WASHINGTON — Defense Secretary Lloyd Austin has ordered a number of improvements in access to mental health care to reduce suicides in the military, but held off on endorsing more controversial recommendations to restrict gun and ammunition purchases by young troops, sending them to another panel for study.
Secretary of Defense Lloyd Austin speaks Wednesday during a briefing with Gen. Mark Milley, chairman of the Joint Chiefs of Staff, at the Pentagon in Washington.
An independent committee in late February recommended that the Defense Department implement a series of gun safety measures, including waiting periods for the purchase of firearms and ammunition by service members on military property and raising the minimum age for service members to buy guns and ammunition to 25.
In a memo released Thursday, Austin called for the establishment of a suicide prevention working group to "assess the advisability and feasibility" of recommendations made by the initial study committee, which would include the gun measures. He also asked for cost estimates and a description of any "barriers" to implementing other changes, and set a deadline of June 2 for that report. He did not specifically refer to the gun proposals or mention gun safety.
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His orders reflect increasing concerns about suicides in the military despite more than a decade of programs and other efforts to prevent them and spur greater intervention by commanders, friends and family members. But his omission of any gun safety and control measures underscores the likelihood that they would face staunch resistance, particularly in Congress, where such legislation struggled in recent years.
The more immediate changes address broader access to care.
To more quickly provide help for troops who may be struggling, Austin directed the Pentagon to hire more behavioral health specialists and implement a scheduling system for appointments where patients receive multiple health care visits weekly when they first seek care.
He also ordered military primary care health clinics to screen for unhealthy levels of alcohol use, make unhealthy alcohol use treatment easier to receive and make sure that mental health care is available through service members' primary care as well.
"The mental health support available for our teammates must be comprehensive and easy to access," Austin said in the memo.
Brig. Gen. Pat Ryder, the Pentagon press secretary, told reporters in a briefing Thursday that Austin's orders involved areas where the department already has the authority to take immediate steps.
"While we recognize that suicide has no single cause, and that no single preventative action, treatment or cure will eliminate suicide altogether, we will exhaust every effort to promote the wellness, health and morale of our total force," Ryder said.
The initial study committee recommended the department require anyone living in military housing to register all privately owned firearms. In addition, the panel said the department should restrict the possession and storage of privately owned firearms in military barracks and dorms.
Confirming findings in annual suicide reports, the panel noted about 66% of all active-duty military suicides — and more than 70% of those by National Guard and Reserve members — are done with firearms. It said reducing access to guns could prevent some deaths.
Craig Bryan, a clinical psychologist and member of the Suicide Prevention and Response Independent Review Committee, said the department should slow down troops' access to guns — specifically those bought in stores on bases — so people under stress can survive periods of high risk.
He likened the expanded gun safety measures to requirements that the department has on motorcycle use — such as mandated helmets — that are often more strict than some state laws. Asked how likely such changes would be, Bryan said he believes troops are more receptive to such limits than civilians may be.
The national suicide and crisis lifeline is available by calling or texting 988. There is also an online chat at 988lifeline.org.
12 signs that you or someone you love might be at risk of suicide
Recognizing the warning signs
More than half of those who died by suicide between 1999 and 2016 did not have a known diagnosed mental health condition, according to a June 7, 2018 CDC report. That means that any warning signs could be subtle at best.
But at the same time, seven out of ten people who survive suicide attempts ultimately never try to kill themselves again, the Harvard School of Public Health reports. This suggests both that suicide is not the answer and that prevention efforts pay off in spades.
With that in mind, here are 12 suicide warning signs to watch for in your friends, your loved ones — and yourself.
1. Feeling like a burden
"When people are not able to perform in a role, or are unable to fulfill a purpose, it’s not just that they feel their life is of no value. They feel that they are a burden to others," Sane.org.uk reports.
2. Being isolated
"The subjective feeling of loneliness increases risk of death by 26 percent," Time Magazine reports.
3. Increased anxiety
"Among individuals reporting a lifetime history of suicide attempt, over 70 percent had an anxiety disorder," the National Institutes of Health reports.
4. Feeling trapped or in unbearable pain
"Often suicidal people are experiencing intolerable emotional pain, which they believe to be unrelenting," according to The Crisis Intervention and Suicide Prevention Centre of British Columbia. "They often feel hopeless and trapped. By helping them to recognize and explore alternatives to dying, you are planting the seeds of hope that things can improve."
5. Increased substance use
"Research has shown that the strongest predictor (link is external) of suicide is alcoholism, not a psychiatric diagnosis," Psychology Today reports.
6. Looking for a way to access lethal means
"Many suicide attempts take place during a short-term crisis, so it is important to consider a person's access to lethal means during these periods of increased risk," the Suicide Prevention Resource Center reports. For example, loved ones can limit a person's access to medications and attempt to store firearms with law enforcement.
7. Increased anger or rage
"An expression of profound distress and rage ... often emphasises the loss of control that the patient is experiencing at that point," Joy Hibbins writes on Huffpost.co.uk. "This fury and loss of control should be of great concern to any clinician who is focusing on trying to ensure that the patient does not harm themself. An intense angry outburst can greatly increase the risk of an imminent suicide attempt."
8. Extreme mood swings
"Long-lasting sadness and mood swings can be symptoms of depression, a major risk factor for suicide," according to ClevelandClinic.org.
9. Expressing hopelessness
"There always is hope. But you may not feel that hope until you receive effective treatment for any disorder that you might have," writes Kevin Caruso for Suicide.org.
10. Sleeping too little or too much
"Teenagers who thought about or attempted suicide were more likely to have suffered sleep disorders in earlier years," researchers suggested in one Reuters report.
11. Talking or posting about wanting to die
Many social media sites, such as Facebook, include pages where you can report suicidal content to get help.
12. Making plans for suicide
This could include giving away significant possessions, making a will, writing a suicide note or clearing up loose ends, The Crisis Intervention and Suicide Prevention Centre of British Columbia reports.
Get help
If you or someone you know is having suicidal thoughts, help is less than a moment away. Call 1-800-273-TALK (8255), text 741741 or visit suicidepreventionlifeline.org for free, confidential support 24 hours a day, seven days a week.
