A General's Personal Battle

A General's Personal Battle
Posted by Daniel [1] on March 31 [2] 2009

Check-out this feature article in the Wall Street Journal about Maj. General Mark Graham's effort to channel his family's personal pain into the fight to reduce the alarming rise in soldier suicides.

A General's Personal Battle [3]

By Yochi J. Dreazen, The Wall Street Journal

Fort Carson, Colo. - The military is facing a sharp spike in suicides, and Maj. Gen. Mark Graham is leading the fight to reduce them. His mission is close to the heart: His own son, a young ROTC cadet, killed himself six years ago.

Maj. Gen. Mark Graham is on the frontlines of the Army's struggle to stop its soldiers from killing themselves. Through a series of novel experiments, the 32-year military veteran has turned his sprawling base here into a suicide-prevention laboratory.

One reason: Fort Carson has seen nine suicides in the past 15 months. Another: Six years ago, a 21-year-old ROTC cadet at the University of Kentucky killed himself in the apartment he shared with his brother and sister. He was Kevin Graham, Gen. Graham's youngest son.

After Kevin's suicide in 2003, Gen. Graham says he showed few outward signs of mourning and refused all invitations to speak about the death. It was a familiar response within a military still uncomfortable discussing suicide and its repercussions. It wasn't until another tragedy struck the family that Gen. Graham decided to tackle the issue head on.

"I will blame myself for the rest of my life for not doing more to help my son," Gen. Graham says quietly, sitting in his living room at Fort Carson, an array of family photographs on a table in front of him. "It never goes away."

Suicide is emerging as the military's newest conflict. For 2008, the Pentagon has confirmed that 140 soldiers killed themselves, the highest number in decades.

At a Senate hearing last week, Gen. Peter Chiarelli, the Army's vice chief of staff, told lawmakers that 48 soldiers have already committed suicide in 2009. The figure puts the Army on pace for nearly double last year's figure. "I, and the other senior leaders of our Army, readily acknowledge that these current figures are unacceptable," Gen. Chiarelli said at the hearing.

Beyond Fort Carson, the Army has launched a broad push to reduce the incidence of suicide. Over the next four months, all soldiers in the Army will receive additional training on suicide prevention and broader mental health issues. The Marine Corps, which is also being hit hard by suicide, will give all Marines similar training this month. In February and March, the Army for the first time ever excused units from their normal duties so, one by one, they could learn new ways of trying to identify soldiers in need of help.

Military officials, including Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, attribute the increase to repeated deployments in Iraq and Afghanistan. Earlier this month, Adm. Mullen visited Kentucky's Fort Campbell, which has had eight suicides so far this year. Asked about the stresses of repeat deployments during a town-hall meeting with soldiers, he said, "I can't believe that is not a huge factor" in the number of suicides. Soldiers have been sent to war zones as many as four times, often with less than a year between deployments. That situation will likely worsen as the Obama administration boosts troop levels in Afghanistan.

"It's cumulative and the problems don't show up right away," says Anne League, the chief of psychiatry at Fort Carson. "Soldiers can seem fine at first, even if they're not."

The Army says that for the first time the rate of suicide in the military exceeded that of the general population last year -- 20.2 per 100,000 people in the military, compared with the civilian rate of 19.5 per 100,000. (The Centers for Disease Control say the overall civilian suicide rate was 11 per 100,000 for 2005 -- the most recent year available -- but the Army adjusts the figure to reflect the military's younger and much more heavily male demographics.) The Army's suicide rate was 12.7 per 100,000 in 2005, 15.3 in 2006 and 16.8 in 2007.

Military suicide rates tend to increase during wartime, according to military mental-health personnel like Dr. League, but the current numbers are the highest since the Army began tracking the issue in the 1980s. During the first Gulf War in 1991, for example, the Army's suicide rate was 14.4 per 100,000.

In the early 1980s, Ann Haas, now the director of prevention projects at the American Foundation for Suicide Prevention, studied a group of 100 Vietnam veterans at a Veterans Administration hospital in Montrose, N.Y. All of the veterans had experienced intense combat and been diagnosed with post-traumatic stress disorder. Over the course of her research, three of the veterans killed themselves, a startlingly high percentage.

"What we now call PTSD has been part of the aftermath of combat as long as we've had wars," she said. "And there is higher incidence of suicide among people who have been diagnosed with PTSD, like returning veterans."

Teasing out the underlying causes is difficult, since it is impossible to fully understand just what prompts someone to commit suicide. Military officials point out that one-third of the soldiers who took their own lives last year had never been deployed to Iraq or Afghanistan, though they say that the soldiers might still have felt the stresses of constant training and pending overseas tours.

Defense Secretary Robert Gates and other senior Pentagon officials believe that the suicide rate is being pushed higher by the Army's rising divorce rate. Repeated deployments to Iraq and Afghanistan are pushing Army relationships to the breaking point, and many military marriages are buckling under the strain.

Some Pentagon officials believe that military drug and alcohol use is also contributing to the increase in suicides. Growing numbers of soldiers take antianxiety medication like Prozac and Xanax after they return to the U.S., and some commanders worry that the combination of drugs and alcohol is upsetting many soldiers' emotional states.

The poor national economy also adds to the strains facing many soldiers and their loved ones. Foreclosures in towns with large military facilities are rising at several times the national average, and hundreds of military families have lost their homes in recent months. The civilian spouses in many families are also struggling to find work, adding to the financial pressures facing modestly paid military personnel.

Army officials acknowledge that many soldiers are reluctant to seek help because of the stigma around mental-health issues. A survey last year by the American Psychiatric Association found that 75% of military personnel felt that asking for assistance would reduce their chances for promotion. Others worried about appearing weak in the eyes of their peers.

In their sunny living room at Fort Carson, Gen. Graham's wife, Carol, smiles as she picks up a favorite photo. The picture shows Kevin Graham standing with his brother and sister on the Great Wall of China during a family vacation.

"I felt like the luckiest mother in the world to have such amazing children," she says. "At that moment our world was perfect."

Gen. Graham fell in love with Carol Shroat when they were both students at Murray State University in Kentucky. The couple married young. Neither came from a military family and Gen. Graham says he initially planned to spend only a few years in the Army.

Instead, he served in the first Gulf War and directed the military evacuation of New Orleans in 2005 after civilian authorities stumbled in their response to Hurricane Katrina. He won several military commendations for his work. He now commands Fort Carson, one of the largest Army bases in the world, and also oversees the training of reserve and National Guard soldiers in the Western U.S.

In 2003, then-Col. Graham was serving as the executive officer to the senior U.S. commander in South Korea. He and Mrs. Graham lived in Seoul, while their three children shared an apartment at the University of Kentucky. Kevin and his older brother were both ROTC cadets, hoping to follow their father into the military.

Kevin was quiet and reserved. He wanted to be a military doctor. His older brother, Jeff, by contrast, was gregarious and outgoing and wanted to lead troops into combat.

At the University of Kentucky, Kevin was the only ROTC cadet chosen for elite airborne training. He had been tabbed to command the other cadets, and seemed destined for a successful military career, according to two officers who participated in the ROTC program alongside Kevin.

Gen. and Mrs. Graham say the program's rigorous workload and unrelenting pressure started getting to Kevin. He was diagnosed with depression, they say, and doctors in Kentucky put him on Prozac. Gen. Graham says he encouraged Kevin to take time off from the ROTC program and offered to pay back his scholarship. Kevin told his father he didn't want to be a quitter.

Jeff meanwhile graduated from the University of Kentucky in the summer of 2003 and was immediately commissioned as an Army lieutenant. After the ceremony, Kevin, beaming, posed for a picture with his brother and sister. It is the last photo that the Grahams have of their three children together.

On June 21, 2003, Kevin made plans to play a few rounds of golf with his brother, but he failed to show up. Jeff dispatched their sister to look for him. She found Kevin hanging from a ceiling fan in his bedroom.

Gen. Graham, like many military figures, preferred not to discuss his son's suicide at first. Mrs. Graham went to the other extreme, believing she had a duty to talk about the dangers of depression and mental illness, she says.

"We felt like the absolute worst parents in the world, like we had somehow not loved our child enough," she recalls.

A few months later, Second Lt. Jeff Graham deployed to Iraq. He left on Nov. 15, Kevin's birthday.

On Feb. 19, 2004, Jeff was leading a foot patrol in Khaldiyah, a volatile city near the insurgent stronghold of Fallujah, according to the family and military records. He spotted something suspicious attached to the guardrail of a nearby bridge. He halted his soldiers and was about to radio back to the rest of the unit when the bomb detonated. The explosion killed Jeff, 24, and Spc. Roger Ling, 20.

That morning, Mrs. Graham woke up just after 5 a.m. in her home at Oklahoma's Fort Sill and read a news report online about two soldiers being killed in Khaldiyah. Worried for her son, she went to the base's small chapel to pray for his safety. When she got back to the house, Gen. Graham was sitting quietly with his boss. Mrs. Graham says that she immediately knew they had lost a second son.

Jeff had carried his brother's driver's license with him on every patrol in Iraq. The Army found the license on his body and returned it to the Grahams, who cherish it as a reminder of the bond between their two boys.

"I really believe that when the bomb went off, Kevin was right there to catch him," Mrs. Graham says, her voice catching. "They were together again."

Kevin and his brother were buried next to each other in a small cemetery in Frankfort, Ken., near where Mrs. Graham grew up. The tombstones are surrounded by American flags and a handwritten sign that reads: "Land of the free because of the brave." The Grahams say they don't know who put it there.

The twin losses left the family reeling. Gen. Graham planned to retire and their daughter transferred from the University of Kentucky to a different college in another state.

At the same time, the family began to notice how the two deaths were treated differently both by the military and by friends. Parents of children killed in combat receive a gold star, for example, and are often invited as a group to meet with the president or other dignitaries. There's no equivalent for suicides.

"When Jeff died...we were told how heroic our son was," Mrs. Graham says. "And I was thinking, 'No, I had two amazing sons, not just one.' "

In the summer of 2007, the Tragedy Assistance Program for Survivors, a nonprofit dedicated to bereaved military families, invited Gen. Graham to Washington to address their annual conference. This time, he considered the request.

Gen. Graham assumed the group wanted to talk about Jeff's combat death. Instead, organizers told him they wanted to hear about Kevin. Bonnie Carroll, who founded TAPS after her husband was killed in a military plane crash in 1992, says she wanted the families of suicides to feel as welcomed as those who had lost family members in combat.

"Our friends' children had birthdays, graduated, got married and had babies, which left us always wondering how the world could keep spinning without Kevin and Jeffrey in it," he told the crowd.

Today, the Grahams speak regularly about Kevin's suicide. In recent weeks, Gen. Graham appeared at a Pentagon suicide prevention conference in San Antonio, as well as at similar events in Phoenix and Denver. Mrs. Graham serves on the board of directors of the Suicide Prevention Action Network, which works to raise public awareness about suicide and mental illness.

Gen. Graham is turning Fort Carson into a testing ground for new ideas about suicide prevention. The most promising initiative involves "mobile behavioral health teams," groupings of more than a dozen mental-health professionals who work with individual brigades before, during and after their time in Iraq and Afghanistan. Currently, troops are screened by mental-health professionals only on their return to the U.S. and have limited access to help while overseas. The idea originated with the Behavioral Health department at Fort Carson's hospital. Last fall, officials from the department met with Gen. Graham to propose creating one team as a trial, and he immediately gave his approval. The first team was established in November.

"The thinking is that the teams will really get to know each of these soldiers so they can identify changes in their behavior and spot the ones who need more help," says Lt. Col. Nicholas Piantanida, a practicing doctor who runs Fort Carson's clinical services. If the teams are successful, Col. Piantanida hopes to see the system replicated across the Army.

Gen. Graham has also used his authority as the commander of Fort Carson to ensure that all soldiers from the base receive full military funerals and memorial services, regardless of whether they died in combat or by their own hand. At many bases, soldiers who kill themselves receive smaller "remembrance ceremonies."

Gen. Graham acknowledges that the idea wasn't popular at first, with some members of the Fort Carson community arguing that it was wrong to treat soldiers who killed themselves the same way as soldiers who fell in combat. As the base commander, Gen. Graham was able to push the change through. "If a soldier dies by suicide, some people think he wasn't killed by the enemy," says Gen. Graham. "But I always tell people that we can never know what they were going through or what kinds of things they were fighting."

In Fort Carson's most recent suicide, which took place on January 19th, Army Spc. Larry Applegate walked into his home here, pulled out an assault rifle and began shooting wildly, according to El Paso County sheriff's department. With a SWAT team outside preparing to storm the house, Spc. Applegate, a decorated Iraq War veteran, shot himself in the head.

Emotional problems at the base have manifested themselves in other ways, too, which are concerning Army brass. In the past three years, nine soldiers at Fort Carson have been involved in 14 homicides. The Army has sent a task force to the base to scour the soldiers' medical and service records. Results of the investigation are expected this month.

The Grahams carry around constant reminders of their dead sons. Gen. Graham wears a silver bracelet engraved with their names and the dates they died. Each of the two silver stars he wears on his dress uniform has one of the boys' names engraved underneath. Mrs. Graham wears a pendant with the likeness of Kevin and Jeff carved into the silver.

At home, they sleep under a quilt made from bits of the two boys' T-shirts and uniforms. On the second floor of their house here, the Grahams have large framed photos of their sons in military uniform.

Gen. Graham wasn't a physically affectionate man before Kevin's suicide. Today, he makes a point of hugging every father he meets who has lost a lost a child to combat or suicide.

"Men grieve differently," he says. "But I still remember someone hugging me after Jeff's death and just whispering, 'Let me take a little bit of that pain off of you.' "

Write to Yochi J. Dreazen at yochi.dreazen@wsj.com [4]
Printed in The Wall Street Journal, page W1

 

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