Quiet Crisis

Her husband suffered a skull-shattering bullet wound in Iraq. She lost her job. Her car was repossessed. A psychiatrist misdiagnosed her, then threatened to commit her if she didn’t take medication that made her feel crazy. These are some of the reasons Torrey Shannon tried to kill herself. Twice.

“It piles on and piles on, and you wake up one day and say, ‘I can’t take it anymore,’” she says.

Shannon is the voice of a quiet crisis. In addition to a high number of U.S. military suicides, spouses and children of those who serve are also taking their own lives. The crisis is rooted in the strain of long wars, an overwhelmed mental health-care system, financial issues, relationship problems, and a code of silence dictated by the stigma associated with seeking help. It’s a problem military families expect to see worsen as the wars wind down and they no longer have the next deployment to postpone dealing with their issues. “The trend is increasing, and I would say in the last two years it has close to doubled,” says Brannan Vines, founder of Family Of a Vet, whose network receives dozens of messages a week from spouses who are contemplating suicide. “At some point, we’re going to get past the tipping point.”

Military family suicide is a significant public health problem, adds psychologist Craig Bryan, associate director of the National Center for Veterans Studies at the University of Utah. He treated military families in a primary care clinic during his time in the Air Force. “If you don’t pay attention to suicide and suicide risk in family members, you are not going to be able to address suicide in the military and society as a whole,” he says.

“We can’t expect DoD and VA to do all of this – they simply don’t have the resources, and in many respects the cultural competency,” says Kristina Kaufmann, executive director of the Code of Support Foundation, which works to bridge the military-civilian divide. “This is not DoD’s Army. This is America’s military.”

Kaufmann has been raising the issue of military spouse suicides for years. She has lost three military spouse friends to suicide and knows of many others who have taken their own lives. They include Kaufmann’s first mentor – “a real practical, strong, get-it-done kind of person who was very involved in her church” – as well as a neighbor who was four months pregnant. Both killed themselves in the summer of 2009.

But Kaufmann is most troubled by the suicide of a woman who lived around the corner from Kaufmann and her husband at Fort Bragg, N.C. “She looked like the picture of a perfect Army wife – always put together, two great kids,” Kaufmann says. She locked herself and her children in the garage and started the car during her husband’s deployment in 2006.

“To this day, it haunts me that I didn’t take that opportunity as a commander’s spouse to speak to our battalion about deployment, depression, stress, suicide and asking for help,” Kaufmann says.

“But I had no idea how to have that conversation.

I couldn’t have done it effectively at that point.”

Part of the problem is that the stigma of seeking mental health care can be as bad – if not worse – for spouses as for servicemembers, Kaufmann says. “The conversation I was too afraid to have in 2006 is a conversation our entire country needs to have,” she says.

Even when military families seek help, it’s often hard to find or inadequate, because the military and veterans mental health-care systems are understaffed and overwhelmed. Jamie Johnston found no support after her husband, a pilot, was killed in a training accident in the mid-1990s. Her husband’s squadron walked her through life-insurance documents and other paperwork, then cut her loose. The sole military counselor she connected with was transferred three weeks after her husband’s death. She had also had a miscarriage just before her husband’s plane went down.

Johnston was forced to sell their house, find a new place to live and deal with the disappearance of her social circle.

“I had friends tell me, ‘You’re too depressing to be around,’” Johnston says.

About a month after her husband’s death, she tried to overdose on sleeping pills. “He was my rock, and my rock disappeared. I just wanted to be able to see him, and I needed to die to do that.”

Johnston’s brother discovered her suicide note and she was hospitalized. She found help through the Tragedy Assistance Program for Survivors (TAPS) – which tracked her down and offered its support – then spent years rebuilding. “I was completely broken,” says Johnston, who requested that her real name not be published because she has since remarried and had children.

Shannon sought treatment while her husband, Dan, was hospitalized at Walter Reed Army Medical Center. He was shot in the head in Ramadi in November 2004. He became part of the front-page story in The Washington Post revealing the terrible conditions that led to dramatic changes at the medical center. Meanwhile, Shannon’s family worried that Dan’s post-traumatic stress diagnosis meant he was a danger to their children and initiated multiple frivolous Child Protective Services investigations, she says.

That pressure, along with financial issues and other family problems, prompted Shannon to seek help. She was assigned to a psychiatrist named Maj. Nidal Hasan, who would later stand trial for shooting fellow servicemembers at Fort Hood in Texas in 2009. Hasan misdiagnosed her with bipolar disorder. “I was prescribed a cocktail of medications,” Shannon says. “I went crazy.” She says she told Hasan the drugs made her feel worse, but he threatened to have her committed if she stopped taking them, she explains.

Shannon tried to overdose in November 2006 and April 2007. “In my skewed thinking, I thought I was doing my children a favor,” she says. After getting out of the hospital following her second suicide attempt, she stopped taking the drugs. While medications are helpful for some, “since I’ve been medication-free I’ve been fine,” she says.

Military children are also falling through the cracks in the mental health system, sometimes with tragic consequences.

Twelve-year-old Daniel Radenz killed himself just days after convincing doctors at Darnall Army Medical Center in Texas that he didn’t need to be hospitalized, despite warnings including drawing graphic suicide pictures and writing on the walls of a school bathroom with his own blood.

The youngest of three boys, Daniel was a good student with perfect attendance and many neighborhood friends, says his mother, Tricia Radenz. He was close to his father and postponed his ninth birthday celebration until his father returned from his first deployment.

Soon after Daniel’s father deployed for the second time, however, the boy started having nightmares. He became withdrawn and didn’t want to go to school. “He was just telling me he was so sad and worried about his dad, and he didn’t know if his dad was coming home,” Tricia says. She found Daniel an appointment with a civilian counselor – the first opening was about 10 days later – then rushed Daniel to Darnall after his teacher called and told her he needed immediate help. He was seen by a psychologist and a psychiatrist, started on a low dose of medication and set up with a counselor.

Daniel’s mood never improved except when his father came home on R&R in March 2009. “After his dad left, he plummeted,” Tricia says. “He started having hallucinations at school and writing in blood on the walls of the school.”

Throughout the school year, Tricia had cut back on her hours as an emergency room nurse at a civilian hospital to be available for her son whenever he needed her. She and Daniel’s teachers corresponded by email throughout the day. His former football coaches took him fishing. “Everybody was trying so hard to help him,” Tricia says. “Nothing was working.” Tricia finally told her husband what was happening. The Army sent him home from Iraq immediately.
While Daniel was happy to see his father, Tricia also believes he felt guilty. “I think he may have wondered, ‘Is Dad in trouble because he came home early because I was having problems?’”

After Daniel drew detailed pictures of people shooting themselves in the head, his parents took him to Darnall. “We were very uneasy,” Tricia says. “We thought he needed hospitalization with the pictures and the things happening at school.”

Daniel convinced doctors he was OK, and they sent him home. He hanged himself within a week. “I thought he went into the kitchen to get a sandwich with his dad. His dad thought he was outside with me. He was out of sight five or 10 minutes. That’s all it took.”

Tricia also wishes she had asked Daniel if he was contemplating suicide. “I think of all of the times I could have opened up the dialogue and prevented it,” she says. “I was afraid of putting the idea in his head. I know now that you don’t put the idea of suicide in someone’s head any more than you cause a brain tumor.”

Darnall told the Radenz family that it has made changes in the way it treats patients as a result of Daniel’s death but would not provide details. “Pointing fingers at this point is counterproductive,” Tricia says. “We have to find out where he fell through the cracks and have it not happen again.”

One of those cracks is the strain on the mental health system. “I know (Darnall) is overwhelmed,” Tricia says.

“I know they couldn’t see him as much as they needed to given his situation. There were probably a hundred Daniels.”

She also believes that parents need more education about the medications their children are given. Tricia read the pharmaceutical company’s warnings about antidepressants increasing the risk of suicide. Still, “I had no idea of the seriousness of it,” she says. “And his doctor told me he had a lot of success with children taking this medication.”

Tricia now speaks about suicide prevention at places such as Fort Hood and Fort Benning in Georgia. She corresponds with children who need a listening ear on Facebook. She worries about other children in despair.

“You have an increase in suicides when hopelessness exceeds the resources,” Tricia says. “That’s where we were.”

Andrew Patrin’s family was there, too.

Andrew went to an Army primary care clinic seeking help soon after returning to San Antonio to attend college. He felt that medications he had been given three months earlier were making him more depressed and wanted to be referred to a mental health specialist or inpatient treatment, says his father, George Patrin, then an Army pediatrician commanding a clinic in California. Instead, the physician changed Andrew’s medications and told him to come back in two to three weeks if he wasn’t better. Mental health appointments, he was told, were only available to active-duty patients.

After that appointment, Andrew told his best friend he had answered “yes” to every question about being depressed and suicidal on a survey he was given during that clinic visit, and still couldn’t get help. Ten days later, Andrew sent each of his family members a goodbye email from a motel room, turned off his computer and phone, and shot himself. “I’m really sorry, Dad,” Andrew wrote. “I’m giving up. I’m stuck at 5 percent all the time because of these stupid human limitations.”
George has since retired from the Army. He and wife Pam started the Serendipity Alliance to work on ending suicide and improving health care. They realize, after speaking with hundreds of other grieving families over the past four years, that steps that would have saved Andrew can also save servicemembers contemplating suicide, George says. That includes referring patients to a mental-health specialist the same day they ask for help, and following up within a few days to see if patients have improved. It means listening to family members when they say a patient is struggling, and including them in a treatment plan when there is risk of depression or suicide. It means screening for mental health issues every time a patient visits a clinic.

Craig Bryan also advocates training mental health professionals in the military and civilian communities to provide the most effective care to servicemembers and their families.
The consequences of not taking these steps are evident in the suicide rates and homelessness of veterans and families who didn’t receive the care they needed 40 years ago. “We have a model of what not to do here: the Vietnam generation,” says Kaufmann of Code of Support. “Are we really going to do that again?” 

Ken Olsen is a frequent contributor to The American Legion Magazine.

Help for those who need it

The American Legion has launched a new webpage listing resources, warning signs and other information to help those confronting suicide.
Family Of a Vet Resources and assistance for servicemembers, veterans and families living with PTSD, TBI and the challenges of life after combat
Give an Hour Provides free mental health care to servicemembers, veterans and families
Tragedy Assistance Program for Survivors (TAPS) Resources and support for families who have lost servicemembers in combat, training accidents, or to suicide or illness
Not Alone Help for servicemembers and families, particularly those dealing with PTSD
Her War, Her Voice! Peer support for the families of servicemembers, particularly those who deploy
Veterans Crisis Line
    (800) 273-8255, press 1
National Center for PTSD