, more of our men and women are surviving combat. However, once home many are grappling with the wounds of battle, both seen and unseen – traumatic brain injury, post-traumatic stress, the other psychological ailments that can contribute to the risk of suicide.
The end of the war in Iraq, the beginning of the drawdown in Afghanistan will hopefully ease some of the strain on our troops, but that will not solve this problem. Indeed, more than half, more than half, of those who have committed suicide in the military have no history of deployment. So we’re dealing with broader societal issues. Substance abuse, financial distress, relationship problems, the risk factors for suicide that also reflect the problems in the broader society, the risk factors that will endure beyond war. For that reason, we have got to develop an enduring suicide prevention strategy.
The Department of Defense is committed to being a part of a comprehensive approach to suicide prevention, we’re committed to doing whatever it takes to protect and support our people. Building off of the recommendations contained in the 2010 DoD Task Force report, last November we’ve established a DoD Suicide Prevention Office. This office will put new resources and a new focus towards implementing the task force report’s recommendations and enhancing the effectiveness of our suicide prevention programs.
But I see our efforts having to focus on four key tracks, and let me discuss each of those areas.
First of all, this is always critical when it comes to an operation like the Defense Department and to our military forces…leadership responsibility. We are directing military leaders to take this issue head on. Like almost every issue in our military, progress on suicide prevention depends on leadership.
I have made that clear, that this issue is first and foremost a leadership responsibility.
All those in command and leadership positions – particularly junior officers and NCOs who have day-to-day responsibility for troops – need to be sensitive, need to be aware, need to be open, to signs of stress in the ranks, and they need to be aggressive, aggressive, in encouraging those who serve under them to seek help if needed. They also must set an example by seeking help themselves if necessary.
As part of their leadership responsibilities, junior officers and NCOs must foster the kind of cohesion and togetherness that is a fundamental part of our military culture and can do so much to improve mental health. My wife was a nurse, worked on mental health care issues, and she said to me time and time again, this is a human issue, a human problem. You’ve got to look in people’s eyes, you’ve got to be sensitive to their emotions, you’ve got to be sensitive to the challenges that they’re facing, you’ve got to be aware, you’ve got to have your eyes open, and the more we can see those problems, the more we can do to try to help people in need. To that end, we have to make clear that we will not tolerate, we will not tolerate actions that belittle, that haze, that ostracize any individual, particularly those who have made the decision to seek professional help.
Leaders throughout the Department must make it understood that seeking help is a sign of strength, not a sign of weakness, it is a sign of strength and courage. We’ve got to do all we can to remove the stigma that still too often surrounds mental health care issues. Outreach efforts such as the Real Warriors Campaign, which work to increase awareness and the use of resources such as the Military and Veterans Crisis Lines, are also a very important part of these efforts.
Secondly, we’ve got to do everything we can to improve the quality and access to health care. This is the second pillar of the suicide prevention strategy – improving the quality of behavioral health care, expanding access to that care.
We now have more than 9,000 psychiatrists, psychologists, social workers, mental health nurses, counselors working in military hospitals and in military clinics. That number has increased more than 35 percent over the last three years. Behavioral health experts are now being embedded into line units, and the Department has worked to place mental health providers in primary care clinics in order to facilitate access.
Guardsmen and Reservists often do not have ready access to the same support network as the active duty force. We’ve got to do what we can to increase initiatives like the Yellow Ribbon Reintegration Program that’s working to address this kind of problem.
And going forward, I want to make sure that all service members and their family members have the quality mental and behavioral health care that they need, the kind of care that must be delivered by the best health care professionals in the world. Thanks to the efforts of so many of you in this audience, we are improving our ability to identify and treat mental health care conditions, and we are working to better equip our system to deal with the unique challenges that these conditions can present. For example, I have been very concerned about reports of problems with the screening process for post-traumatic stress in the military disability evaluation system. For that reason, I have directed a review of this process across all of the uniformed services. This review will help ensure that we are delivering on our commitment to provide the best care for our service members. We’ve got to do everything we can to make sure that the system itself is working to help soldiers, not to hide this issue, not to make the wrong judgments about this issue, but to face facts and deal with the problems upfront, and make sure that we provide the right diagnosis and that we follow up on that kind of diagnosis.
Thirdly, we’ve got to elevate the whole issue of mental fitness. A third pillar of suicide prevention is better equipping service members with training and coping skills that they need to avoid or bounce back from stress.
To that end, all of the Services, all of the Services – under the leadership of General Dempsey and his Senior Enlisted Advisor, Sergeant Major Bryan Battaglia – are working to elevate mental fitness to the same level of importance, we’ve got to elevate mental fitness to the same level of importance that DoD has always placed on physical fitness.
Separately, a whole of government effort that has been led by the President and Mrs. Obama to combat veterans’ unemployment and boost hiring of military spouses is aimed at helping to reduce the financial stress faced by military families and veterans.
Finally, fourthly, we’ve got to increase research in suicide prevention. In partnership across government and with the private sector, the fourth pillar of our approach is to improve our understanding of suicide, to improve our understanding of related mental health care issues through better and more improved scientific research. I’d like to note the leadership of Health and Human Services Secretary Kathleen Sibelius on this issue and thank her for coming to address this conference earlier.
All of us recognize that there is still far too much that we don’t know about the causes of suicide, the effectiveness of particular suicide prevention programs, and the linkage between psychological health and traumatic brain injury. Trying to find out more about these very difficult, complex issues is not easy, but we’ve got to do everything we can to continue the research effort into learning more about this difficult issue. Many of you are working tirelessly to address these gaps. As part of this effort, the Department of Defense and the Department of Veterans Affairs are working together to build a data repository that will help us better analyze suicides and suicide attempts and do what we can to spot trends and to get ahead of that. Likewise, we are improving program evaluation so that we can better focus our resources on those programs that are proven to be effective.
The Department is also working to fundamentally transform the nation’s ability to understand and treat traumatic brain injury and post-traumatic stress – the signature unseen wounds of the last decade of war. Earlier this month, the Department and the Intrepid Fallen Heroes Fund announced a plan to construct state-of-the-art treatment centers for brain injuries and psychological disorders at nine of our largest installations in the country. I am delighted that we were able break ground on the first two of these centers, at Fort Belvoir and Camp LeJeune. These centers, these centers made possible by the generosity of private citizens, and God bless them for their generosity and what they do, because of their generosity, this will help compliment the National Intrepid Center of Excellence in Bethesda, and provide cutting-edge evaluations, treatment planning, research and education for service members and for their families.
My long-term goal for the Department of Defense is to be a game-changing innovator in this field. Just as we helped foster the jet age, the space race and the Internet, I want us to break new ground in understanding the human mind and human emotion.
In doing so, we will be drawing on a rich history of military needs spurring innovation in this field. During World War II, millions of servicemen saw first-hand the need for better psychological services and psychological treatment. In its aftermath, through the GI Bill and the new Veterans’ Administration clinical psychology training program, the entire field of modern psychology has transformed, it really has. For the first time, for the first time, psychology was a field that was richly funded in training and in practice, and the result has been better treatment and better care for millions of Americans.
believe we could help bring about another transformation, made possible by the hard work of men and women like all of you. I know that you will not rest and will not be satisfied until we have given our service members, and their family members, and our veterans the support they need.
There are, as I’ve said, no easy answers to the problem and the challenge of suicide. But that is no damn reason for not finding the answers to the problem of suicide. We have to keep trying to do everything we can to prevent it. And all of us, and frankly for that matter, all Americans, have to always support and care for those who have stepped forward to defend our country in uniform. We are a family, we are a family, and by God, we have to take care of our family members. That’s just not Italian, that’s American. We owe it to those who protect us to do all we can to protect them.
May God bless you and may God bless all of those that protect this great nation.