Advertisement

United States: ‘Combatting’ Self-Harm and Suicide in the US Military and After: Culture, Military Labour and No-Harm Contracts

  • Paul TaylorEmail author
  • Andrew Reeves
Chapter
Part of the International Perspectives on Social Policy, Administration, and Practice book series (IPSPAP)

Abstract

Taylor and Reeves’ chapter opens with the increasing concerns regarding the self-harm suicide rate among the veteran community across the United States. The authors highlight powerfully that this issue wrenches the attention beyond those veterans who have sustained mental injury from conflict alone. The issue’s contemporary relevance is focused around the US military’s proposal to draw up ‘no-harm contract’ under a ‘Separation Oath’ model. The chapter provides an overview of the current situation facing US military veterans’ engagement with health and welfare sectors. The authors assert that the roots of stigma and the avoidance of help-seeking are operating at both formal and informal levels in the military, at the added expense of mental health crises experienced by those in noncombat roles, which are often carried out into their civilian lives. The chapter then critically examines the notion of the no-harm contract suggestion – finding a distinct lack of evidence for their efficacy in reducing the potential for suicide and self-harm. The chapter closes with a critic of the adoption of Oaths on Exit as a therapeutic intervention.

Keywords

Mental vulnerability Oath Identity Duty Shame 

References

  1. Acosta, J. D., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., et al. (2014). Mental health stigma in the military. Santa Monica, CA: RAND National Defense Research Institute.CrossRefGoogle Scholar
  2. Andrews, M. (2017). Remembrance and the working class soldier hero in austerity Britain. In D. Berry (Ed.), Cultural politics in the age of austerity (pp. 47–66). Abingdon: Routledge.CrossRefGoogle Scholar
  3. Ben-Zeev, D., Corrigan, P. W., Britt, T. W., & Langford, L. (2012). Stigma of mental illness and service use in the military. Journal of Mental Health, 21(3), 264–273.  https://doi.org/10.3109/09638237.2011.621468.CrossRefPubMedGoogle Scholar
  4. Bryan, C. J., Jennings, K. W., Jobes, D. A., & Bradley, J. C. (2012). Understanding and preventing military suicide. Archives of Suicide Research, 16(2), 95–110.  https://doi.org/10.1080/13811118.2012.667321.CrossRefPubMedGoogle Scholar
  5. Bryan, C. J., Hernandez, A. M., Allison, S., & Clemans, T. (2013). Combat exposure and suicide risk in two samples of military personnel. Journal of clinical psychology, 69(1), 64–77.Google Scholar
  6. Buelow, G., & Range, L. M. (2001). No-suicide contracts among college students. Death Studies, 25(7), 583–592.  https://doi.org/10.1080/07481180126577.CrossRefPubMedGoogle Scholar
  7. Clausen, J. A. (1981). Stigma and mental disorder: Phenomena and terminology. Psychiatry, 44(4), 287–296.  https://doi.org/10.1080/00332747.1981.11024117.CrossRefPubMedGoogle Scholar
  8. Coll, J. E., Weiss, E. L., & Yarvis, J. S. (2011). No one leaves unchanged: Insights for civilian mental health care professionals into the military experience and culture. Social Work in Health Care, 50(7), 487–500.  https://doi.org/10.1080/00981389.2010.528727.CrossRefPubMedGoogle Scholar
  9. Connorton, E., Perry, M. J., Hemenway, D., & Miller, M. (2011). Occupational trauma and mental illness - combat, peacekeeping, or relief work and the national co-morbidity survey replication. Journal of Occupational and Environmental Medicine, 53(12), 1360–1363.  https://doi.org/10.1097/jom.0b013e318234e2ec.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53.  https://doi.org/10.1093/clipsy/9.1.35.CrossRefGoogle Scholar
  11. Duhart, O. (2010). Soldier suicides and outcrit jurisprudence: An anti-subordination analysis. Creighton Law Review, 44, 883.Google Scholar
  12. Garisch, J. A., Wilson, M. A., O’Connell, A., & Robinson, K. (2017). Overview of assessment and treatment of nonsuicidal self-injury among adolescents. New Zealand Journal of Psychology, 46(3), 98–105.Google Scholar
  13. Garvey, K. A., Penn, J. V., Campbell, A. L., Esposito-Smythers, C., & Spirito, A. (2009). Contracting for safety with patients: Clinical practice and forensic implications. Journal of the American Academy of Psychiatry and the Law, 37(3), 363–370.PubMedGoogle Scholar
  14. Harrell, M. C., & Berglass, N. (2011). Losing the battle: The challenge of military suicide. Washington, DC: Center for a New American Security.Google Scholar
  15. Herman, A., & Yarwood, R. (2014). From services to civilian: The geographies of veterans’ post-military lives. Geoforum, 53, 41–50.  https://doi.org/10.1016/j.geoforum.2014.02.001.CrossRefGoogle Scholar
  16. Hillen, J. (1999). Must U.S. military culture reform? Orbis, 43(1), 43–57.  https://doi.org/10.1016/s0030-4387(99)80056-8.CrossRefGoogle Scholar
  17. Jobes, D. A., Gregorian, M. J., & Colborn, V. A. (2018). A stepped care approach to clinical suicide prevention. Psychological Services, 15(3), 243–250.  https://doi.org/10.1037/ser0000229.CrossRefPubMedGoogle Scholar
  18. Kinder, J. M. (2015). Paying with their bodies: American war and the problem of the disabled veteran. London, UK: University of Chicago Press.CrossRefGoogle Scholar
  19. Klin, A., & Lemish, D. (2008). Mental disorders stigma in the media: Review of studies on production, content, and influences. Journal of Health Communication, 13(5), 434–449.  https://doi.org/10.1080/10810730802198813.CrossRefPubMedGoogle Scholar
  20. Kleykamp, M., & Hipes, C. (2015). Coverage of Veterans of the Wars in Iraq and Afghanistan in the US Media. In Sociological Forum (Vol. 30, No. 2, pp. 348–368).Google Scholar
  21. Lewis, L. M. (2007). No-harm contracts: A review of what we know. Suicide Life Threatening Behaviour, 37(1), 50–57.  https://doi.org/10.1521/suli.2007.37.1.50.CrossRefGoogle Scholar
  22. Mankowski, M., Haskell, S. G., Brandt, C., & Mattocks, K. M. (2015). Social support throughout the deployment cycle for women veterans returning from Iraq and Afghanistan. Social Work in Health Care, 54(4), 287–306.  https://doi.org/10.1080/00981389.2014.990130.CrossRefPubMedGoogle Scholar
  23. McVeigh, K. (2013, March 26). US military veterans face inadequate care after returning from war – report. The Guardian. Available: https://www.theguardian.com/world/2013/mar/26/us-veterans-inadequate-care-war
  24. Miller, M. C., Jacobs, D. G., & Gutheil, T. G. (1998). Talisman or taboo: The controversy of the suicide-prevention contract. Harvard Review of Psychiatry, 6(2), 78–87.  https://doi.org/10.3109/10673229809000314.CrossRefPubMedGoogle Scholar
  25. Nash, W. P., Silva, C., & Litz, B. (2009). The historic origins of military and veteran mental health stigma and the Stress Injury Model as a means to reduce it. Psychiatric Annals, 39(8), 789–794.  https://doi.org/10.3928/00485713-20090728-05.CrossRefGoogle Scholar
  26. Novaco, R. W., Cook, T. M., & Sarason, I. G. (1989). Military recruit training. In D. Meichenbaum & M. E. Jaremko (Eds.), Stress reduction and prevention (pp. 377–418). Boston, MA: Springer.CrossRefGoogle Scholar
  27. Parry, K. (2010). Media visualisation of conflict: Studying news imagery in 21st century wars. Sociology Compass, 4(7), 417–429.  https://doi.org/10.1111/j.1751-9020.2010.00299.x.CrossRefGoogle Scholar
  28. Pew Research Center. (2019). The changing face of America’s veteran population. https://www.pewresearch.org/fact-tank/2017/11/10/the-changing-face-of-americas-veteran-population/. Accessed 30 April 2019.
  29. Pflanz, S. (2001). Occupational stress and psychiatric illness in the military: Investigation of the relationship between occupational stress and mental illness among military mental health patients. Military Medicine, 166(6), 457–462.  https://doi.org/10.1093/milmed/166.6.457.CrossRefPubMedGoogle Scholar
  30. Pitchford-Hyde, J. (2016). Bare strength: Representing veterans of the desert wars in US media. Media, Culture & Society, 39(1), 45–61.  https://doi.org/10.1177/0163443716672299.CrossRefGoogle Scholar
  31. Rausch, M. A. (2014). Contextual career counseling for transitioning military veterans. Journal of Employment Counseling, 51(2), 89–96.  https://doi.org/10.1002/j.2161-1920.2014.00044.x.CrossRefGoogle Scholar
  32. Redmond, S. A., Wilcox, S. L., Campbell, S., Kim, A., Finney, K., Barr, K., & Hassan, A. M. (2015). A brief introduction to the military workplace culture. Work, 50(1), 9–20.PubMedGoogle Scholar
  33. Reeves, A. (2010). Counselling suicidal clients. London: Sage.Google Scholar
  34. Rudd, M. D., Mandrusiak, M., & Joiner, T. E., Jr. (2006). The case against no-suicide contracts: The commitment to treatment statement as a practice alternative. Journal of Clinical Psychology, 62, 243–251.  https://doi.org/10.1002/jclp.20227.CrossRefPubMedGoogle Scholar
  35. Sayers, S. L., Farrow, V. A., Ross, J., & Oslin, D. W. (2009). Family problems among recently returned military veterans referred for a mental health evaluation. Journal of Clinical Psychiatry, 70(2), 163.CrossRefGoogle Scholar
  36. Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: Mental health disorders among 103 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167(5), 476–482.  https://doi.org/10.1001/archinte.167.5.476.CrossRefPubMedGoogle Scholar
  37. Shekelle, P. G., Bagley, S., & Munjas, B. (2009). Strategies for suicide prevention in veterans. Washington, DC: Department of Veterans Affairs, Health Services Research & Development Service.Google Scholar
  38. Silcock, B. W., Schwalbe, C. B., & Keith, S. (2008). “Secret” casualties: Images of injury and death in the Iraq War across media platforms. Journal of Mass Media Ethics, 23(1), 36–50.Google Scholar
  39. Strayer, R., & Ellenhorn, L. (1975). Vietnam veterans: A study exploring adjustment patterns and attitudes. Journal of Social Issues, 31(4), 81–93.CrossRefGoogle Scholar
  40. Stavrianakis, A. (2009). In Arms’ Way: arms company and military involvement in education in the UK. ACME: an international e-journal for critical geographies, 8(3), 505–520.Google Scholar
  41. Stars and Stripes (2017). Plan to institute military oath against suicide could backfire, some experts say. Retrieved from: https://www.stripes.com/news/plan-to-institute-military-oath-against-suicide-could-backfire-some-experts-say-1.482252
  42. Sundin, J., Fear, N. T., Iversen, A., Rona, R. J., & Wessely, S. (2010). PTSD after deployment to Iraq: conflicting rates, conflicting claims. Psychological medicine, 40(3), 367–382.Google Scholar
  43. Taft, C. T., Schumm, J. A., Panuzio, J., & Proctor, S. P. (2008). An examination of family adjustment among Operation Desert Storm veterans. Journal of Consulting and Clinical Psychology, 76(4), 648–656.  https://doi.org/10.1037/a0012576.CrossRefPubMedGoogle Scholar
  44. Talbot, S. (2012). Warriors, warfighting and the construction of masculine identities. Defence Science and Technology Organisation.Google Scholar
  45. Thomas, M. M., Harpaz-Rotem, I., Tsai, J., Southwick, S. M., & Pietrzak, R. H. (2017). Mental and physical health conditions in US combat veterans: Results From the National Health and Resilience in Veterans Study. The Primary Care Companion for CNS Disorders, 19(3).  https://doi.org/10.4088/pcc.17m02118.
  46. Thompson, M. (2009, April 20). The dark side of recruiting. Time Magazine.Google Scholar
  47. Tsai, J., Pilver, C. E., & Hoff, R. A. (2014). Potential mental health needs of US adult residents under different provisions of the Affordable Care Act. The Journal of clinical psychiatry, 75(12), 1402–1410.Google Scholar
  48. Vatne, M., & Nåden, D. (2012). Finally, it became too much–experiences and reflections in the aftermath of attempted suicide. Scandinavian Journal of Caring Sciences, 26(2), 304–312.  https://doi.org/10.1111/j.1471-6712.2011.00934.x.CrossRefPubMedGoogle Scholar
  49. Vogt, D., Perkins, D. F., Copeland, L. A., et al. (2018). The Veterans Metrics Initiative study of US veterans’ experiences during their transition from military service. BMJ Open, 8, e020734.  https://doi.org/10.1136/bmjopen-2017-020734.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Weiner, J., Richmond, T. S., Conigliaro, J., & Wiebe, D. J. (2011). Military veteran mortality following a survived suicide attempt. BMC Public Health, 11(1), 374.  https://doi.org/10.1186/1471-2458-11-374.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Wiklander, M., Samuelsson, M., & Åsberg, M. (2003). Shame reactions after suicide attempt. Scandinavian Journal of Caring Sciences, 17(3), 293–300.  https://doi.org/10.1046/j.1471-6712.2003.00227.x.CrossRefPubMedGoogle Scholar
  52. Williamson, V., Stevelink, S. A., Greenberg, K., & Greenberg, N. (2018). Prevalence of mental health disorders in elderly US military veterans: A meta-analysis and systematic review. The American Journal of Geriatric Psychiatry, 26(5), 534–545.Google Scholar
  53. Woodward, R., & Duncanson, C. (Eds.). (2017). The Palgrave international handbook of gender and the military. London: Palgrave Macmillan.Google Scholar
  54. Woodward, R., & Winter, T. (2007). Sexing the soldier: The politics of gender and the contemporary British Army. London: Routledge.Google Scholar
  55. Zogas, A. (2017). US military veterans’ difficult transitions back to civilian life and the VA’s Response. Providence, RI: Brown University.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of ChesterChesterUK

Personalised recommendations