Introduction increases with incidences of PTSD and the stresses

Introduction

This
paper focuses on the relationship between family involvement and military
personnel suicide rates. On average, twenty-two (22) veteran suicides occur in
the United States every day (Weisenhorn, et al., 2016).  This significant number of deaths demands
answers.  There must be a better
understanding of the suicide risk military personnel face as well as the ways
in which preventive measures can be best instated to lower the instance of
suicide and aid the transition of service men and women.  New findings are being presented as time goes
on to better understand veteran PTSD and propensity towards suicide.  However, very little has been done to focus
on how family involvement impacts a veteran’s mental health or the ways in
which such involvement and support lowers the incidence of suicide. 

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In
2009, 1.6 million were deployed to Iraqi, Afghanistan.  More than 300,000 returned with mental health
concerns (M. McCarthy, et al., 2015). 
Currently, about 1.2 million are enlisted (“American Veterans by
Numbers”, 2015) within the US military and as of 2015 there were approximately
18.8 million veterans (“American Veterans by Numbers”, 2015) navigating
civilian life.  Many military personnel
return from deployment to civilian, non-military, life experiencing significant
challenges.  The challenges experienced
range from adaptation to non-military environments to struggles finding jobs
and adjusting to a new job environment to the emotional tolls of having to
process the experience of war (Logan, et al., 2012). These challenges are
further complicated by the presence of some form of Post-Traumatic Stress
Disorder, commonly known as PTSD.  Post-Traumatic
Stress Disorder is a mental health disorder that
is the direct result of exposure to a traumatic event (Weisenhorn, et
al., 2016).  The suicide risk in military
personnel increases with incidences of PTSD and the stresses of civilian life.

Though
affecting significant numbers of military personnel, little research has been
done on the effects of PTSD. The Veteran’s Health Administration (VHA), a
department of Veteran Affairs, has strengthened their mental health program
over the last eight years, specifically for suicide prevention (J. McCarthy, et
al., 2015).  A majority of the research
focuses on the need for greater research within mental health while expressing
the many limitations of their own results (Eisen, et al., 2012).  Further studies need to be conducted on PTSD
and how family involvement aids in a return to civilian life. Family
involvement could be defined as investment in the well-being and daily life of
an individual.  For example, one study (Weisenhorn,
et al., 2016) noted how previous research suggests family and children are a
protective factor but that they failed to examine whether marriage status has a
relationship to lower rates of PTSD. 

            The need for research into the role family plays in
lowering the incidence of veteran suicide is imperative to the therapeutic care
of military personnel and their families. 
The 22 veteran suicides a day (Weisenhorn, et al., 2016) span across
generations, wars, ethnicities and social lines.  The number of people in the military
returning to civilian life represents thousands of families affected by the
mental health concerns of one service man or woman.  There will continue to be ongoing conflicts
and disasters requiring military involvement and it would be most advantageous
to devise effective means of treating PTSD and lowering risk of suicide. 

Discussion

With
the deployment and return of many military personnel, there has been an
increase in studying their mental health. 
Many studies have been done to assess the suicide risk in veterans and
the ramifications of PTSD. Much data is received via web-based surveys (Blosnich,
et al., 2014) and mailed surveys (Eisen, et al., 2012) and rely on veterans
self-reporting their own mental health status (Miller, et al., 2012).  Multiple assessments were done 90 to 180 days
post-deployment while some assessments were looked at over a longer period, 12
months (Eisen, et al., 2012). The National Death
Index (NDI) is a primary source where researchers can identify if a person’s
death was due to suicide.  When this
information is added to the numerous military databases, a clearer picture of
veteran suicide can be gathered. 

Research
done by Eisen, et al. could aide in future research regarding military
suicide.  Results shared information
about the four main branches of the military and their chances of PTSD and
depression.  Eisen indicated military
personnel within the Army and Marines had worse mental health function than
personnel within the Navy or Airforce (2012). 
In comparison the Army and Marines scored higher percentages for many
triggers and symptoms than the Navy or Airforce (Eisen, et al., 2012).  This approach
to understanding the research is valuable to assessing the diverse levels of
mental health in the different military branches.  Future research identifying branch specific
care and suicide prevention could be beneficial.   

Eisen
was not the only one to see the value of approaching research by a focus on different
branches of the military and their mental health states.  Logan, et al. collected data focusing on US
Army suicide decedents during 2005 and 2007 across 17 US states (2012).  His data collected showed results which shed
light into the backgrounds of each of these Army veterans and what kind of life
they led (Logan, et al., 2012).  This
approach to research understands that the military experience of a veteran is
not the only relevant data to identifying the risk of PTSD or suicide.  By understanding what kind of life is lived,
further research can continue to recognize personal flags which increase risk,
such as drugs and alcohol (Logan, et al., 2012) as well as what supports
systems may come into play to reduce risk.

McCarthy,
et al. (2012) also focused a particular branch with research on Airforce
veterans. Like Logan, there is a look towards the personal life of the
veteran.  Where Logan points towards the
potential of things like social supports, McCarthy dives deeper into such
research.  Having collected data via a
web-based self-report questionnaire that each person within the study filled
out (McCarthy, et al. 2012), a trend of post-deployment was identified in
support systems.  He notes that “combat
veterans who have high levels of social support are at less risk for
depression, trauma-related problems, and suicide after a combat experience than
peers who have inadequate social resources” (M. McCarthy, et al., 2012, p. 63).
This emphasis towards social resources in lowering suicide risk could be
further pursued as a means to develop plans for intervention geared towards
prevention.  Additionally, the kind of
social support available to a veteran should be researched to identify the most
beneficial interactions. 

These
places of research and others have been beneficial in beginning to understand
the issues facing military personnel and their increased risk of suicide.  It points to some meaningful trends; such as
the previously differences in mental health function within each branch of the
military.  Their findings suggest further
efforts towards military suicide prevention. 
Knowing each branch of the military experiences different levels of
combat implies there should be different mental health focuses for each of
them. Furthermore, this research points to a need for research to take into
account specific branch of the military. 
Failure to account for which military branch the veteran experienced
when researching suicide risk and prevention could be problematic and
potentially skew results. 

Though
the leading research approaches in identifying the suicide risk of veterans has
been meaningful, they are also limited and incomplete.  Just as failing to account for military
branch could provide inadequate or even misleading results, problems in
understanding the severity of the situation result when fields are narrowed or
neglected.  Miller attempted to compare
the difference between civilian and military suicide and conclude there was not
a statistically significant difference (Miller, et al., 2012).  Looking at the incidence of suicide for
veterans, 26.2 per 100,000 persons; and nonveterans 18.8 per 100,000 persons;
however, there seems to be clear differentiations (Miller, et al., 2012).  Miller admits that he has narrows the field
by age, race, and survey year (2012) to reach his conclusions.  

Some
research recognizes its own limitations. 
Zivin acknowledges that because there is “limited research examining
completed suicide, little is known about the relative risks of suicide
associated with demographic and clinical factors among depressed veterans” (Zivin,
et al., 2007, 2193).  Furthermore, Miller
discovers that studies revolving around the mental health of military personnel
are almost entirely among men.  There is
a lack of research, and therefore understanding, of women veterans (Miller, et
al., 2012).  Attempting to apply the
notable research of male veterans to female veterans returning to civilian life
may prove ineffective. 

Further
limitations and problems with the research need to be identified by the ethical
and cultural implications within the information gathered by researchers.  Data was collected via email, postcards or
web-based programs (Logan, et al., 2012), yet while allowing for anonymity,
there is no way of verifying validity of these responses.  Therefore, the data that was obtained and
compiled together could have skewed results. 
Population surveyed is of both ethical and cultural concern.  Within the research studied, majority of the
data was collected from men, most white, while one research article (Miller, et
al., 2012) clearly stated that women were not addressed within their
statistics.  In order to have a clear
understanding of suicide rates and mental health stability, it would be
important to focus on both genders as well as other cultures that serve within
our armed forces.

As
noted, there are many places available research could and should continue in
the future to adequately understand the suicide risk of veterans as well as
move towards prevention and therapeutic treatment of PTSD.  Future military branch specific research
identifying experiences, risk, and PTSD is necessary to meet the needs of
veterans on an individual basis. Logan and McCarthy would both cite the need
for the necessity of further research understanding the role of social supports
in lowering the risk and rate of suicide. 
Logan cites how increasing positive partner relationships and coping skills
have shown to be beneficial (Logan, et al., 2012) but does not indicate how to
obtain those results.  McCarthy, et al.
stated it best: “closeness to family members also enhances military members’
resilience after traumatic combat-related experiences as do homecoming
ceremonies” (2012, p. 63).  Further
research should be conducted on how family impacts the mental health of
military personnel post-deployment. 

Research Proposal

As
previous studies have shown, little has been researched on the specific
involvement of family post-deployment and if it effects suicide rates.  A study on marriage (Weisenhorn, et al., 2016)
showed marriage influenced suicide rates, but more research was required to
gather conclusive data. The research proposal being presented focuses on how
family involvement can impact suicide rates among military personnel
post-deployment.  Available research
readily notes the tests and studies being conducted but few include a family
component. The present goal is to do quantitative research with a predictive
model of focusing on family involvement. 
Both proposals and hypotheses will be considered here with an
explanation as to the importance of this research.  The military is a functioning piece of our
government, ensuring freedom amidst conflict. 
As humans, fellow citizens, and individuals whom willingly sacrifice for
others, their mental health and suicide risk should be a cause of concern.  There is a responsibility to ensure the care
of the military personnel as they themselves have already demonstrated. 

            The proposed research question is “what is the
relationship between family involvement and military personnel suicide
rates?”  It is hypothesized that family
involvement with military personnel will significantly reduce suicide rates.  With first-hand experiences on this topic,
one can clearly see the impact family can have on returning veterans.  McCarthy (2012) stated that military
personnel have a certain level of resilience with the more tours they are
deployed on, yet how does that relate to home life?  It is important to consider these results as
it seems natural for individuals to put their best foot forward when they know
they are being supported.  This falls in
agreement with qualitative studies showing the positive effects that
community/home support played with the mental health of military veterans (Katz,
2012).  Future focus on how specific
familial support affects suicide rates within military personnel is important.

            Another focus and research proposal would ask “what is the
relationship between family involvement in therapy sessions and military
personnel suicide rates?”  It is
hypothesized that family involvement in therapy with military personnel will
significantly reduce suicide rates.  One
would think that family/support in therapeutic sessions may not play a
significant role in post-deployment well-being, but one researcher suggests
future research needs to be done to bridge the gap of the gap of the unknown (Weisenhorn,
et al., 2016).  Further exploration could
shed light on how support shapes a soldier’s mental status upon returning. 

            There is a great need for research into the role family
plays in lowering the incidence of veteran suicides.  Twenty-two veteran suicides a day are 22 lives
lost, part, and communities affected.  The
mental health concerns of one service man or woman are worth identifying the best
therapeutic treatment for, of which family could be a catalyst to a full mental,
physical, and emotional return to civilian life.  As the need for military personnel continues, it
is imperative to continue to devise effective means of treating PTSD and
lowering risk of suicide. 

Work Cited

American
veterans by the numbers. (n.d.).  Retrieved
January 14, 2018, from

            http://www.infoplease.com/american-veterans-numbers

Blosnich, J. R., Kopacz,
M. S., McCarten, J., Bossarte, R. M. 
(2014).  Mental health and self-

directed
violence among student service members/veterans in postsecondary education.  Journal
of American College Health, 63(7), 418-426. 

doi:
10.1080/07448481.2014.931282

Eisen, S. V., Schultz, M. R., Vogt,
D., Glickman, M. E., Elwy, A. R., Drainoni, M.-L., Osei-Bonsu, P. E., Martin,
J.  (2012).  Mental and physical health status and alcohol
and drug use following return from deployment to iraq or afghanistan.  American
Journal of Public Health, 102(S1), S66-S73. 
doi: 10.2105/AJPH.2011.300609

Katz, I. I. (2012).  Lessons learned from mental health
enhancement and suicide

prevention
activities in the veterans health administration.  American
Journal of Public Health. 102(S1), S14-S16. 
doi: 10.2105/AJPH.2011.300582

Logan, J., Skopp, N., Karch,
D., Reger, M., Gahm, G. (2012). Characteristics of suicides
among US army active duty personnel in 17 US states from 2005 to 2007. American
Journal of Public Health, 102(S1),
S40-S44. doi: 10.2105/AJPH.2011.300481

McCarthy,
J. F., Bossarte, R. M., Katz, I. R., Thompson, C., Kemp, J., Hannemann, C. M.,

            Nelson, C., Schoenbaum, M.  (2015). 
Predictive modeling and concentration of the risk

            of suicide: Implications for
preventative interventions in the us department of veteran

            affairs.  American
Journal of Public Health, 105(9), 1935-1942.

            doi: 10.2105/AJPH.2015.302737

McCarthy,
M., Thompson, S., Knox, K. (2012). Use of the air force post-deployment health

            reassessment for the identification
of depression and posttraumatic stress disorder: Public

            health implications for suicide
prevention.  American Journal of Public Health, 102(S1),

            S60- S65.  doi: 10.2105/AJPH.2011.300580

Miller,
M., Barber, C., Young, M., Azrael, D., Mukamal, K., Lawler, E.  (2012). 
Veterans and

            suicide: A reexamination of the
national death index-linked national health interview

            survey.  American
Journal of Public Health, 102(S1), S154-S159. 

            doi:10.2105/AJPH.2011.300409

Weisenhorn,
D. A., Frey, L. M., van de Venne, J., & Cerel, J.  (2016). 
Suicide exposure and

            posttraumatic stress disorder: Is
marriage a protective factor for veterans? 
American

            Journal of Child and Family Studies,
26(1),
161-167.  doi: 10.1007/s10826-016-0538-y

Zivin,
K., Kim, H. M., McCarthy, J. F., Austin, K. L., Hoggatt, K. J., Walters, H.,
Valenstein, M. 

            (2007).  Suicide mortality among individuals receiving
treatment for depression in the

            veterans affairs health system:
Associations with patient and treatment setting

            characteristics.  American
Journal of Public Health, 97(12), 2193-2198. 

            doi: 10.1016/j.jad.2014.04.067

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