A great article by Boston Globe Correspondent Karen Weintraub talking about how the Military is monitoring social media to cut the suicide rate.

"Nearly every day, an active-duty service member takes his or her own life, causing waves of grief among families and peers.  And each day, on average, 22 military veterans in the United States commit suicide.  Roughly one in five Americans who commit suicide is or was in the service.  The military has been working aggressively since 2007 to try to stem suicides, but everyone agrees there will be no easy fix.

Now, however, big-data specialists, including the Newton software firm Attivio Inc., are collaborating with military suicide experts to try to address the problem by using social media to monitor veterans for signs of despondency.

The specialists said they are identifying key words and phrases that suggest someone is spiraling downward, while developing an analytics system that could examine thousands of online posts and alert medical specialists and family members when a veteran’s comments indicate he or she is at risk of committing suicide.

Relatively few people come out and say they are suicidal. But by tracking the postings of veterans who agree to participate in the system, organizers hope eventually to identify those at high risk, and to intervene early enough to make a difference.

The program, called the Durkheim Project after the man known as the father of sociology, Emile Durkheim, is developing algorithms to determine which phrases or combination of phrases are most predictive of suicide attempts.

“It’s the words they are using that’s the reliable signal,” said Chris Poulin, the director and principal investigator of the Durkheim Project and a predictive-analytics expert.

Although Poulin would not reveal the precise phrases the Durkheim Project has identified, suicide researcher Craig Bryan, a University of Utah psychologist who is advising the project, said that the coded language of the suicidal often includes phrases such as “You’d be better off without me,” “I messed everything up,” and “I can never be forgiven for my mistakes.”

Moreover, behaviors such as buying a gun or giving away belongings can help to identify at-risk veterans and are often reported on social media, Bryan said.

In the first phase of the project, which was just completed, Poulin and colleagues developed a language-driven predictive model to estimate suicide risk.

They based their research on doctors’ notes from the records of three groups of veterans: those who had committed suicide, those who had psychiatric challenges but were not suicidal, and those with no apparent psychiatric issues.

From the doctors’ notes, Poulin said, it was possible to distinguish between the three groups.

Those whose psychiatric problems were not life-threatening tended to talk about their eyesight, for example, or their preoccupations and personal hygiene. Those who were healthy talked to their doctors about muscle or joint pain or eating disorders. And the suicidal discussed their agitation and fears, along with their need for painkillers.

In the next phase of the Durkheim Project, Poulin and others will test the predictive quality of those insights among as many as 100,000 service members and veterans who agree to have their social media and mobile posts shared.

This kind of varied language, as well as the shorthand used on social media, can be extremely challenging to analyze, said Sid Probstein, the chief technology officer for Attivio, which is responsible for that analysis.

How those phrases change over time can also be a warning sign, Probstein said, so a huge amount of data has to be gathered from text messages, Twitter, Facebook, and other social media outlets and analyzed.

This kind of analysis of so-called “natural language” has been possible only recently, Probstein said, “so it’s really only in the last decade that you could imagine doing something like the Durkheim Project.”

Facebook, which helped debug the program, will assist in recruiting volunteers, Poulin said. The military provided a two-year start-up grant for the research.

Eventually, those whom the project identifies as at-risk will be automatically linked to resources in their area to get help, and their support network will be notified.

Users will be able to opt in and out of the system, so their privacy will not be compromised by the data analysis without their knowledge, said Poulin, who also worked with former colleagues at the Geisel School of Medicine at Dartmouth College.

“You don’t just get the person to opt in, but you get their friends and family to opt in, and let family know this person is suffering,” Poulin said.

If they do not have such support in their lives, there are scripts that can be read to at-risk people that have been shown to help, he said.

Even people who feel alone will leave a footprint on Facebook or via a text, Poulin said. “Their social network may be very small, but not so small that they don’t use a phone,” said Poulin.

Bryan, associate director of the National Center for Veterans’ Studies at the University of Utah, said the pressures on the military have increased exponentially over the past decade, as wars in Iraq and Afghanistan have dragged on and downsizing has meant service members doing more with less, increasing their stress and suicide risk, both during their service and after retirement.

Multiple deployments also take their toll on service members, who may be away from home for most of six or seven straight years, said Kelly Posner, director of the Center for Suicide Risk Assessments at Columbia University.

In combat, service members are distracted by the urgency of their tasks. Now that the wars are winding down and they are back home for good, “they’re having to face what they saw, what they did, what they didn’t do, their unmet mental health risks, their families that have not been together,” she said.

Suicide, she said, is the fourth-leading cause of death for those ages 18 to 64, and probably the most preventable, “but we need to keep working hard.”

By using observable behavior, the Durkheim Project may help the invisible become visible, Bryan said.

“That is really one of the missing links in suicide prevention, both inside and outside military.”"

The suicide crisis is getting more and more attention in the press.  While it's good that people are talking about it, I don't see the ACTION needed to help.

NBC News just printed a story 'The Enemy Within: Soldier suicides outpaced combat deaths in 2012' by Bill Briggs.  Please read and share.


More soldiers took their own lives than died in combat during 2012, new Department of Defense figures show. The Army's suicide rate has climbed by 9 percent since the military branch launched its suicide-prevention campaign in 2009.

Through November, 177 active-duty soldiers had committed suicide compared to 165 during all of 2011 and 156 in 2010. In all of 2012, 176 soldiers were killed in action -- all while serving in Operation Enduring Freedom, according to DOD.

Army suicides have increased by at least 54 percent since 2007 when there were 115 — a number the Washington Post then called "an all-time record." An Army spokesman said Wednesday it is uncertain if 177 marks a new annual high (with December numbers still to come), or if suicides have ever outpaced combat deaths in a single year, because the Army has not always tracked suicides.

Some Army families who recently lost members to suicide criticize the branch for failing to aggressively shake a culture in which soldiers believe they'll be deemed weak and denied promotion if they seek mental health aid. They also blame Army leaders for focusing more heavily on weeding out  emotionally troubled soldiers to artificially suppress the branch's suicide stats versus embracing and helping members who are exhibiting clear signs of trouble.

Furthermore, in September, two U.S. lawmakers pressured the Pentagon to immediately use unspent money specifically appropriated to the agency to help slow the suicides within the military. Rep. Jim McDermott, D-Wash., and Rep. Leonard Boswell, D-Iowa, also pushed for increased anti-suicide funding for the Department of Defense in 2013.

“The Pentagon hasn’t spent the money that it has for suicide prevention for this year — and that money wasn’t nearly enough money to reach all the soldiers who need help. Now we are hearing about bureaucratic technicalities at the Pentagon that are preventing them from acting. This is unconscionable,” Rep. McDermott said. “The Pentagon is funded to help soldiers and needs to do much more on the epidemic of suicides."  

But the Department of Defense contends that anti-suicide programs installed throughout the armed services soon will curb military suicides — and that such initiatives already have helped douse mental-health stigmas.

"We have seen several programs that we are optimistic are going to start making a dent in this issue," said Jackie Garrick, acting director of the DOD suicide prevention office. "We’ve asked all of the services to use the same messaging, the same talking points. So the Army, included in that, is trying to adapt and promote those same messages because we realize that this is an across-the-board problem."

The Army could not provide a suicide-prevention officer to comment, but an Army spokeswoman did forward NBC News a link to the “Army Suicide Prevention Program.”

Within that initiative, soldiers are taught to “Ask, Care, and Escort” any Army buddy who mentions considering suicide, to usher them to behavioral-health provider, chaplain, or a primary-care provider, and to “never leave your friend alone." The U.S. military also installed a prevention “lifeline:” 1-800-273-TALK.

What's more, soldiers are assured that seeking mental-health counseling will not harm their chances at gaining a security clearance. And on that website, a videoshows Sgt. Maj. Raymond F. Chandler III, the Army's top non-commissioned officer, speaking to other NCOs: “Know your soldiers. Know the resources available to them when they are in crisis ... Encourage your soldiers to seek help ... Seeking help is a sign of courage.”

The anti-suicide strategy was rolled out in April 2009 by Army Vice Chief of Staff Gen. Peter W. Chiarelli.

In July 2010, the Army released a report that sought to explain its suicide epidemic. Some Army families were irked by one of the key findings: Loosened recruitment and retention standards — due to the furious pace of repeated deployments — had allowed more than 47,000 people to remain in the Army despite histories of
substance abuse, misdemeanor crime or “serious misconduct.”

Chiarelli further frustrated many Army families who had lost members to suicide when, amid the release of that same report, he added: “I think it’s fair to say in some instances it would be a soldier that’s possibly married, couple of kids, lost his job, no health care insurance, possibly a single parent.” Those types of soldiers, he added, are “coming in the Army to start all over again, and we see this high rate of suicide.”

Two days before Charielli’s comments, 28-year-old Army soldier Brandon Barrett showed up at his parents' home in Tucson, Ariz. The family believed he was on leave following a brutal, year-long deployment in Afghanistan with the 5th Stryker Brigade during which he saw several buddies killed or wounded by bombs and did some killing himself.

During that visit, Barrett’s family thought his Army experience seemed to be helping him to mature, recalls his brother, Shane Barrett, a detective with the Tucson Police Department.

In August, Brandon Barrett left his parents’ home and drove — for unknown reasons — to Salt Lake City where he donned his combat fatigues, boots and helmet, grabbed his AR-15 rifle, went to a hotel and told an employee to call the police. As he waited for the officers, Barrett paced the hotel parking lot as if he was on patrol, a  hotel video showed. A police officer arrived. Barrett shot him in the leg. The officer returned fire and killed Barrett with a bullet to the head. His family believes Barrett intended to commit “suicide by cop,” his brother
acknowledged.

“He’d been home for nearly a month,” Shane Barrett told NBC News. “We had no contact from anybody in the Army until my brother’s incident. And then, after the fact, it was: ‘Your brother was AWOL (absent without leave).’ Really? We didn’t know that.

“If a guy goes AWOL, the Army is supposed to notify the family immediately. We never received phone calls, letters. We were blindsided. At the police department where I work, they ran all kinds of record checks on him. But they found absolutely nothing (about an AWOL report).

“My mother has always believed he was declared AWOL after the fact just so the Army could get him off the rolls and not have his suicide count against the Army,” Shane Barrett said. “To just discard him, like he never existed, is just wrong. And there’s no paper trail, no nothing to back up the AWOL claim.”

The Barrett family later learned that Brandon had confided to a chaplain within his unit, revealing that his year of combat in Afghanistan had left him depressed and anxious. And possibly mulling suicide.

“From talking to a couple of other guys in his unit, he didn’t want to come forward (to seek mental-health help) because you’d be red-flagged. It would be your exit out of the Army,” Shane Barrett said. “The guys in the Army are just flat-out afraid to come forward.”

At the Department of Defense, anti-suicide chief Garrick was asked if the Army is indeed clinging to a culture of “suck it up" and handle your own problems,” as some Army families contend.

“No, I think all of the services have done a pretty good job of trying to get a message out. The Army ... they’ve done the 'shoulder-to-shoulder,' (approach, and have said) ‘no soldier stands alone.' That’s been some of their messaging, now going back a while,” Garrick said.

“The Secretary of Defense (Leon Panetta), this past year, issued a statement talking about how our service
members are our most valuable resource and that we need to do everything we can to take care of our people. So we’re doing everything we can to prevent suicides in the military, recognizing that it’s a complex and urgent problem.”

An impactful article on what goes through one person's mind and the crisis facing


Matt Kuntz did not want to die. But he thought he must.  It was November 2000 when he mapped out his exit strategy.

“It felt like you’re a person in a dark room, terrified and scared of the dark,” said Kuntz, 35, now executive director of Montana’s Chapter of the National Alliance on Mental Illness. “All you can feel is that single doorknob.
You know that you don’t want to turn it, but in the end, can you be in the dark any longer?”

 From all appearances, Kuntz seemed to have it all. He has a keen intellect and was a remarkable athlete, playing rugby, all-state football, wrestling and swimming. In 1999, he graduated from West Point and was commissioned an Army infantry officer.

Life was good.

Then, over the course of six months while stationed in Hawaii, a severe ankle injury in Ranger School left him crippled and his military aspirations in tatters. On top of that, his fiancée betrayed him, and he was homesick for
Montana.

The confluence of events triggered earlier bouts of depression that had been suppressed since high school and West Point.

“I couldn’t take it another second,” Kuntz said. “The pain hurt so bad – deep pain.”

He looped a rope around a rafter in the attic, secured it with an overhand hitch knot and tested it to ensure it would hold his 200 pounds. As a chair wobbled beneath his feet, he tested the noose again.

“You feel like you’re under water,” he said. “All you can think about is that breath and being overwhelmed by the torment your brain is throwing at you. All you can think about is ending it. I’ve been at the bottom of the Madison River in March getting bashed around by rapids. I can tell you, that’s nowhere near as terrifying as being in the grips of depression.”

Before he could go through with it, he decided to go downstairs and write a note. As he descended the steps, he stopped to say a prayer.

 “God, I love you. But I just can’t do this any more. If you have some reason that I should stay alive, I’ll give you five minutes to show me a sign.”

He then drafted two notes, but trashed them, settling finally on brevity.  “I’m sorry,” he wrote, and signed it “Matt.”  He tacked the note on the wall and climbed the stairs again.

As he slipped the noose around his neck, he realized he hadn’t paid his rent. Out of respect for his landlords, he wanted to pay them. But he didn’t think he had any blank checks, and the daily withdrawal limit on his ATM card was short of what he needed.

“You’re not thinking clearly,” Kuntz said. “Your brain is not working. It’s fundamentally not working.”

His mind wrestled with whether to go looking for a blank check or just get on with it.  He removed the noose, stepped off the chair and frantically scoured his apartment for a check. He found one, filled it out and walked outside to drop it in the mailbox. On his way back, he noticed his neighbor, Jeff, sitting on his porch and crying.

The men talked for the next two hours. Jeff’s marriage was on the rocks, he feared he was about to be laid off and was fearful of what it would mean for his children.

“I didn’t have answers, but we talked until he felt better,” Kuntz said. “Somewhere along the way, I began to feel better, too. Helping him took my brain away from that irrational thought. I believe for a fact that my prayer was answered.”

An estimated 15 Montanans attempt suicide every day. In 2011, at least 452 people completed the act. Montanans kill themselves with greater frequency than any other state in the nation. It is such a longstanding
problem in the state that mental health leaders characterize it as a public health crisis.

The crisis has many causes: a shortage of mental health professionals and mental health facilities; the state’s high rates of alcoholism; a cowboy culture where seeking treatment may be seen as weakness; and the prevalence of firearms.

Kuntz was no stranger to suicide or mental illness. As a boy, he lost a friend to an eating disorder. As a teen, two of his buddies at Capital High School in Helena killed themselves.

In March 2007, his stepbrother Chris Dana, a Montana National Guardsman, returned from Iraq with post-traumatic stress disorder and fatally shot himself.

It was about that time that Kuntz became the first director of NAMI Montana, campaigning to improve mental health care in Montana and change the way the public perceives mental illness.

“I felt I had the opportunity to change some big things,” he said. “We need to have a better understanding of mental illness if we want to keep these people alive.”

NAMI is the nation’s largest grass-roots mental health organization dedicated to improving the lives of millions of Americans affected by mental illness. NAMI advocates for access to services, treatment and research. It is committed to raising awareness of mental illness.

NAMI Montana has affiliates in Billings, Bozeman, Butte, Flathead, Great Falls, Helena, Lewistown, Livingston, Mission Valley and Missoula.

Cindy Uken is a reporter for the Billings Gazette. Her reporting on Montana’s suicide epidemic was undertaken with the help of a California Endowment Health Journalism Fellowship from the University of Southern California’s Annenberg School of Journalism.

I'm seeing more and more attention being paid to this crisis but not enough solutions being offered. 


Gregg Zoroya, USA Today

With six weeks left in the year, the Army and Navy are already reporting record numbers of suicides, with the Air Force and Marine Corps close to doing the same, making 2012 the worst year for military suicides since careful tracking began in 2001.

The deaths are now occurring at a rate faster than one per day. On Nov. 11, confirmed or suspected suicides among active-duty forces across the military reached 323, surpassing the Pentagon's previous high of 310 suicides set in 2009.

Of that total, the Army accounted for 168, surpassing its high last year of 165; 53 sailors took their own lives, one more than last year.  The Air Force and Marine Corps are only a few deaths from record numbers.  Fifty-six airmen had committed suicide as of Nov. 11, short of the 60 in 2010.  There have been 46 suicides among Marines, whose worst year was 2009 with 52.  "We continue to reach out to and embrace those who are struggling," the Army's chief personnel officer, Lt. Gen. Howard Bromberg, said in a statement Sunday. "We've taken great strides to prevent suicides, but our work isn't done."

Military and medical leaders have been searching for answers to what Defense Secretary Leon Panetta describes as an "epidemic" of suicides ever since the numbers began increasing among soldiers and Marines in 2005.

 Military suicide researcher David Rudd sees a direct link with the effects of combat and frequent deployments.
"The reason you're going to see record numbers is because these wars are drawing down and these young men and women are returning home," Rudd said. "When they return home, that's where the conflicts surface."  

While post-traumatic stress disorder was not a factor in large numbers of suicides, data show, among nearly 85% there were failed relationships, something linked to frequent separations.

 Still, at at least a third of soldiers who killed themselves this year never went to war, and some leaders draw a correlation with societal stress, perhaps related to the poor economy.  "This is not just a military issue or an Army issue," said Gen. Lloyd Austin III, Army vice chief of staff.  "Across the military, we're a microcosm of what's in the nation," said Navy Vice Adm. Martha Herb, director personnel readiness.

The trend in suicides now seems to be impacting the branches that have had fewer troops in combat: the Navy and Air Force.  Suicide rates for the military, while rising, have remained lower than for the general population until this year. The current rate for the Army is close to 30 per 100,000, outpacing an estimated 24-per-100,000 rate among a demographically similar civilian population, according to military statistics.

The record-setting numbers reported by the military pertain only to active duty troops. The Army, for example, has recorded an additional 114 suicides among G.I.s in the National Guard or Reserve who were demobilized — its citizen soldiers.

When Army suicides among those on active duty and demobilized status are combined, the number exceeds the 207 soldiers who have died so far this year in Afghanistan, a difference further skewed because some of those combat zone deaths were also suicides.

The military in recent years has invested more than $50 million in research efforts to produce evidence-based tools for preventing suicide.  Among the first studies is one involving 50 soldiers who attempted suicide at Fort Carson, Colo. It recently found that by teaching them meditation and relaxation skills to manage emotions and relationships, suicidal behavior was dramatically reduced, said Rudd, who is leading the research.

 "We weren't thinking about the issue as really one of curing mental illness," he said. "(It) is about installation of hope."

More members of the U.S. Armed Forces died by their own hand — usually with a gun — during the first nine months of this year than had their lives ended by the enemy in Afghanistan during the same period.

That startling suicide statistic has led to a realization by National Guard units across the country that more effort needs to be spent identifying Guard members who could be suicidal, and getting them the help they need before a tragedy occurs.

During the first nine months of 2012, there were 247 suspected suicides among Army active- and reserve-duty personnel, compared to 222 military deaths among active and reserve personnel from “hostile causes” as of Sept. 28.

Members of the Massachusetts National Guard are as much at risk as their counterparts across the nation, although the number of suicides among Massachusetts Guard members since 9-11 has remained in the single digits, according to Major Gen. L. Scott Rice, adjutant general of the Massachusetts National Guard.

“That’s still more than we have had in the past,” said Major Gen. Rice, although he did not have exact figures.

“Every single one is more,” he said. “Every single one is special, making it important that we figure out why, what and where and how do we make it better for the future.”

With each suicide a tragedy, efforts are now under way to identify and treat Guard members who might be vulnerable, as well as build resiliency among Guard members before they head overseas.

In the commonwealth, those efforts will involve a partnership between the University of Massachusetts Medical School in Worcester, the National Guard and the Massachusetts Department of Veterans’ Services.

An announcement of the joint venture was made last week at the medical school by Dr. Michael Collins,
the school’s chancellor; Coleman Nee, secretary of the state Department of Veterans’ Services; Maj. Gen. Rice; and Dr. Barry Feldman, director of psychiatry programs in public safety and assistant professor of psychiatry at
the medical school.

“Working together, we will build a collaborative program that will not only help address the unique health needs of today’s members of the Massachusetts National Guard, but which also can serve as a model for addressing the needs of military members of all branches, as well as veterans, across the nation,” said Dr. Collins.

Nationally, suicides among active and non-active military personnel are increasing. In July alone, a
record 38 confirmed or suspected suicides were recorded, including 26 among active-duty soldiers and 12 among National Guard or reserve soldiers who were not on active duty.

The behavioral health faculty at the medical school will collaborate with the National Guard and the Department of Veterans’ Services to implement suicide prevention strategies specifically designed for military personnel, including training by medical school experts for National Guard personnel in suicide prevention and resiliency building.

The medical school and Veterans’ Services Department participated with the National Guard in a statewide stand down this past September that focused on suicide prevention.

According to Maj. Gen. Rice, there were numerous Guard members who volunteered to be trained to identify comrades who are at risk for suicide, as well as to find them help.

“It’s not an assigned duty,” he said.

Resiliency — helping to fortify Guard members who may go oversees — is also an important feature of the work that will go on between behavioral faculty members and the military, according to Dr. Feldman.

Resiliency training does not mean just preparing Guard members for some of the sites and scenes they may encounter, but also letting them know that the various reactions they may experience are not something they have to keep to themselves.

“They need to know that if they experience feelings that are upsetting, it is all right to talk to others about this,” said Dr. Feldman.

The partnership will also seek and educate civilian medical personnel, who are often the primary medical providers for reserve members and veterans, to prepare them to respond to the unique social, psychological and
medical needs impacting military members and combat veterans.  Medical personnel can be trained in the intricacies of military language and acronyms, as well as the confusing myriad of federal, state and military regulations that often prove an obstacle to getting services. Additional training in military culture could also be provided to civilian medical personnel.

According to Dr. Feldman, UMass Medical School has joined more than 100 medical schools around the country in mobilizing its resources “to meet the health care needs of the military and their families.”

There is a national hot line that those in the military or their families can use. The National Suicide Prevention
Lifeline number is (800) 273-8255; press 1 for the Military Crisis Line.