Wednesday, June 25, 2008

After four suicides by Guardsmen, risk taken very seriously

After four suicides by Guardsmen, risk taken very seriously

Some soldiers and airmen find it difficult to return to regular life after service
By Tom Lawrence
The Weekly News
A soldier’s biggest battle sometimes occurs after he or she returns home.

As American service members continue to fight and die in Iraq and Afghanistan, many men and women in uniform come home profoundly changed. Some discover they suffer from post traumatic stress disorder (PTSD). Others struggle with depression, anger and/or substance abuse and find it difficult to readjust to civilian life.

A few can’t deal with the pain they feel. They commit suicide.

There have been four suicides among South Dakota National Guard members in the past four years. Two

Guard members killed themselves last year in the state but had never

been deployment overseas. Another took his life during a deployment to Iraq in 2004. A fourth killed himself in early 2006, more than 11 months after returning from a deployment to Iraq.

The two combat veterans who took their own lives were members of a South Dakota Army National Guard unit that served in Iraq from February 2004 to February 2005. It is unknown if they witnessed the previous death of a fellow soldier who was killed by an improvised explosive device in April of 2004, according to Maj. Orson Ward, a Rapid City-based spokesman for the state Guard.

Ward, who has had to deal with his own PTSD-related issues, said the Guard is very aware of the mental health concerns that soldiers and airmen face in and out of combat.

Maj. Gen. Steven R. Doohen, who commands the South Dakota Air and Army National Guard, said he has learned that the “big tough men” and the women he commands can be very vulnerable.

When soldiers and airmen come off the plane as they complete an overseas deployment, the general greets them with a handshake — and a card advising them of counseling available to them. “I strongly encourage them to go,” Doohen said.

He said going to counseling with a family member can be useful. A soldier may not be aware, at least consciously, of changes he or she has undergone. But a loved one can often spot the pain they are feeling.

Taking suicide, depression and PTSD seriously is a priority for the state Guard, Doohen said.

“I’ve had it hit pretty close to home,” he said. “There is nothing more devastating than suicide.”

He said the idea that a person is so lost that they saw no other option — “it’s the only out they see,” Doohen said — is agonizing to contemplate. It gnaws away at survivors, Doohen said.

The Guard has decided to “do everything we can” and to “take the stigma away.”

Part of the problem is that for many Guard members, talking about their pain or weaknesses is difficult. They’re tough, Midwestern guys and gals who often lock their emotions inside. “I think men have an issue with that, definitely,” Doohen said.

They feel they can overcome the pain, confusion and mental anguish, he said. They repress it, ignore it, and hope it will go away.

But through counseling efforts and with the general leading the way, positive steps are being made, Doohen said. “I think it’s changing and it’s changing for the better,” he said. “(We) get them to seek help early.”

People suffering from PTSD pull back, the general said. They isolate themselves from family, friends and co-workers. “That’s what makes it really hard to reach them,” he said.

South Dakota’s vast size and many small towns add to the problem. Some Guardsmen and women return home to a community with no health-care options.

But the Guard will send counselors to soldiers’ homes, he said. “If they want help, we can give them help,” Doohen said.

‘We’re not paid to be weak’

Capt. Kenn Kerfont of Rapid City has witnessed soldiers he has commanded struggle with PTSD, depression and other anxieties.

Kerfont serves on the Pierre-based 152nd Combat Sustainment Support Battalion and has been in the Guard for 20 years. He has had three deployments in Iraq: during Operation Desert Storm in 1991 and twice during Operation Iraqi Freedom, in 2003 and 2004.

He first learned of PTSD and other emotional struggles soldiers endure when he was in college and volunteered at a veteran center. “I had a good heads-up,” Kerfont said. “I was prepared for it.”

He has commanded soldiers in war zones and said it’s important to be aware of their mental state. “Everybody goes over there pretty strong mentally and, hopefully, physically,” Kerfont said.

But he said seeing people killed or suffering a wound, as well as the overall stress of being in combat can push some people over the edge and they begin to suffer from depression and PTSD. Some turn to alcohol, Kerfont said.

Soldiers who may feel stressed or are experiencing mental problems are often loathe to admit it, he said. But a commander has to let them know it’s important to be upfront, Kerfont said.

“I have to know: Is your head in the game?” he said. “It’s a mental thing — how do you cope?”

If anonymity is assured, soldiers will usually be open about their problems, he’s learned.

“Soldiers say, ‘Will it affect the military job? I don’t want to be labeled that I have mental issues.’”

But he said he constantly tells soldiers to let him, a buddy or a chaplain know if they are in trouble. “If someone needs help, we have lots of resources,” Kerfont said.

A program called ACE: Ask your buddy, Care for your buddy and Escort your buddy, has helped soldiers deal with the pain, he said. It emphasizes the need for soldiers to spend time with their comrades and make sure they aren’t at risk of hurting themselves. It also stresses the need to share information with officers, chaplains or health-care providers.

The program advises soldiers to “Have the courage to ask the question but stay calm. Ask the question directly: ‘Are you thinking of killing yourself?’”

Maj. Jeff Norris, also of Rapid City, said getting soldiers to come forward is difficult.

“I think it is with soldiers in general,” said Norris, 41. “We’re not paid to be weak. But it’s OK to reach out to accept that help.”

He said the workload soldiers experience when they’re deployed is also a factor. It’s called “OP Tempo” and Norris, who served in Desert Storm in 1991 and did an extended tour in Iraq in 2003-2004, has lived it, at times working from 5 a.m. until 11 p.m. during a deployment.

He watches for soldiers who are angry and aggressive or are “using alcohol as a crutch.”

Combat stress teams made up of professionals in mental health fields evaluate soldiers as they return from battle, Norris and Kerfont said. They understand the pain and shock many feel.

“It’s not natural to see people killed,” Kerfont said. “It’s not natural to see a buddy killed.”

Soldiers who experience such trauma are closely watched, he said. But some people fall prey to PTSD because of the overall experience and the stress of being away from home and in a dangerous setting.

“Every soldier is unique,” Norris said. “Every soldier has his own threshold.”

1st Lt. Ken Honken, a chaplain candidate, said personal issues are often just as dangerous. He said a recent study indicated that more than 70% of soldiers who had attempted suicide did so because of a broken relationship.

Honken, 27, said a Strong Bonds program has been established to help soldiers and airmen learn how to handle a marriage or a relationship. The Guard offers assistance before, during and after a relationship. A marriage enrichment program is designed to assist soldiers and airmen and their spouses or significant others.

Norris joked that some single soldiers are taught how to build successful relations through a program called PICK, or Premarital Interpersonal Choices and Knowledge, which used the book “How To Avoid Marrying a Jerk” to help convey the message.

Another area that leads to stress and can trigger PTSD is readjusting to family life. A soldier may be gone for a year or more and come home to find his or her spouse has taken control of the home and family.

“Life goes on back home,” Norris said. “That transition is tough. We tell them to go in slow.”

He said Honken has “been up and down I-29” working with Guardsmen who have returned home. ‘Our chaplain is very pro-active,” he said.

‘Ask the Pentagon’

While the South Dakota National Guard and other branches of the armed forces are clearly doing a great many things to help men and women in uniform deal with stress, sometimes the efforts fail.

According to Pentagon figures, 108 soldier, sailors and airmen committed suicide in 2007. Suicides have been on the increase for some time, with 102 reported in 2006 and 85 in 2005.

The same report states that PTSD was up 50% in 2007 as the wars in Iraq and Afghanistan raged on. About 40,000 soldiers have been diagnosed with it since 2003 and officials are sure that many more are struggling with it privately, fearing career consequences or simply unwilling to admit they’re in pain.

Multiple deployments are often pointed to as a factor and South Dakota Guard officers admit that’s a major issue. But they said they must do what they are commanded to do, and that means sending their men and women back to combat time and time again.

“We follow the orders that have been given to you,” Norris said, when asked why suicides and PTSD reports are skyrocketing at the same time the armed forces are offering so many programs to deal with them.

“Those are good, hard questions,” he said. “You should ask those questions to the Pentagon.”

But Norris and Kerfont said the men and women who enlist in the all-volunteer armed forces “know what they’re getting into.” South Dakota has been at or near the top in recruitment and retention of its Guard members, they pointed out, and the patriotic soldiers and airmen are eager and willing to serve.

Lt. Col. Andy Gerlach, 41, of Pierre, is the commander of the 152nd. He said the Guard is doing all it can. Gerlach said it’s important to note that people who suffer from PTSD can recover.

Some lose portions of their memory, he said, but eventually regain it. Early intervention and proper care during and after a person’s service can reduce the problem. Kerfont said he has annual physicals done and encourages other soldiers to be pro-active with their physical and mental health.

“I think we’re well on our way,” Gerlach said. “I don’t know if we’re ever going to do everything for people

All the South Dakota National Guard can do is reach out, offer assistance and care for each other, Norris said.

“We’re … a close-knot family,” he said. “We can keep an eye on our soldiers and their families as well.”

They said the South Dakota Guard suicides were tragedies that have not gone unnoticed. “One’s too many,” Kerfont said.

An eternal issue

General Doohen serves on Gov. Mike Round’s cabinet as the secretary of Military and Veterans Affairs and Gerlach is his second in command. He said soldiers, airmen and sailors have undoubtedly experiences the same emotions for eons.

“I don’t think it’s any different,” Doohen said. “I think it’s been going on as long as we’ve had war — there has been the issue.”

Doohen, 60, joined the South Dakota National Guard in his hometown of Sioux Falls in January 1971. He was trained be a pilot and flew airplanes for 35 years, including some missions over Panama where he was the target of small-arms fire.

That didn’t cause him to suffer from PTSD. Doohen said, but he has undergone counseling in his life. He said while discussing his own life isn’t something he does easily, he realizes he may help other soldiers understand that it’s OK to get expert assistance in times of mental anguish.

Soldiers don’t even have to have experienced combat to be stricken with PTSD and depression, Doohen said. If they were stationed at a base that was under mortar fire at times, the knowledge that their tent could be struck by enemy fire could cause PTSD.

“They’re always kinda on edge,” Doohen said.

Not all soldiers suffer from PTSD and some can live through the same incident as others and not have it bother them greatly. “Everyone is different,” Doohen said.

But he said it’s clear that “very traumatic incidents” can cause people to suffer from PTSD. Everyone may define such an incident differently, he said.

He said research is indicating that PTSD may never go away. But people who suffer from it can be taught how to control it and reduce its impact on them, he said. Techniques taught to them can help them relax and that can be a major help, he said.

Veterans often ‘hyper-vigilant’

Ward said he realized after coming back from Iraq he had changed. At first, he wasn’t aware of the impact his overseas service had on him.

But in talking with counseling professionals while doing research for a story he was writing for the Guard, he realized he was more cautious while driving, and had become “hyper-vigilant.”

When he drove from his home in Lead to Camp Rapid, he was “scanning the sector” as if there were imminent dangers on the highway, he said.

Frank Marohn, one of two Pennington County veteran services officers, understands the pain these soldiers, airmen and veterans feel.

The 61-year-old Air Force veteran did two tours in Vietnam. The first was almost pleasant; he performed aircraft maintenance while stationed near a beach. But when he returned, it was a different story.

“The second time I went back, it was hell,” Marohn said.

Rocket attacks roared to remind him a war was going on. Snipers fired away, creating a sense of unease.

Marohn said he came home with disturbing memories. They linger today, more than three decades after the war ended.

He sees a counselor every other week and said it helps to talk to people. That’s what he tells veterans he speaks with. “The big thing is to talk to somebody,” Marohn said. “Don’t just put it away.

“I tell guys, ‘Hey, it doesn’t get any better,” he said. “Talk it out.”

Perhaps one of the disturbing parts of PTSD is the fact that it often lingers. “As you get older, it gets tougher,” Marohn said. “You don’t have the energy to keep it in.”

The good news is that soldiers, airmen and sailors who return home today are greeted far more warmly than Vietnam veterans were, he said. The Black Hills is especially supportive, Marohn said, with veterans welcoming home their fellow service members and people who didn’t serve also showing support.

Pennington County is home to 12,000 veterans, more than any other county in the state, Marohn said, many like him who were stationed at Ellsworth Air Force Base. It’s the only county in South Dakota with two veteran service officers.

When he ended his 26 years in the Air Force, he settled in Rapid City. During his years as a veteran service officer, he’s witnessed the pain veterans suffer.

Two local Vietnam veterans he knew committed suicide, unable to deal with the dreams and memories. Marohn said he doesn’t know of any local veterans of the current wars who have committed suicide.

He thinks veterans who served in Iraq are coming home in worse shape than those who were in Afghanistan, but he sympathizes with all of them — and offers a helping hand.

The longer activations and repeated tours of duty cause a lot of the pain and strain, Marohn said. In recent months, a serviceman came to his Rapid City office and sought help.

“He sat here and cried and said, ‘I don’t think I can do it,’” Marohn said.

Norris said he had a similar experience during the 1991 Gulf War. Sometimes soldiers simply can’t go on, he said.

Veterans centers offer a place where people can talk and hear about a fellow veteran’s experiences. “I think it gives me an advantage by being a Vietnam veteran,” Marohn said.

Doohen said he’s willing to talk to people about his own struggles and his personal connections to suicide and depression to persuade the men and women who serve under him to combat the issues.

“The leadership has to lead,” Doohen said. “Maybe I can help take away the stigma.”


Veterans counseling and assistance resources





Veterans, military offices




Pennington County Veterans Service Office, Public Service Building, 725 North LaCrosse Street Rapid City, SD 57701 (605)394-2266

S.D. Department of Military and Veterans Affairs (877) 579-0015, available 8-5, M-F

S.D. Family Readiness Center at (800) 658-3930 available 24/7

South Dakota Department of Military and Veterans Affairs – (877) 579-0015 or (605) 773-4981

South Dakota National Guard Family Readiness Center – (800) 658-3930 or (605) 737-6728

South Dakota National Guard State Benefits Advisor – (605) 737-6669


Veterans Administration offices:




Fort Meade at (800) 743-1070 or (605) 347-2511

Hot Springs at (800)-764-5370 (605) 745-2000

Sioux Falls (800) 316-8387 or (605) 336-3230

Vet Center – Rapid City (605) 348-0077, Sioux Falls (605) 330-4552, or Martin Outstation (605) 685-1300

County or tribal veterans service officers are listed in phone books under county government.


Hotlines




VA Suicide Prevention Hotline (800) 273-TALK (8255), available 24/7

Military One Source (800) 342-9647, available 24/7

VA Suicide Prevention Hotline – (800) 273-TALK (8255)

Military One Source (800)-342-9647, available 24/7


Web sites




Veterans Administration Home Page www.va.gov

South Dakota Department of Military and Veterans Affairs http://www.state.sd.us/applications/MV91MVAInternetRewrite/default.asp

Military OneSource http://www.militaryonesource.com

Mental Health Self-Assessment Program at www.militarymentalhealth.org

South Dakota National Guard http://sdguard.ngb.army.mil/Default.asp

SDNG Family Readiness Center http://sdguard.ngb.army.mil/sdnginternet/mainFamilyProgram

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This is going on in every state in the nation that has deployed national guard and reserve troops, Naval or Air Force detachments or Marines and sent back to small towns across the nation.

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