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Suicide Prevention Week: NH expert focuses on veterans

New Hampshire Union Leader

September 04. 2014 8:50PM

CONCORD — The executive director of the National Alliance for Mental Illness NH said the voices not heard often enough in suicide prevention efforts are those of people who survived their suicide attempts.

“The numbers of attempts are huge,” said Kenneth Norton, noting 90 percent of the people who survive an attempt do not go on to die by suicide. They have a lot to offer in helping other people avoid choosing suicide, he said.

Suicide Prevention Week is Sept. 7-13.

Norton recently prepared a presentation to the congressional mental health caucus on suicide in the military.

“Did you know,” he said, “that half the (military) suicides are people who have not deployed?”

Norton said that’s because many of them are in the age group most at risk for suicide — 15- to 24-year-olds. Suicide is one of the top three causes of death in that group, accounting for 14.4 percent, according to the Centers for Disease Control and Prevention. That figure only accounts for confirmed suicides, not “accidental” car crashes and overdoses, Norton said.

He said many young people in the military have the same issues as their civilian contemporaries: jobs, finances and relationships. Joining the military may have seemed like a solution, but it can actually make things worse because of isolation and lack of support. But he said the focus of military programs addressing suicide is on those who have been in combat situations.

“We’ve learned a lot,” he said. Post Traumatic Stress Disorder (PTSD) has been under study for some time. Now there is research being done on the effects of repeated concussions and of constantly being on high alert, or “driving on adrenaline.” Norton said studies show brain chemistry starts to change and those veterans are at higher risk.

Sudden shift to civilian

Another factor is the sudden shift from war zone to civilian life. World War II veterans returned home on ships, a trip that could take as long as 45 days and gave veterans an opportunity to decompress in the company of their comrades.

In contrast to that, he said, he was recently having a drink at a bar in the Baltimore Airport and struck up a conversation with a serviceman in uniform who was headed home on an emergency leave.

“He had been in Afghanistan 16 hours earlier,” said Norton.

Improvements in communication with loved ones at home, by Skype, email and even phone calls, are supposed to be a good thing. But being more engaged can be a mixed blessing.

While having the dog go to the bathroom on the rug may be a crisis for the person at home, it’s hard to see that when you are dealing with roadside bombs or a comrade who’s been severely wounded or killed.

“There’s a cultural disconnect,” said Norton.

He said he got a lot of grief when “military intimacy” was one of the slides he was preparing for a presentation to veterans. People told him it wouldn’t be politically correct. But Norton said the slide referred to “the intimacy they develop with combat buddies in their unit ... It’s lost when they return to civilian life.”

When the slide went up, Norton waited for the reaction. After they read it, he said: “I see them all nodding.”

When veterans return, he said: “There are a lot of challenges around how they integrate.”

He said: “As a society, as a country, we welcome these veterans home.” But we need to understand, he said: “When our strongest men and women have mental health issues, it’s not weakness or moral failings.”

Last month President Barack Obama told the American Legion convention attendees in Charlotte, N.C., that steps are being taken to improve the availability of mental health care as veterans return to civilian life. There will also be more research, the President said, into PTSD and suicide.

Older veterans at risk

Older veterans are part of the group which has seen the sharpest increase in suicide in recent years.

The Centers for Disease Control and Prevention collects statistics on suicide and in the most recent period, 1999-2010, the greatest percentage increase — 40 percent — was in the 45-to-64 age group. The increase was greater than for any other age group, including youth and the elderly, the highest-risk groups.

Norton said actor and comedian Robin Williams fit into that group, at age 63. Williams also chose the method showing the greatest increase, suffocation, predominantly by hanging.

Norton said the media coverage of Williams’ suicide showed an increased understanding of suicide and helped by talking about depression as an illness. When the symptoms are in remission, people are able to function, as witness Williams’ success.

Norton said that in the past several years, there has been “a real change in people’s understanding of mental illness as an illness.” Williams’ suicide has provided a “teachable moment,” said Norton.

He said Williams had an extreme talent, but struggled with two often co-occurring issues: addiction and depression. But while Williams spoke about his drug and alcohol addictions and treatment for them, and even made them part of his comedy routines, he never spoke about his depression.

“He was always a champion for cancer,” said Norton, but never for mental illness.

Norton pointed out that talking about cancer was once taboo, but that’s changed. Research and treatment have resulted in more people surviving. The same thing can happen with depression and mental illness, Norton said.

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