After Teri and Patrick Caserta’s son, Navy Aviation Electrician’s Mate Striker Brandon Caserta, died by suicide in June 2018, the couple channeled their grief into raising awareness of the impact that leadership can have on junior sailors and the struggles facing troops who need mental health care.
Since Brandon’s death, the Casertas have walked the hallways of Congress pressing for legislation they believe could save lives: a way for service members in a mental health crisis to “tap out” of their situations, getting help without retribution.
At least one lawmaker seems to be listening.
During a Senate Armed Services personnel subcommittee hearing Wednesday on military and veterans suicides, Sen. Kirsten Gillibrand, D-N.Y., recounted Caserta’s death and asked pointed questions about “toxic” leadership, as well as Pentagon policies that require mental health professionals to notify a command in some behavioral health cases.
Gillibrand asked Navy Capt. Michael Colston, the Defense Department’s director for mental health programs, whether command climate could discourage a service member from seeking help.
“Would you agree that … fearing retribution from supervisors, and the possibility of a mental health provider contacting his command, may have dissuaded Brandon from seeking help?” Gillibrand asked.
Before his death, Caserta was struggling with several problems, including depression over washing out of Navy Basic Underwater Demolition/SEAL training after breaking his leg, disappointment in his new rating and job, and stress over his immediate supervisor, a petty officer who was known to be verbally abusive and had been shifted between units for his behavior.
Caserta’s story was detailed in June by Military.com.
Gillibrand, known for her work in the Senate to change how the services handle and prosecute sexual assault cases, expressed dismay that the Pentagon requires mental health professionals to disclose a member’s mental health condition to the command in cases of harm to self, others or mission, inpatient care, acute medical conditions that interfere with duty, substance abuse and three other circumstances.
Colston said the reporting policies exist for a reason, but he apologized that the policy may be harming troops.
“We do have some mission imperatives around insider threat … we need to strike a balance. But as a provider, that balance usually goes to the patient. I think we get it, and that’s how we train our residents, but I’m not surprised to hear we have fallen short, and I’m sorry,” he said.
Colston told that panel that the services have a “zero policy for hazing” and in cases where it happens, these “are leadership failures.”
Gillibrand and subcommittee chairman Sen. Thom Tillis, R-N.C., called the hearing to learn what the DoD and VA are doing to tackle the issue of suicide among their members.
Both departments released reports this year that showed suicides continue to rise, despite efforts to prevent them.
The DoD’s 2018 Annual Suicide Report, released in September, found the suicide rate for active-duty U.S. service members in 2018 was 24.8 deaths per 100,000 troops, the highest on record since DoD began tracking suicides closely in 2001.
The age-adjusted suicide rate in the general population in 2017 was 18.2 deaths per 100,000, according to the DoD.
In 2018, the Army had the highest number of active-duty suicides in 2018, 139, for a rate of 24.9 per 100,000. The Navy experienced 68 deaths, a rate of 20.7 per 100,000, while the Air Force had 60 suicides, a rate 18.5 per 100,000, and the Marine Corps, 58, or 31.4 deaths per 100,000.
The National Guard had the highest suicide rate across the board among the three components, with a rate of 30.6 per 100,000.
The report also disclosed that there were 186 suicides among spouses and dependents in 2017 — the first year the DoD made such information public.
The VA also announced its latest information on veterans suicide in September, disclosing that more than 6,100 veterans died by suicide in 2017, or about 17 persons per day. Although the numbers appear to reflect a decline from the previously estimated 20 veterans who die by suicide per day, based on the veteran population and revised calculations, the number is actually an increase of 2 percent from 2016 and a 6 percent rise since 2007.
Both departments have initiated new programs to address suicides. Matthew Miller, acting director of the VA’s Suicide Prevention Program, said VA launched a program Monday that ensures that every newly separated veteran gets a phone call from VA within their first month of leaving military service.
“I’m optimistic,” Miller said. “We are introducing them to VA, we are introducing them to services within VA, and we are offering them connection and resources within that conversation,” Miller said.
The program is part of the VA’s Joint Action Plan, established by an executive order in May 2018 by President Donald Trump.
Karin Orvis, Defense Suicide Prevention Office director, told lawmakers that the Defense Department has embraced several new initiatives and is working with the private sector on “promising practices” now under development.
The efforts include expanding treatment to include clinically proven psychotherapy and medications, encouraging treatment and reducing the stigma of mental health treatment, promoting connections and encouraging safe storage of weapons that could be used in a suicide.
She added that administratively separating service members with personality disorders also “may help.”
“A review of data shows a trend between the decrease in administrative separations for personality disorder and an increase in suicide, which may stem from persons with personality disorders having high rates of suicidality or their suicidality having contagion effects,” Orvis said.
Gillibrand asked Colston and Orvis whether service members should be provided a safe avenue for seeking mental health treatment that wouldn’t trigger command notification, similar to the restricted sexual assault reports that allows a victim to get treatment but doesn’t launch an investigation.
Colston told her that “something along those lines, codified in law, might not be a bad idea.”
Tillis said he is frustrated by the rising problem of suicide among military personnel, veterans and the general public. He asked DoD officials to ask for help if they have ideas, “however minor.”
“The DoD and VA have improved capacity for mental health treatment but he rates of suicide have not increased. … While suicide represents a growing public health challenge in the civilian world, the unique composition and mission of our military makes this challenge one of particular importance that we need to address,” Tillis said.
If you or someone you know needs help, call the Veterans Crisis Line 24 hours a day, seven days a week, at 800-273-8255, press 1. The line is also available at www.veteranscrisisline.net or by text, 838255.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.