Mental Health & Suicide Prevention Need Deeper Defenses
- Josh Jones
- May 3, 2022
- 10 min read
May is Mental Health Awareness Month - what more will it take for us to be AWARE & ACT?
Seeing a rise in mental health issues and suicide tragedies in the military, country music royalty, in college athletics and all around us is frightening, something we cannot continue to look the other way from.
Just this week we add the suicide of Naomi Judd #NaomiJudd, country music hall of famer and music icon from the last few decades to a horrible 2022 list. Naomi joins Katie Meyer #KatieMeyer the University of Stanford soccer goalie and national champion from 2019, Lauren Bernett #LaurenBernett the JMU softball catcher and 2021 college world series champion, Sarah Shulze #SarahShulze the University of Wisconsin track star, Cheslie Kryst #CheslieKryst the former Miss USA and multiple military servicemembers from the USS George Washington.
These are just a few of the higher-profile suicides we have seen so far in 2022, and there are countless others as the suicide rate is growing by the minute globally and in the US, with 5 deaths by suicide occurring every hour in the US (over 130 a day, EVERY DAY). Suicide is the last most painful sign of mental health struggle that is far too common and far underserved. All of this so far in 2022 as we start May which is mental health awareness month. I hope we eventually become aware of this true crisis all around us. More than 40% of us struggle or will struggle with mental illness in various degrees, this is not a small-scoped issue. We need better recognition, tactics and strategy to fight this war.
I remember my soccer coach when I was in middle school telling us that we would build such a common understanding of our game and tactics, strategy, everyone’s role on the team that we would eventually be able to play blindfolded. We would be able to count on knowing that before you pass the ball, that your teammate knows exactly where to be, what to do, and we would work together as an orchestra. That would be the measure of success for our team, not scoring goals or winning tournaments, but we would be champions when we all truly understood the way to play together and how to do so, without even speaking. In many practices we would scrimmage for an hour or more without the ability to talk, and while it was difficult at first, eventually we all learned how to play our instrument and work together as a single unit, not 11 individuals. And we did see great success on the field, more valuable though - we also built a bond that was unbreakable for many years, and to this day, with some of those teammates. It took us the good part of two seasons to get to that point, it was not easy, we all learned at a different rate, needed to be coached up in different ways. But we progressed forward and stuck to the plan and the vision, and in the end we were elevated to a different place than we ever imagined. Mental health needs similar common understanding and a team approach.
I don’t think we as a team, or at least I know that I didn’t as an individual, understand the power of this vision. Sure, it was very satisfying to know where the ball needs to go before you receive the pass, to know with certainty where your teammate would be – the beauty of what was created went far beyond scoring goals and winning soccer games. To have that certainty and understanding between one another was a precious thing, something that we all should strive for in other aspects of life. To say you know someone is there for you, that they understand you without having to say a word, that they are running in the same direction towards the same future and goals as you is priceless. It’s a mentality that is a powerful societal utopia. Perhaps a total pipedream, but if we can move in that direction in small ways we will be better. To get there takes a process, dedication, commitment, long hours of sweat and learning. As I wrote about earlier, we have to break down a complex subject, starting simply with realization of the scope of the issue, basics like education on terminology and vernacular, creating time in the day and interjecting this subject matter into our lives. Schools need to have more practical psychology and emotional intelligence classes just the way we do for sex education. Mind education, heart education must become a reality.
I was reading a story about the military recently and it brought a very similar thought to my mind. I doubt boot camp covers the mental aspect in the way we should, other than from the brute force methodology of weeding out any ‘weak’ minds through a grueling process. How many more would make it through the gauntlet, how much better would our servicemen and women be if we helped them to strengthen the most important muscle first, the brain? Would our platoons and units be much stronger if they embraced the mental and emotional side of the work better and spent more time learning how to process the external pressures that would bombard them and challenge their singular and collective mental capacity in times of crisis? I think we would all be better.
Evidence that we need more coaching on the emotional, mental side of things is abundantly clear when we see growing numbers of mental health issues and many more signs of stage 4 disease in the military and in our youth (#B4Stage4).
This article on the Navy hit me close to home literally because I grew up in the Hampton Roads area and remember how significant the military mindset and presence was there.
To see a high number of deaths, 7 in the last 12 months from the crew of the USS George Washington while the ship has been at port for maintenance and refurbishment (refueling and overhaul they say) in Newport News, VA is very unexpected. At least 4 of the deaths have been confirmed as suicides. While the stop in port is meant for replenishing the vessel itself, perhaps the crew is most in need of refueling their minds and souls, and a mental health overhaul. Three of the four confirmed suicides occurred in just the last month.
We will never know just what caused internal trauma and terror for these four, that is another tough aspect of mental health when it leads to suicide. We will never be able to answer the question of Why. Why wonder when you can know – that is a very poignant reference to design thinking from GE Healthcare applicable to mental health. https://thisisdesignthinking.net/2014/12/changing-experiences-through-empathy-ge-healthcares-adventure-series/ #DougDietz
Early engagement is the key to understanding someone’s thoughts, mood, feelings, struggles and fears in order to help before we lose that chance and things progress to the point of engulfing and overtaking the life of a lost soul. Never will we truly understand the struggles of Master at Arms Seaman Recruit Xavier Hunter Mitchell Sandor, Retail Services Specialist 3rd Class Mikail Sharp or Interior Communications Electrician 3rd Class Natasha Huffman, the names of the three who lost their battle that we know of today. Never will we know what disrupts 5 lives every hour in the US due to suicide.
This aspect of the simple, to-the-point reporting of the facts of the matter from CNN also struck me:
Though based on the West coast, the USS George Washington has been at Newport News shipyard since 2017 going through its Refueling and Complex Overhaul (RCOH), a process carried out halfway through the life of a carrier that replenishes its nuclear fuel and updates its systems. The process typically lasts four years, but it has been delayed multiple times by the pandemic and other setbacks.
If an aircraft carrier requires a four-year tune-up halfway through its life and all the issues can easily be seen and diagnosed, remedied from a mechanical perspective, are we spending the right amount of time refueling and repairing ourselves which is a much more complex and intangible set of machinery? And four years time and effort is under routine circumstances, not to mention the additional external pressures we face, just as the USS George Washington has faced due to the pandemic.
The Navy has taken steps in the right direction, already adding resources to support crew mental health – with the additional of a clinical psychologist and a licensed clinical social worker, a quicker referral process to pair crew with a mental health service provider to get the support they need more effectively. These are good moves, and more moves are needed in broader fashion in the military, in our colleges and universities, in our public school systems from K-12. If ever there were a time to deploy the Department of Defense (DoD) and US Navy’s Nuclear Propulsion program Defense-in-Depth strategy it would be now for the mental health crisis we have in both private and public sectors covering adolescents through adults and retirees. This is an effort that spans every walk and age of life whether you are a civilian, student, professional or military serviceperson. We are all a ship that must be protected from nuclear meltdown that has significant consequences. And there is no single characteristic or plant system that is enough to prevent this occurrence.
What is Defense-in-Depth you might ask?
From a general military perspective, DiD has been around for a long time as a way to delay rather than fully prevent the advance of an attacker, buying time and causing additional casualties by yielding space. Rather than defeating an attacker with a single, strong defensive line, defence in depth relies on the tendency of an attack to lose momentum over time or as it covers a larger area. A defender can thus yield lightly defended territory in an effort to stress an attacker's logistics or spread out a numerically superior attacking force. Once an attacker has lost momentum or is forced to spread out to pacify a large area, defensive counter-attacks can be mounted on the attacker's weak points, with the goal being to cause attrition or drive the attacker back to its original starting position.
Defence in depth requires that a defender deploy their resources, such as fortifications, field works and military units at and well behind the front line. Although attackers may find it easier to breach the more weakly defended front line, as they advance, they continue to meet resistance. As they penetrate deeper, their flanks become vulnerable, and, should the advance stall, they risk being enveloped.
The earliest example of defense or defence in depth came at the Battle of Cannae in 216 BC, when Hannibal employed this strategy in order to encircle and destroy eight Roman legions. There are also many other examples of this strategy being deployed by the Romans in the 3rd and 4th centuries AD. Others include the Byzantine military, American Revolutionary War, First World War, Turkish War of Independence and Second World War (Normandy, Tarawa, Saipan, Peleliu, Iwo Jima and Okinawa). The best modern example was in the Battle of Kursk.
More recently this concept has been applied to the computer security sector and fields of life-saving technologies where it is critical to avoid a disaster, or to save lives. I have even used DiD as a way to establish deep operational overlapping controls for critical tasks in the pharmaceutical industry. So this mindset and methodology can serve us well in the mental health space and many others beyond the traditional battlefields.
From a Nuclear Naval philosophy standpoint, DiD is the idea that it takes many different approaches and overlapping controls to prevent a nuclear catastrophe on a submarine miles under the ocean. DiD encompasses multiple layers or lines, fortifications that come together to provide protection in a holistic robust and reliable every time approach. To drive change in the mental health space we need many layers to provide a deep defense. We need redundancies, we need different angles of approach to be successful. This is the kind of approach to mental health we need to adopt.
A few other points and stats from the CNN article are also noteworthy to me – in 2020 580 service members committed suicide as reported by the DoD, and we know those numbers are continuing to rise with 18 in the Navy alone for this year as of April 22nd, the overall numbers in the military and civilian ranks rising just as they have the last four years.
Maybe this case on the aircraft carrier can be the forefather of change for the military and their practices. And in so many other ways, we take lessons from the military, perhaps this lesson will be another example and we can all march in sync together to a new beat and battle.
The crew of the USS George Washington is 2,700. Four deaths by suicide is still below a 1% rate, but the rate of suicide from the crew is more than an order of magnitude higher (over 10-times higher) compared to the average of 13.5 per 100,000 people in the US over the last 10 years.
In 2020, the most recent year for which full data is available, 580 military members died by suicide, a 16 percent increase from 2019, when 498 died by suicide, according to the Defense Department. Nineteen out of every 100,000 sailors died by suicide in 2020, compared to members of the Army, which had the highest rate, at about 36 per 100,000, Pentagon statistics show.
So a deep investigation for understanding needs to be undertaken, and that is what the US military is committing to. Let’s see what is found from that investigation. What can we apply elsewhere, what layers of defense can we deploy more broadly to combat mental health. For we are all more complex than a nuclear submarine and a single loss of life due to mental implosion is a meltdown we must work to prevent.
Just yesterday there was a follow-up article and we will keep monitoring the situation on the USS George Washington, I hope that the crew can find more than a new home as they move off of the ship temporarily.
Details of conditions that must be changed on the USS George Washington are in black and white here.
The story of Hannah Crisostomo taking 196 pain relievers tells you in a tragically symbolic way just how difficult the pain of her daily life onboard was to stomach. Perhaps, it takes these painful details to open our eyes, no matter how difficult to read and visualize.
“If they keep me in the Navy, and they put me back in the same situation, I’m going to kill myself,” she recalled thinking, “and I’m going to be successful the next time.”
Crisostomo and several other George Washington sailors said their struggles were directly related to a culture where seeking help is not met with the necessary resources
“Beating suicide is like beating cancer,” he said, according to a transcript of the address, released Monday by the Navy. “There are many different causes, many different reasons.”
“He was the life of the party,” Jefferson said. “He never showed his pain.”
“We talked about it. She tried to get help,” the sailor said.
“She wasn’t getting any assistance from the Navy, as much as she tried,” the sailor added.
“And then that’s when we got the phone call that she wasn’t with us anymore.”
“You can’t just snap your fingers and grow a psychiatrist,” he said, adding that the sailors should be “each other’s counselors.”
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