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Children of Servicemembers Face Greater Risk of Suicide

Previously Published in The War Horse (April 15, 2020)

Geoffrey Davis lost count of how many times he attempted suicide.

His relatives described him as “the stereotypical boy next door,” an athletic teenager who hardly seemed like a troubled Army brat. To his family, friends, and teachers, Davis was a well-liked soccer player and member of his high school’s Army Junior ROTC in El Paso, Texas. The son of a 12B combat engineer, he succeeded as a student even as the Army moved his family to Texas from their southeastern Michigan home after his freshman year of high school.

He even became a pillar of stability for his mother in anxious times, as his father, an explosives expert, was sent into harm’s way for months-long training exercises, as well as a year-long deployment to Iraq.

But Davis was in crisis. Suffering from undiagnosed depression and post-traumatic stress disorder, he would lock himself in his bedroom and try to take his own life. Sometimes he tried to hang himself. Other times he would sit with the muzzle of his father’s loaded shotgun in his mouth. He drank and swallowed handfuls of opioids at night and hoped to never wake up. Yet every morning he did, heading off to school like nothing was wrong. Davis, now 26, calls it a miracle that he survived long enough to be forced into treatment his sophomore year of college.

“I’m one of the lucky ones,” he says.

No one has counted how many children of service members have died by suicide in the years since 9/11, but studies suggest teens and young adults from military families are at significantly greater risk than their peers.

Researchers at the University of Southern California found that over a seven-year period, nearly 25% of military-connected students in California schools had considered suicide or attempted it, a rate 10% higher than their classmates. Subsequent studies in other states showed similar results.

There are more than a million military children in U.S. schools — and more than four million Americans with a parent who served during the past two decades of war, according to the Military Child Education Coalition — yet scant attention has been paid to the prevalence of suicide among military children. Even as the number of veteran suicides has increased from previous years to 20 per day, a number that’s discussed by policy makers and the Pentagon, efforts to measure and mitigate the mental health of children of service members remain sporadic.

“We’re saying we love military families, we care about military families, suicide is our number one priority, and military families are our priority, but then what are we doing to actually address these issues?” says Jackie Garrick, former director of the Pentagon’s Defense Suicide Prevention Office. “If that’s true, where are we spending the money?”

Studies show a range of factors that put military kids at higher risk for suicide. Exposure to trauma from a parent’s combat experience, resistance to mental health care, and high rates of gun ownership likely all play a role. But researchers say the frequent school changes and parental absences experienced by most military families can be destabilizing and erode the support structures that help kids cope with crisis.

Constant relocation is a defining element of military life. For children of service members, it means being torn from friends and classmates every two to three years with little notice. Over and over again, they are the new kid in school, leaving behind peers, teachers, and coaches they’ve grown accustomed to seeing and befriended.

This instability has consequences, says Kim Ruocco, vice president of Suicide Prevention and Postvention at Tragedy Assistance Program for Survivors, a nonprofit that helps military families deal with loss.

“Those moves are a big stressor for kids,” explains Ruocco. “We know especially in teenagers and young adults their peer group is often their biggest support and the people they rely on to talk and have a safe place. These kids have to recreate that support group every time they move.”

At the same time, a military parent’s extended absences due to deployments or trainings can undermine support structures within the family. Children may feel it’s inappropriate to talk about their own problems when they sense their remaining parent is having trouble coping with their spouse’s absence, experts say. And a military spouse pushed past their bandwidth trying to handle both parental responsibilities may miss warning signs in their children they would otherwise see.

Geoffrey Davis experienced this firsthand. After nearly two decades in the civilian world, his father rejoined the army when Davis was 14. The transition into military life — the moves, the long absences, the danger of his daily work as an explosives expert — created enormous stress for his mother, as anxiety over her husband’s well-being was compounded by the additional workload of managing a household alone, says Davis.

By this point, Davis had attempted suicide multiple times and was developing an ever-greater reliance on alcohol. But amid what felt like chaos, the mounting evidence of his struggles went unnoticed.

“With everything else that was going on in my family, there was a lot for everyone to be looking at other than what was happening with me,” he says. “With all of those big life changes, especially because my dad rejoined when I was a bit older, it gave this big opportunity for me to hide behind that and find other ways not to share what was going on.”

Davis also points to the stigma surrounding mental illness within the military community. It’s a common refrain among those who advocate for families of service members.

“The biggest challenge to me is still the culture in the military that views mental health issues as a weakness in character,” says Ruocco. “There’s this unwritten code that you don’t bring this kind of family business outside of the family, because that could impact the way your service member is looked at or their ability to be promoted.”

Despite the evidence that children of service members face an increased risk of suicide, advocates for military families have been frustrated by what they describe as a lack of urgency at the Department of Defense. Even efforts to quantify the scale of the problem have languished in bureaucratic limbo.

In 2014, Congress ordered the DOD to begin tracking how many military children and spouses die by suicide each year. Jackie Garrick, who led the Pentagon’s Defense Suicide Prevention Office from 2011 to 2015, says she had the numbers ready within months, yet they were never published.

“I really tried to get this thing off the ground, thinking that preventing suicide was our number one priority,” says Garrick. “But it just was a dogfight at every turn.”

The report’s release followed years of pressure from advocates like Kristina Kaufmann, a leading voice in mental health advocacy for soldiers’ families and CEO of the Code of Support Foundation, a nonprofit that helps veterans and those in active duty access critical services.

“There’s certainly a cognitive dissonance between what the military says about the importance of family and how that actually translates into action and research and policies,” says Kaufmann. “There’s a big difference between giving lip service to caring about military families and taking action because it’s affecting the mission. That is what drives the military to make a change or to do anything — because it’s directly effecting its main mission, which is preparedness to fight wars.”

Both Kaufmann and Garrick express frustration with what they say is the DOD’s penchant for throwing money at anti-suicide messaging and awareness campaigns, a superficial approach that they suggest does little to save lives. What’s needed, they say, are comprehensive public health approaches that identify at-risk kids and proactively connect them with services and support. There are DOD services available for military children, but their efficacy and accessibility are issues.

“We keep trying to do the same old same old of reducing stigma and improving help-seeking behavior,” says Garrick. “We need to be thinking about what’s wrong with our help-offering behavior.”

At schools operated directly by the Department of Defense, every teacher and staff member is required to complete a training curriculum on identifying at-risk students and directing them toward available resources. In 2019, the DOD’s school system, the Department of Defense Education Activity, known as the DODEA, signed an agreement with the Defense Suicide Prevention Office and the military’s health services provider formalizing a collaboration on suicide prevention efforts. While only a small fraction of military kids attend DOD-run high schools — roughly 12,694, which includes students in DOD schools overseas — DODEA provides funding for programs intended to lower risk factors for the children of service members in certain military-heavy school districts.

A team of social workers at the University of Southern California spearheaded DODEA-funded programs in 144 California schools that trained teachers to better understand military culture and the risk factors unique to military-connected students. Participating schools developed systems to connect all of their students with mental health services and engage them as soon as they enroll, hiring military family liaisons, holding outings to build camaraderie, and identifying peer leaders to interact with new military-connected students.

“The most vulnerable time is during the immediate transition,” says Ron Avi Astor, now of the University of California, Los Angeles, a leading researcher of suicides among military teens who helped found the USC-led initiative in 2010. “If the school is super welcoming right when they come in, and they get put in with a group of other kids who are not a risky peer group, those kids don’t fall between the cracks.”

There are military children enrolled in every school district in the country. But whether a student has access to this kind of program varies greatly depending on the school district a child is sent to.

Fallbrook High School sits just a short drive from the Marine Corps’ Camp Pendleton in Southern California but has few targeted services for its 200 or so military students. The school was once part of the USC initiative, but it was unable to continue the program without additional funding.

“We have the shell of the program ready to go; we just need money to run it,” says Tony Morrow, the school’s assistant principal and Navy veteran who spearheaded the collaboration.

Although 10% of the school has a military affiliation, Morrow sees very little knowledge among teachers about their military-connected students.

“Ideally, we’d have programs in place where we’re always keeping track of them, just like we do with our homeless and our foster programs,” he says. “But ‘at risk’ is not a term I hear people here associate with military kids.”

While suicide prevention efforts targeting kids of active duty soldiers may be sporadic, they are practically nonexistent for children of veterans. The children whose parents saw multiple deployments during the height of the conflicts in Iraq and Afghanistan are now largely teens and young adults — a generation that must now also contend with the mental health challenges many of their parents suffered after being discharged. Indeed, even as awareness of veteran suicides grows, neither educational institutions nor the VA provide suicide prevention and mental health services focused on the unique experience of their kids. Presently, little data exists to track how many children of veterans have died by suicide.

For UCLA’s Astor, this is nothing short of the country failing those who served.

“I think the military and the country has an obligation here,” says Astor. “If we’re going to stick with 1% of the population as our fighting force, the least we can do is provide them and their families with support if they’re suicidal.”

For children of service members or veterans who attempt suicide, access to mental healthcare can be difficult or nonexistent. Even those covered by military insurer Tricare often describe a system ill-equipped to handle their needs.

It’s an issue that Geoffrey Davis knows all too well.

When Davis woke up after his final suicide attempt and was rushed to a Texas Tech clinic, he acknowledged for the first time that he was in crisis. After calling his mother, Davis agreed to be driven to a well-regarded recovery facility nearby.

But Tricare had other ideas, Davis says.

According to the Davis family, the insurer said it would only pay for recovery services at a state facility more than three hours away and suggested Davis buy a bus ticket to get there.

“If you know anything about recovery or getting sober, you know you only have a tiny window after someone admits they need help,” says Davis, now a counselor at a recovery-focused high school in Austin. “If I got on that bus there’s no way I would have got sober when I did.”

Davis’s family agreed to pay for the local clinic out of pocket, a decision that has led to seven years of sobriety but a protracted battle with the insurer. It’s an experience that has left residual bitterness toward the armed forces for which his father, and his entire family, made significant sacrifices.

“There’s a lot of anger there,” he says.

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