Dr. Ben Suitt joins Secretary Shulkin and Lou to talk about his recent study regarding the shockingly high numbers of veteran suicides. He explains that the recent drop in suicides reported by the VA, might just be a numbers game that doesn't reflect reality.
Dr. Ben Suitt joins Secretary Shulkin and Lou to talk about his recent study regarding the shockingly high numbers of veteran suicides. He explains that the recent drop in suicides reported by the VA, might just be a numbers game that doesn't reflect reality.
We're talking about over 30,000 post 911 era veterans and active component servicemembers dying by suicide compared to the, at the time I report 7057 servicemembers who died in military operations it's it was just absolutely staggering, realizing the pandemic is going to have an effect. I think the thing that's really going to have an effect is this. Pulling out of Afghanistan, the the call volume to the National Veterans suicide hotline has been increasing. And that does seem to be an indicator that we are wrestling with more suicidal ideation at the moment, and it will be really important to see this 2021 numbers when ever they do catch up.
Announcer:Welcome to the policy bets podcast engaging with leaders, scholars and strong voices to fill a void in support of policy development for America's veterans. With your hosts, former Secretary of Veterans Affairs, Dr. David Shelton, and former executive director of the American Legion Louis Celli. Today's guest is Dr. Ben suit, a contributor to the Brown University Watson Institute, cost of war project.
Louis Celli:Mr. Secretary, so is September is National Suicide Awareness Month, I think it's important that we that we wrap up the month talking about this extremely important issue.
Dr. David Shulkin:Blue, it's hard for me to think about suicide prevention being a month, because this is a year long issue. Of course, as you know, this was the top issue for me when I was at VA and continues to be a top priority for VA and the administration
Louis Celli:now and rightfully so. And as a matter of fact, I don't know if it was time to this way, but they just dropped their most recent report just a couple of days ago.
Dr. David Shulkin:Yeah, you know, these reports have taken on a lot of importance. I think that the first suicide reports. For VA, it covered a period between 2001 to 2014. It was released when I was under a secretary. And it was really quite disturbing when we saw the impact of this data. And each year, a report has come out to be able to monitor the progress that we've been making.
Louis Celli:What really surprised me was there was no national mechanism by which to track this, the VA actually had to go to each state and pull all of the death records and count them manually, which is is somewhat archaic, you would think that there would be some kind of national reporting system?
Dr. David Shulkin:Well, I think even in this most recent report, you see that the data lags two years behind their reporting on suicides from 2019. And the world has changed dramatically since 2019, with the pandemic and the withdrawal from Afghanistan. And there has to be a better way of getting more accurate and faster data so we can actually follow the progress and the issues that are happening at the time. So this is a report that needs to sort of enter the 21st century and get real time data collection.
Louis Celli:I'm really glad you said more accurate data, because I've always wondered, and theorized that the data that they collect, that has been documented in death records doesn't account for a great many suicides. There are religious reasons why people don't want suicide listed on a on a death certificate. There are insurance reasons that people don't want it listed. There are pride reasons or familial reasons. There's the whole single car accident, you know, death by cop, there's just all of these other factors that play into someone seeking a way to end their own life, that doesn't always get recorded in suicide. And I think we have to find a way to capture that information. But there's
Dr. David Shulkin:no doubt that these data are under recording the true incidence. So what's happening for all the reasons that you said. But I can tell you, the people at VA who put together these reports, really try hard to make these reports accurate, but they have to rely upon the way that these are reported at the local levels that rolls up to the CDC mortality index. And it's just really hard to make sure that these are accurate. One of the things that makes it even more challenging for people to understand it seems like the definitions of how they report on suicides are changing gear ear so it's really hard to follow whether we are making progress or or gone backwards. Well, it's
Louis Celli:not just the definitions that are changing from year to year. Each of these reports have changed the structure, the way they report the way they count the way They, the way they present the reports, it makes it extremely difficult to go back to each report and figure out whether progress is being made or whether we're counting the same numbers, the same groups of of age groups, time periods and service. It actually looks like in this most recent report that the numbers have gotten better that, that we've gone from 18 suicides a day for veterans down to 17. But you have to pull that out of the report. It's very hard to read these.
Dr. David Shulkin:Yeah, it really is. And, you know, I've gone through these reports to try to see whether you can make accurate comparisons. Of course, many people still use the number 22 veterans a day. I think when you take a look at the data, and you try to compare apples to apples, we probably still are and always have been around 20 veterans a day that are taking their own life. I do think that this recent report that was released, does have some reason to be optimistic. It looks like there may be a trend, that number may be decreasing. But I certainly think it would be way too premature to declare mission accomplished or that we're, we figured out exactly the right way to be able to address this situation.
Louis Celli:Mr. Secretary, that is such a great point. So what do you attribute the lower numbers to? Is the government getting it better? Is society getting it better? Like? How do we get better?
Dr. David Shulkin:I don't think that you can simply give an answer to that. I think that the focus of the agency, the focus of so many community groups, the public attention to veteran suicide, clearly should be part of why things may be getting better. And the fact that people now are more willing to reach out when they have problems, that the stigma of mental health issues and asking for help is finally beginning to be taken away so that people aren't embarrassed about saying that they have an issue that they need help with. But, you know, I want to just return lewd to the things that I think we do know work. When it comes to veteran suicide in the prevention of veteran suicide. The real superpower here is peer support. And I think that it's not recognized enough. When veterans are experiencing issues, they want to talk to other veterans who know what they've gone through. And the power of peer support, I think is the single biggest weapon that we have. The second issue is is that the area where the biggest concern still exists is that one year period after transitioning out of the military back into the civilian population. And while we've been talking about reverse boot camps, for a while, we just haven't seen it done. And we haven't seen it done well. So I think that that's something that needs to be done. The third areas is that when you look at the way that many veterans take their lives, it is overwhelmingly with firearms, and that's much higher than the civilian population. So we've got to begin to address death by firearms in a way that has been very, very complicated to take on. And finally, I really want to make sure that people understand people don't take their lives just because they wake up one day and decide that that's the only alternative. These have to do with the underlying conditions that people are experiencing. Depression, PTSD, chronic pain, substance abuse. And so looking at the effectiveness of our behavioral healthcare system, and looking at the ways that we can begin to do early identification and effective treatments, I think is ultimately going to be the long term solution here.
Louis Celli:You've touched on so many really great points here. And one of the things that that you talked about was a sense of community and peer support. I think it's important to look at things like moral injury, our guest today, Dr. Ben suit is going to talk a little bit about moral injury. And what's interesting in his report, I don't think he mentions it when we talk to him but in his report, he even highlights the DSM five, the Diagnostic Statistical Manual, the Bible for mental health doesn't even have a section on moral injury yet, and I think it's important that we talk about that The other thing that you talked about is, you know what we're getting right. And I absolutely have to believe in my core, that the Veterans Crisis Line is making a difference. I don't know if you can attribute, you know, the the drop in suicide rates that we're seeing now that the trend that that could be going down. I don't know if we can attribute that to the Veterans Crisis Line. But the amount of calls that I know that they get, the work that they do, and some of the stories that we've heard coming out of that has got to be making a difference somewhere. And, you know, finally, the, you know, that sense of belonging, if a veteran reintegrates, like you talked about a reverse boot camp, when veterans reintegrate back into into the into the society, I think that we as a community, I know that veterans recognize this, but the society has to remember that their entire life has changed. And it's changed in a way that it's not only their career, but it's their support network. It's the it's the culture that they used to operate in, whether it was a combat culture, or just being on base. They've been, essentially air dropped back into society. And it takes it takes a period of readjustment. And if that readjustment doesn't go, well, it's really just going to contribute to the veteran not being as as successful, which can also contribute to divorce rates, unemployment. And then ultimately, in some cases, very tragically, veteran suicide.
Dr. David Shulkin:I think these are such important points low I think, you know, your point about the veteran crisis line, I can't imagine a harder more stressful job than being a person who answers that, that blind in on the phone all day long. And I've spent time with the Veterans Crisis Line responders, these are amazing people. And where else can you find somebody to talk to at three o'clock in the morning, so. So I have no doubt that they are part of the solution here. The other thing that you mentioned was the interaction with the community. As we know, the vast majority of veterans that take their own lives aren't getting care in the VA system, they're out in the community. So they're interacting with, you know, their neighbors, with their churches and the Veteran Service groups, and you know, people at work. And so getting people to recognize when somebody needs help, and being there to reach out to them to be that listening partner, I think is so important. And that's why these educational efforts, and even things like our podcasts that's talking about it is educating people as to why this is so important.
Louis Celli:I couldn't agree more. So let's, let's get Ben in here. And let's let's go through some of these issues that he talks about, you know, like the moral injury in the sense of belonging. And when veterans come back, if if they don't feel like they're a valued member of the society. One of the top things that we've heard, and I'm not even sure if it's outlined in this paper or not, but I've heard it time and time, again, is that when veterans have incomplete suicides, and we're able to interview them, what they often say, or what they leave in notes are things like, I didn't want to be a burden. And they feel like they're being a burden, they don't feel useful. And that is something that we can all address. That's something that we can address
Dr. David Shulkin:today. Couldn't agree more. So why don't we get started? Let's do that.
Louis Celli:Ben, thank you for joining us today on the policy. That's podcast.
Dr. Ben Suitt:Thank you so much for having me, Lou. I really appreciate you inviting me on.
Dr. David Shulkin:Ben. Good morning. Thanks for being on with us. Can you start by just telling us why you decided to do research about veterans suicide?
Dr. Ben Suitt:Yes. So I was working on my dissertation work at Boston University and the Religious Studies Department. And I was looking at the role of faith in the lives of post 911 veterans. And so oftentimes, faith would be something that was very positive for them. But it could also be something that could end up being damaging. So if you imagine being told your entire life, that killing is wrong, and then you find yourself in a position where you are killing others, this could be something that could upend sort of your view of religion in the world, and your relationship with God. And so in looking at that, I spoke with over 50 veterans and military chaplains about their experiences. And something that became very clear was that the majority of them had stories of trauma, and those that didn't, certainly knew others who had one of my mentors Professor Nita Crawford, who was working on tallying up the actual cost, like financial cost of the wear and tear. She knew that I was working on a concept called moral injury. And relating that to the stories of faith and trauma that I heard. And so she asked me to look into the mental health costs of the post 911 wars. And what became clear was the way to talk about that was to talk about the increasing rates of suicide, particularly when I got my hands on the data.
Louis Celli:Yeah, one of the things that I really appreciated about the paper is that you've done a really good job in collecting information just from a variety of sources. So what did you find to be the most difficult data to procure, and what data surprised you the most,
Dr. Ben Suitt:and the most difficult data to procure was the Department of Defense data only, because if you look at their annual reports, they will so they will show trend lines, but they don't necessarily show all of the data over the years. And so I did have to put in a request with the department defense suicide event report. And eventually, the defense health agency got back to me with those exact figures. One of the difficulties there as well was that they've only really consistently begun counting suicides since 2008. And they've only had a consistent scale and way of adjusting those rates since 2011. So the data there is difficult to put together, particularly because before 2008, you had this sort of broad category called self inflicted, but self inflicted isn't necessarily suicide, that could be a car wreck, or a weapon misfire, drug overdose. And so there's a bit of piecing the past together to be able to get the right denominator and get an accurate number for suicide. But the most surprising data overall, was really just the putting the sheer volume together when I was even looking at the veteran data, the VA doesn't separate their data by era of war. Which makes sense, a lot of Gulf War Veterans also fight in post 911 wars. But it does make it tricky, trying to piece together those numbers. And so going by age demographics, and then also comparing that with the percentage to total that we know of veterans who fought in post 911 wars. When those numbers came back and realizing that we're talking about over 30,000 post 911 era veterans and active component servicemembers dying by suicide compared to the the termite report 7057 servicemembers who died in military operations, it's it was just absolutely staggering. And just to update their the the current number as of September 6, for those that have died in military operations is 7074.
Dr. David Shulkin:For a while now the VA Department of Defense, the President, Congress have really prioritized veteran suicide and have put the resources into programs have worked hard to make this something that they're really working on. So you say in your paper that we need to do more, what do you think the VA the Department of Defense the Congress needs to be doing in order to do more?
Dr. Ben Suitt:That's a great question. The I think, in a broad term looking at this, it would be that we need to be more proactive rather than reactionary. So the way the system is set up right now is that we pour billions of dollars into the VA to help veterans with suicide. But the amount of spending that we put into the actual armed forces for suicide prevention is just a drop in the bucket. It's nowhere in the realm of what we spend for suicide prevention. With the VA. It comes down to this sort of frustrating aspect that the Department of Defense likes to use this logline I talked about in my report, but that because the suicide rates among active component service members are about the same as those in the civilian population, that there's not a problem, except we know historically that the rates of active component service members are lower than that of the civilian population and tended to go down in wartime, after World War One, except for Vietnam, and now post 911 wars. So that rate has come to meet the civilian population. And looking at the most recent data, it looks as though it has surpassed the civilian rate. They haven't released numbers since 2018. They do have a problem on the front end that they do need to be focusing on the Department of Defense in the armed forces. They're very good at, you know, maintaining their weapons, taking physical fitness very seriously. But they're not so great at looking at mental health as a force multiplier, and realizing that just as they service their weapon and maintain their physical fitness, they need to be taken care of their mental health as well.
Louis Celli:Your paper is is pretty relevant. You dropped it last month. And then right after that, as you mentioned, the VA has dropped some recent data to cover 2018 so My question is it looks like from VA is more recent data, that the the number of daily veteran suicides has actually dropped from from 18 a day to 17 a day. But according to your research, they're not really counting all of the veteran categories. Can you explain that
Dr. Ben Suitt:the data used to say that 22 veterans died per day, they've been adjusted the way that they count veterans. And so the 22 a day was counting just a brighter category. So it could be national garden reserves, who were never federally activated a broader part of the military, that just, they decided didn't quite count in terms of those veteran numbers. So when they made that adjustment, it did bring it down to 18. And it does look like it's gone down to 17. So when you try to look at those broader numbers, for just those in the reserves and National Guard, who maybe were not federally activated, they, the Department of Defense would point you to sort of civilian records, because they civilian records would show whether they died by suicide, but that wouldn't be captured in the Department of Defense records.
Dr. David Shulkin:Well, why do you think that they made a switch in the way that they count, because when they were counting it as 22 veterans, they included the National Guard, and then they changed it, and in some cases have been claiming that this is progress. But what you're saying is this is really just looking at two different groups of of people instead of keeping it with this similar definition. So what's your explanation why they changed the way that they count us?
Dr. Ben Suitt:One of the reasons was that, before they made that switch, there might have been potential overlap between the Department of Defense reports and the VA reports. I think they're also working on trying to have a more consistent denominator with who they're counting. And in addition to that, they are probably not counting them, because they are trying to keep the focus on what problems might be unique for veterans, they might put those suicidal problems up to societal issues rather than military issues. I don't know that that's correct. I think that being involved in the military organization is going to affect your life in some way. But I think that that's probably their logic.
Louis Celli:Tell us some stories about the veterans that you've interviewed some of the some of the folks that you spoke with, what our listeners really want to hear is they want to hear, you know, kind of that that personal interaction, and the numbers are important. They want to, but they want to hear really about the human stories. And I'm curious, what are the numbers today, right? So if they're not counting everything, and your research has been able to kind of tease out that they've missed, really some categories, or you know, just not even looking at it. If we were to add all the categories together, what would those numbers look like today,
Dr. Ben Suitt:adding those numbers up together does look like about 30,177 is my very conservative estimate of how many may have died. The reason I went with a conservative estimate is just making sure that I'm not overstating because that wouldn't end up being useful. But to your point about stories of that I've heard I mean, I, I sort of opened my report with Ford observer, he was in Cedar City at a sort of very violent time and chosen five and afford observer. They like to call themselves sisters or Pfister's. But they do have a very dangerous job having to go sort of deep into enemy territory to make those calls about where to aim artillery. The officer that I was speaking with, he realized that the youngest in his sort of unit that he was in charge of caring for died, and he felt personally very guilty for it. He said that he remembered praying to God, and asking for God to protect his men. And when that young man died, he said it just absolutely destroyed his his worldview and his faith. But he said the real work actually came when he came home. He finally had a sort of the ability to reflect on his experiences, and for the first time, realize what his experiences did to him and his in his life, and he developed suicidal ideation and post traumatic stress had moral injury. More than that, when he started speaking with other people in his unit, he realized that they were having a difficult time too. And at the time of speaking with me, he revealed that more people in his unit had died by suicide than ever died in combat, despite being in Seder city in such a dangerous time. And when I looked at his story, and other stories of people I spoke with it became clear that many of them had similar stories. Realizing that people in their unit had died that they knew people had died by suicide. even looking at Iraq and Afghanistan Veterans of America data, it seems that well over 60% of veterans who fight and post 911 wars, know someone who successfully attempted or has attempted suicide, if if they didn't attempt it themselves.
Dr. David Shulkin:One of the challenges of the data that you talk about, and the data that you had to get from VA and the Department of Defense is that it lags by a couple of years, I think the report that just came out is 2019 data. So it's two years old. And of course, a lot has changed in these past two years, we've had a pandemic, we've now disengaged from Afghanistan, which has had a big impact on many of our veterans who have served in the recent conflicts. So what do you think, has happened to the suicide rate? in these last couple years? What do you think we're going to see two years from now? And what do you think the impact of both the pandemic and the withdrawal from Afghanistan is going to have on the suicide rates?
Dr. Ben Suitt:So the numbers that came out, just this past week from the VA, were heartening, because it did show that the rate even among the 18, to 34 demographic, which tends to that is certainly the demographic that has the most post 911 veterans, that those rates have gone down the lowest numbers that it's been since 2015. So that is great. But to your question, it's hard to know how the pandemic is going to affect that when I spoke with Matt Miller, who's the national director of suicide prevention at the VA, he said, the raw data coming in looks like it might continue to go in a downward trend, I'll be very interested to see if that's actually true. But if you look at just the total number of people who die by suicide, it's going to look like the 55 to 74 demographic is hurting the most. But when we're looking at this data, it's really important to think about the rate per 100, or 100,000, not just the lump sum totals. And so the demographic that's hurting the most is that 18 to 34 demographic, realizing the pandemic is going to have an effect, I think the thing that's really going to have an effect is this pulling out of Afghanistan, one of the things that's been going around in the news, and the Daily Beast was the first to sort of break the story, but the the call volume to the national veteran suicide hotline has been increasing since the pulling out of Afghanistan. And that does seem to be an indicator that we are wrestling with more suicidal ideation at the moment. And it will be really important to see those 2021 numbers when ever they do catch up.
Louis Celli:You know, you've mentioned moral injury Now a couple of times and and I want to drill down on that something that I really found to be very helpful in your writing in your paper, was the fact that you actually list a variety of different stressors that contribute to veteran suicide, which is something that that other papers really don't highlight that as much and I think that that's important. Can you talk a little bit about that
Dr. Ben Suitt:about moral injury specifically,
Louis Celli:not just about moral injury but you know, there's a there's a list moral injury, loss of purpose divorce, a nation that doesn't get it, I think that's extremely important. Veterans a wondering if their sacrifice was worth it. One statistic that did surprise me was the number of adults that you that were polled that actually thought that the war was over years ago. I mean, that that really surprised me. So can you talk a little bit about that?
Dr. Ben Suitt:Absolutely. So when I looked at the the possible causes for increasing rates and suicide, I realized that there were we could categorize them into two different parts. So on the one hand, you have things that would be novel to the post 911 wars, and on the other hand, you would have things that might be true of all wars, and what those things that would be unique to the post 911 Wars post have words were characterized with just a tremendous increase in the number of improvised explosive devices on the part of enemy forces. So this would just itself create an enhanced state of fear or stress burden on servicemembers that that alone could increase suicidal ideation. But for those that experienced improvised explosive device explosions, this led to a tremendous increase in the number of traumatic brain injuries. But what we also had were incredible medical advances that meant that if a person had a traumatic brain injury, they were also likely to be able to be redeployed, because we're able to help them. The issue is that IEDs were used to such a degree that traumatic brain injuries became It was called the signature injury of The war on terror. And so servicemembers would come back with a traumatic brain injury and then be redeployed. And this would happen over and over to the point that the sort of the average was around three. But the higher estimates were 15 traumatic brain injuries and still being redeployed. And anecdotally, with veterans I spoke with, they would say, Oh, I knew a guy who had 20. So fortunately, soldiers and service members are surviving. Unfortunately, having increased traumatic brain injuries that compound on one another, that severely increases the rate of suicidal ideation among that group, in addition, that if you're surviving injuries that might otherwise take you out of the fight, but you're able to redeploy, you might develop chronic pain. Also, just experiencing trauma, you're going to have your body's natural response to trauma, which is what we call Post Traumatic Stress Disorder, but it's just that deep in the amygdala, you're able to continue to have this fight or flight response that just won't shut off. And so those three together we call poly trauma or the clinical triad, and that is very closely tied to increasing rates of suicidal ideation. In addition to that, you have what is similar to what happened in Vietnam, but it is unique to post 911 wars. It's just the stereotypes and the societal burden of being a veteran. And so in Vietnam, it would be that they would call returning veterans, baby killers or awful things like that the point that veterans of Vietnam felt like they were never welcomed home that they were outside of society, what it was like for post veterans is coming home, that they would be treated as heroes, even those that didn't feel as though they had done things that were heroic. But at the same time when they're treated like they were necessarily broken people that can make them feel as though they're outsiders to society. But couple that with the the point, you mentioned that 42% of the voting public in 2018, didn't realize we were still fighting the war on terror, that can also cause a bit of an issue when your identity is wrapped up into the fact that you fought in the war, that you gave up a part of your life, and you come back to a public that is so deeply apathetic to what's going on, that they don't even realize the sacrifices you've made. And I think that that does end up tying to what's going on with pulling out of Afghanistan. It's just this idea that, you know, if it's a big part of your identity, that you were doing good work, or that what you did had a purpose. And suddenly, we're leaving the nation, basically, where we found it either worse off or about the same. That that can sort of disrupt this narrative that we we all carry that I'm a good person, I'm doing good work. If you suddenly feel as though all of your life's work or the sacrifice, you made work for nothing that can enhance suicidal ideation.
Dr. David Shulkin:I want to go back to clarifies some of the discussion that that you were talking to us about before about whether being in combat actually being deployed into an area with conflict? is a risk factor for suicide? Or is it actually a protective factor? And are we seeing more suicides on the people that aren't deployed? Can you just clarify that?
Dr. Ben Suitt:Yes, there's some nuance there. So when we look at the rates among those in combat roles versus those in support roles, depending on the year, it can look like the rates among support roles are higher than those in combat roles. And so something that I've seen in a report before was that being in combat might be a protective factor that is, would only be true to a very specific point. So we know that witnessing atrocities or perpetrating atrocities yourself, do increase suicidal ideation, and suicide risks. So it's sort of like the type of combat would make a difference. So if you've experienced atrocities, or if you have perpetrated violence yourself, those suicide rates do go up. But it is an important point to bring up that you don't need to be in combat to have high suicide rates. So those in support roles do have high suicide rates. That can be for a number of reasons. One can be secondary trauma. So being in a, an organization that does a lot of good, but also does a lot of violence can increase your risk for suicide. But one important issue to bring up is also military sexual trauma, which is a unique form of sexual trauma because the victim often has to continue working with their attacker and this affects both women and men. But especially women that is certainly linked to the development of post traumatic stress, but also it's a an indicator of risk for suicide as well. Just milk sexual trauma,
Louis Celli:in addition to the data in your paper that talks about the higher, higher accounts of suicide among veterans who were not deployed, you also talk about the highest amount of suicides among Guard members. Can you talk a little bit about that?
Dr. Ben Suitt:Yes. So while my, my report doesn't focus as much on the National Guard, it does appear depending on the year that the National Guard rates do tend to be among the highest, if not the highest, often sort of neck and neck with the army, those rates do seem to be up. I think one of the things in post 911 Wars specifically is that the National Guard was deployed under the purview of the army, that the National Guard would be put into positions that maybe when they sign up for National Guard, they weren't really they didn't suspect that they would be called upon to have boots on the ground and be fighting. In that way. One of the National Guard men that I spoke with his job was just he was going to be just doing sort of operational management dealing with supply lines. And when he was deployed to the Middle East, he realized that they were going to be changing his role. So where he thought he was going to be doing operational management, suddenly, they were putting him on convoys, and putting them into war zones, and he was going to have to fire on the enemy. He's specifically said that he never signed up for that, obviously, you know, going to the military, you're certainly trained to use your weapon. But he wanted to seek out support roles, he never wanted to have to kill someone. And now suddenly, he found himself in that position, it did end up sort of wrecking his his worldview. And it's just such a tragic story, because being put into a position where when you signed up, and you're making that commitment, but you did specifically sign up for National Guard, knowing what that would look like, the National Guard tends to be one foot in the military and one foot in the civilian world, having that significant role change. I just can't imagine what that would do.
Louis Celli:We could cover your paper for the next hour and a half. I mean, it's very rich and data. As a matter of fact, we're going to go ahead and post it on our website. Before we go, I want to ask you, what can we as a community, VA, the government, what can we be doing better?
Dr. Ben Suitt:In terms of civilians, I think that the what we can do better is to invite veterans into our communities, it is shown that even just reaching out lowers suicide rates. So showing care. That Rasmussen study that showed 42% of the voting public didn't realize we are at war is so upsetting that it's just absurd. So showing care, being involved in veteran lives, coming back to the civilian world is difficult, you know, your identity changes, when you enter the military, you become a warrior. And having to come back to the civilian world, you know, the change back to being a civilian doesn't happen overnight. And it would certainly help for civilians to be involved in that. In terms of the VA, I think they need to try to begin taking more holistic approaches, they tend to focus on one specific piece. But as my report shows, taking care of one piece is not going to solve the problem, we have to look at it from so many different angles. And in terms of the Department of Defense, they need to take suicide prevention more seriously. And think about ways to reframe it so that active component service members take help seeking attitudes more seriously.
Louis Celli:Then that really covers the question that I was going to ask you last before we left and that is to summarize, you know, your your, your research in your report in about two sentences, but you just did a perfect job. Listen, I really want to thank you for joining us today and absolutely time to to speak with us.
Dr. Ben Suitt:Thank you so much for having me. I really appreciate it.
Dr. David Shulkin:Thank you.
Louis Celli:Well, that's gonna be it for today. Hey, join us next week we have a very special guest the honorable Randy Reeves, who's the former VA Undersecretary for Memorial affairs. He was also the state director for veterans affairs in Mississippi. And he's going to talk to us about state veterans homes. When veterans die in state Veterans Home who's responsible? Find out next week.
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