How The Military Can Cope With The Mental Health Impact Of A Decade At War
Foreign Policy managing editor Yochi Dreazen has had an accomplished career as a conflict journalist, and spent five years reporting from Iraq and Afghanistan. But his first book, "The Invisible Front: Love and Loss in an Era of Endless War," spends relatively little time on the battlefield. It's about the psychological traumas of war - and what the US military is and isn't doing to assist soldiers affected by post-traumatic stress disorder and other mental health issues.
The book tells the story of the efforts of two-star general Mark Graham and his wife Carol to change the Army's attitudes towards mental health after losing both of their sons in a few short months. Jeffrey Graham, a second lieutenant in the Army, was killed by a roadside bomb attack in Iraq. His brother Kevin, a promising Reserve Officer Training Corps cadet, killed himself months earlier and had gone off of his antidepressants because he feared discovery of his depression would lead to the end of his military career.
The Grahams succeeded in pushing for anti-suicide and mental health reforms within the military. But the first half of 2014 saw an uptick in the military's already troubling active-duty suicide rate. And as Dreazen explained in an exclusive interview with Business Insider, there's still a lot of work to be done.
This interview has been edited for length and clarity. You can read an excerpt from The Invisible Front here.
Yochi Dreazen: I don't. I think in some ways the military doesn't understand the civilian world and the civilian world doesn't understand the military. I think the gap between the two is really heartbreaking and potentially kind of dangerous in the long-term.
Part of it that only 1% of the country serves. But Part of it is that that 1% doesn't live in the major cities for the most part. It's clustered in the South or in the Midwest. The bulk of the country that lives in cities probably will never meet somebody who serves or if they meet them they won't have them as a close friend or family member.
So when we're in the airport and we see somebody walk by in uniform and people thank them for their service or they applaud, that's a wonderful thing compared to post-Vietnam, when that wasn't the case. But paired with that is a complete lack of connection or understanding …
You have the civilian bubble, and the military bubble and often times often times people don't go from one to the other.
BI: Not only does the civilian world not have an adequate idea of what the people in the military have gone through, but the military world hasn't been able to integrate some of the attitudes of the civilian world toward certain issues like mental health. How optimistic are you that this can change?
Yochi Dreazen: I think it's changing but very slowly.
The military obviously is the definition of a hierarchy. You have people at the top who are talking about stigma and the importance of seeking help [for PTSD], and saying that seeking help isn't a sign of weakness. There's a ton of money and hundreds of millions of dollars being spent by the military on the issue.
What's tough is that to really change something you have to have someone at the top not simply say in a general sense "go seek help, it won't harm your career," but in a very specific sense say "I sough help and it didn't harm my career."
Over the course of the book I interviewed close to a dozen generals, people I had personally known from Iraq and Afghanistan. When we were talking - off-record at first - they were telling me about how they couldn't sleep or they had anger flashes or their family didn't recognize them. Most of them did not use the phrase PTSD, but they were clearly talking about PTSD.
When I said to them, general so-and-so, it would be valuable for me to use that in the book and it would really help a lot of people to know that somebody could go as far as you've gone with the issues you've wrestled with. And with one exception they all said no.
So when we're talking about how to change a culture, if the people at the top who are the people everyone else in that culture looks to. If they won't talk about it, it won't change. And right now they won't talk about it.
Yochi Dreazen: I think there are three things that can be done. They're difficult but I think they are doable ...
One is having people at the very top, having generals who have had this disorder talk about it so that people at the bottom can see that if they can seek help, their career will not end, they can still be promoted up, and they can still be a success in the military. I can't overstate how important that would be.
Number two - and in some ways this is a much more practical one but it's gigantic - is simply to make it harder for a person to get a gun. Ninety percent of military suicides, if not higher, are with handguns. And a lot of times these are handguns that were issued to the person, but a lot of the time they were personal weapons.
Israel had a case for a while where they noticed a giant spike of military suicides. And when the Israelis looked into it what they realized is that for decades when soldiers went home on leave they took their weapons with them. It was a safety thing, and part of the culture of the Israeli military.
So they did the logical thing which was take those weapons away and say if you're leaving on a Friday you leave your gun and your pick it up on a Monday. And the suicide rate plummeted.
There are little things we know form the civilian world that can help. Trigger guards make it so you have to unlock a gun to be able to use it. It's an easy thing to do; they cost about $2 to put in. Giving one to every soldier would help but it's not being done.
The third thing - and this is something that we as a culture can do - is that it's very easy for us to just say that we support the troops.
The hard thing to do is to actually meet someone who's served and try to actually talk to them. And they'll be somewhat reluctant because they might say, you're a civilian, you can't understand, how could you possibly know.
But it will open up, and it will change, and it will help the people who come back and feel lonely and think the rest of the world doesn't understand or doesn't care about them. Even just that little human connection can make an enormous difference.