Fort Hood takes aim at stigma as it battles record suicide pace

Inside a darkened theater, camouflage-wearing soldiers shuffle toward their seats to confront an enemy that has taken record numbers of their comrades in the past year.

On the stage, four actors re-enact a situation in which a soldier who recently returned from war describes the pain and hopelessness he feels but doesn’t know how to handle. Jamey Gadoury , an Army veteran who served in Iraq and Afghanistan, interrupts the action and talks directly to the troops, many of whom are about to deploy to Iraq next month.

“We talk a lot as an Army about warrior culture,” he says. “As an Army we know what courage on the battlefield looks like. The question is, when it comes to a life-and-death situation with a buddy, can I dig deep to that same sense of courage?”

This sprawling Army post, the nation’s largest, is set to pass an unwelcome milestone. Through July, officials say there have been 14 confirmed or suspected suicides of Fort Hood soldiers, eclipsing last year’s total by three and matching the total in 2008, which saw the most suicides of Fort Hood soldiers since the wars began. The spike at Fort Hood comes as the suicide rate for the whole Army doubled between 2005 and 2009, leaving military leaders searching for answers and scrambling to implement suicide prevention measures.

“The Army realized too late that there was a very serious problem,” Gen. Peter Chiarelli , the vice chief of staff for the Army, wrote in a report last month that provided a stark assessment of the Army’s suicide prevention efforts.

Fort Hood officials, who have watched suicides spike in 2010 as the post’s population swelled with thousands of troops returning from Iraq, have been similarly blunt.

“Despite our best efforts, we are not succeeding,” Maj. Gen. William Grimsley , the acting Fort Hood commander, wrote last month in the Fort Hood newspaper. “Too many of our Soldiers are seeking a permanent solution to a temporary problem.”

At Fort Hood, prevention efforts have largely taken aim at the barrier experts say has kept too many soldiers from getting the help they need: the lingering stigma within the military that seeking mental health help is a sign of weakness and poison for career advancement. An August report by a Department of Defense task force on suicide prevention found “discriminatory and humiliating treatment” of some service members who sought help throughout the armed services.

“That stigma, it certainly is very real in the military culture,” said Ed Colley , a retired Air Force captain and the father of a Fort Hood soldier who killed himself in 2006. “I don’t know how to totally get rid of it. They are trying to give soldiers the message that toughness can be displayed by getting help. That’s a good message, but it’s a tough sell for a (service member).”

Stephen Colley , a 22-year-old Fort Hood helicopter mechanic, killed himself in May 2007 after returning from Iraq, before the Army began its current campaign to reduce stigma and encourage soldiers to seek help.

He returned from war physically unharmed, but carrying unseen wounds. Ed Colley said that at first, Stephen seemed to be handling things well, but he soon became moody and withdrawn. He had financial problems, and his marriage was suffering. In mid-May he was given a standard behavioral health screening and for the first time indicated that he was thinking about suicide. But instead of being sent to the emergency room, he was given an appointment for a sleep study, Ed Colley said. The next day, under the influence of Percocet prescribed after a dental procedure, Stephen Colley hanged himself in the backyard of his Fort Hood home.

While he is frustrated at the Army’s missed chances to help his son, Ed Colley said his son also worried that seeking help would jeopardize his Army career.

“He didn’t self-identify early on,” Colley said. “Like most soldiers, he said, ‘I’m tough enough.’

“It’s a macho culture. The military is in an impossible situation,” he added. “Soldiers have to be trained, indoctrinated if you will, into a tough mindset: I’m tougher than the enemy, tougher than anyone else. That of course sends a corollary message: You should be mentally tough. You shouldn’t have issues.”

Fort Hood has unrolled a series of programs aimed at suicide prevention in recent years, including intensive training in what officials call suicide first aid. Graduates of the training program, including more than 650 last year, are given distinctive green stickers to put in their workplaces that let soldiers know they can approach them for help. Soldiers also carry laminated cards with tips on how to help a buddy in need of help and have access to substance abuse counseling.

And last year, Fort Hood launched what it calls a resiliency campus, where soldiers and family members can receive everything from yoga classes and relationship counseling to financial advice in hopes of easing anxiety and stress. Post officials say about 3,500 soldiers use the campus per week.

Col. Thomas Yarber, chief of the Resilience and Restoration Center at Fort Hood’s Carl R. Darnall Army Medical Center, said it’s helpful when officers are simply seen in the waiting room of a behavioral health clinic. “On occasion if I work with a senior (noncommissioned officer) or officer, I reinforce that they are a great role model for other soldiers,” Yarber said.

Officials say such an array of programs is necessary because they don’t see any clear-cut trends in the soldiers who have killed themselves. Of the 14 Fort Hood suicides this year, three soldiers had never deployed, seven had deployed once and four had been on multiple deployments.

Fort Hood officials conduct a review after every suicide, and Yarber said factors often include deployments, relationship issues and financial problems. “It’s the big picture,” he said. “Frequent deployments may be a factor, but it’s not just that; you have to look at the whole picture.”

The role-playing exercise, unique to Fort Hood and held three times a week at the post’s Palmer Theater, is one way that Fort Hood officials are trying to change that mindset among troops. As the four actors role-play uncomfortable, painful situations, they ask the soldiers in the audience to think about how they would talk to a friend who might be suicidal. Soldiers are brought onstage to take part in the scenarios. Gadoury, who serves as a kind of facilitator during the show, repeats his mantra that seeking help for suicidal thoughts is not a sign of weakness.

“Being honest and getting help is a sign of strength and good judgment,” he tells the roughly 150 soldiers. Occasionally during the performances, soldiers who are struggling with their own issues walk out of the theater and seek help from the behavioral health therapist who is on hand for every show.

“We have to start a dialogue on talking about a hard issue like this,” said Timothy Block , who coordinates Fort Hood’s employee assistance program and works with the post’s suicide prevention programs. “These are really touchy subjects. We want folks trained up to be not too intrusive, but not lackadaisical.”

The scenes have been shown to nearly 30,000 soldiers since they began last year.

“There was a lot of information I could use in the future to approach someone,” said Pfc. Courtney Elie , a 23-year-old Killeen native who is deploying for the first time to Iraq next month. Elie said he feels his chain of command would support him if he ever sought out mental health help. “They would think I was soldier enough to ask for help,” he said.

Sgt. Michael Smart , 38, said suicide prevention measures have expanded dramatically in recent years.

“It’s spoken about a lot more openly than when I first came in,” Smart said. “Everyone needs to talk sooner or later. With multiple deployments, everyone needs to vent somewhere no matter who you are.”

Fort Hood officials say that while top commanders are learning that they need to let go of outdated attitudes about mental health, the challenge has been reaching more junior officers.

“I think senior leaders totally get it,” said Col. Bill Rabena , commandant of Fort Hood’s resiliency campus. “We’re working our way down.”

Chuck Luther , an Iraq veteran who founded the soldier advocacy group Disposable Warriors, said he’s seen a sea change at Fort Hood in terms of how seriously commanders are taking the mental health problem.

“I had been beating my head for 2½ years at Fort Hood to get these guys some help,” he said. “When guys are taking their lives at a record pace, you’ve got to step back and let the macho attitude go.”

jschwartz@statesman.com; 912-2942