The link between combat trauma and battlefield stress was known long before post-traumatic stress disorder (PTSD) was clinically diagnosed in the 1970s. Terms like “shell shock” and “combat fatigue” have long been used to explain how the horrors of combat affect the minds and behavior of soldiers. That said, the current conflicts in which the United States finds itself are among the longest in America’s history, dating back to the attacks of 9/11, and that extended exposure has had disturbing consequences for personnel on the front lines.
One of the most disturbing of these has been a rise in the number of suicides, which have spiked over the past few years. Perhaps most worrisome is that the suicide rate is not the only troubling metric facing senior military leaders as they look at continuing overseas wars that may go on for years to come. Substance abuse, divorce, family violence, and other rates of problem behavior are also on the rise, and earlier this year, the Army decided to task one of its most senior leaders to lead the effort to better care for the Army’s soldiers: Vice Chief of Staff of the Army Gen. Peter Chiarelli. We sat down with him recently to see how this effort has been developing.
John D. Gresham: You have a reputation for being really passionate on behalf of the American soldier. What is it in your background, life experience, and career in the Army that makes such a description from your peers and subordinates valid in your mind?
Gen. Peter Chiarelli: That’s a pretty tough question to answer, but I would have to argue that it probably goes back to my upbringing with my father and mom. My father was definitely a huge influence in my life, and he talked often of his experiences in World War II, of some of the great leaders that he had worked for, and how he always thought the highest of those who cared for their soldiers. He entered the Army a private, got a battlefield commission, and left as a lieutenant, but I remember him telling stories to me of Gen. Omar Bradley, who had a reputation for being an individual who really cared for soldiers and their welfare. I have to probably say that, and the fact I spent the majority of my time in operational units and not in headquarters, are the two things that caused me to always ask the question: How will this affect soldiers and their families?
Which takes us to the next question. You have had a number of command assignments over the past couple of decades in combat and crisis zones, so you’ve probably seen as much as anyone. What is it that today American soldiers are doing and dealing with on a personal level? I mean, what are we really asking of these young people to put on hold?
Well, first of all, I think you have to understand that the conflicts in Iraq and Afghanistan are different than any we have ever fought before. I think if you go and talk to historians and people who write on these issues, and you would find that the kind of stress that the soldiers are under is even greater than American soldiers were under in World War II, Vietnam, and even Korea. And why I say that, is it’s a continuous stress. This is not necessarily three or four-day kinetic battles that go on for a period of time, but rather, it’s the understanding that any time you go outside the forward operating base perimeter – and, quite frankly even when you are in the forward operating base with the threat of enemy rockets and mortars – that you are looking the Devil in the eye.
But those soldiers that go outside the forward operating base, be they infantrymen conducting missions or logisticians moving supplies, are under constant threat, with the big killer in these particular conflicts being the Improvised Explosive Device (IED). Now when you look at that, the continuous combat that they find themselves in – and it is a different kind of combat I grant you – the personal level of stress and strain is much greater than it was in the wars I mentioned earlier. I think that point is understood by all.
At the same time, … you [have to] understand that we’ve got individuals that have been on three and four overseas combat deployments since 9/11, with just 12 to 15 months in between those deployments. Many of those deployments were more than 12 months, and we are just now getting off of the 15-month deployments. Frankly, we won’t be completely off 15-month deployments with our enablers until September this year. So you find that the stress factor is not based upon only a single event, or a single 12-month period. We today have soldiers who have spent just seven years in the Army, but have spent upwards of 48 months in combat.
We’ve never asked that of any U.S. soldier, have we?
We’ve never asked that of any soldier. And then when they get back home, they are under the same kind of stresses that anybody would be who is away from their family for 12 to 15 months. They have to reintegrate with the family, while at the same time lurking in the background is the fact that they know in a couple of months after arrival at home, that they are going to be getting ready to head back over. That is tough on them and it’s tough on their families.
We are looking at the start of FY 2010. Therefore, I am assuming you have at least some idea of what your funding and force commitments within the next couple FY’s are going to be. If you could look forward, say into the next year, or two, or three, how would you describe what your soldiers are going to be doing? What are your soldiers’ lives going to be like as we turn into the next decade? What kind of operations tempos, challenges, and stresses, will they be facing? Will they be the same, or will they be easing? What can you offer those kids in the way of expectations?
Well, I can offer the commitment of both the chief [of staff] and the secretary of the Army, to do everything within their power to increase the “dwell” time. By this, I mean the time at home, the time between deployments into the combat theaters, and to increase that as quickly as we can and get it to a minimum of 24 months. That is absolutely critical. We call that term dwell. We know dwell has a tremendous impact on some of the stressors that I have seen on the force. When you turn around a unit or an individual between combat deployments – and really what we are talking about is individuals – in just 12 to 15 months, that individual does not have time to get back and take care of minor medical problems he might have. Elective kinds of surgeries on knees and elbows and whatever, to recover from his body or her body being torn down by fighting in Afghanistan in altitudes of 8,000 to 12,000 feet. So, we know that dwell is important. The secretary of the Army and the chief, and for the small part that I play, are totally committed to increasing that dwell. And I think that our main job is to convince the decision-makers that it is also their responsibility to get us that needed dwell. We need 24 months or more for individuals to be at home in between deployments.
I can also say that the chief and the secretary have moved all the monies for family programs into the base budget. It’s very, very important that those monies are there and it is not held hostage to the Overseas Contingency Operation fund [OCO]; what we used to call supplementals. As they are cut, and we expect them to be cut in the out years, it is absolutely critical to get these family programs into the base budgets. That’s where they are, funded throughout the POM [program objective memorandum], and that is a critical factor. But, my final point that I would tell soldiers is that we are in a period of what I call “persistent engagement,” which some call persistent conflict. And while that period of “persistent engagement is going to see continued overseas combat deployments, we do expect to see soldiers returning from Iraq. And with the return of those soldiers, we are hoping and praying that our assumptions hold true, and that we will see dwell increase to 24 months and perhaps greater in some instances.
Obviously, there is also the matter of your citizen soldiers: the National Guard and the Reserves. Are you seeing the same sorts of pressures and trends with them? Or are there additional factors and/or situations unique to their status as citizen soldiers that are layered on top of what your active duty folks are going through?
Yes, that is something that I have been watching since, quite frankly, 2001. I never understood why an active component soldier comes back off a deployment and has 14 days of mandatory reintegration training; yet when we bring back a reserve component soldier, the goal is to get him demobilized and back home as fast as you possibly can. It doesn’t make sense to me, and it’s never made sense to me. Thank goodness, in the last couple of years, for programs like the Yellow Ribbon Program, which a very enlightened governor in Minnesota pushed, and now has become a program that is available to all Guardsmen who return. This is a critical, critical program. It meets their needs, and gets at some of the issues that I see – maybe not all of them, but gets at some of the issues that I see.
I think that it is absolutely essential that we find new and innovative ways to deliver different kinds of mental health care counseling to our reserve components. You know, I have seen an increase in suicide rates of those who are not on active duty as opposed to those who are on active duty. When you look closer at that, what you see is a portion of the population, a soldier coming off of a 12 or 15 month deployment, who is demobilized in three or four days, then goes back to a civilian community and is separated from the resources and people who understand what he or she went through. Maybe these units are spread out, because some are in multiple states, and soldiers in these units, some are individual augmentees. They just don’t have the great co-located resources that the rest of the military community has when they come back. They sometimes don’t have people who understand what they have gone through or programs available to take care of them. So, we are working very, very hard at providing as many of these services as we can to soldiers, whatever part of the Army they serve in. In particular, we are looking at innovative ways we can deliver these, to those who are in geographically remote areas, through the Internet.
Which takes us to one other Army community, your special warfare (Special Operations Forces – SOF) personnel, who have their own completely different operations tempos and deployment schedules from the rest of the force. How are they holding up?
Our SOF units and personnel operate on a different operations tempo, normally on a six to seven-month deployment cycle, which of course is different than the rest of the Army and more along the lines of the Marine Corps deployment model. But as you know, many of them have five, six, seven rotations of that six- to seven-month deployment model. In fact, we would like to get the active component force down to something in that vicinity, possibly 9 months, but the problem when you do that is you have a significant amount of additional friction and that friction right now is unsustainable given the demand on the force.
That said, the Army Special Forces (the “Green Berets”) have regularly deployed in this fashion not only in this conflict but in the past. I think in many ways, many of their support systems are better, because they have been doing this for a while, and experience gives you the opportunity to improve those things. In addition, they are a smaller force, and being a smaller force it becomes a little easier to deliver some of these critical services, as opposed to the large active component general purpose forces and reserve component forces that we have.
How much of the pressures on deployed soldiers that you are seeing are coming from home station, family and other things back here in the United States? And what, in your mind, can the Army do to help reduce those? I am not just talking about improving the lot of the families but making it so that their lot in life does not blow back on soldiers deployed.
You know, there is no doubt that the connectivity of the Internet, and the ability to communicate back home daily, is by and large a good thing. Our ability to provide Internet connections for something as simple as Skype (r) [the free Internet-based phone system] has made an amazing difference for our soldiers. I had soldiers who were deployed, who would get on Skype (r) every single day and talk to their spouse back at home [if they could]. That can be a very positive thing if people handle that right, but it can also be a very negative thing if either partner tries to drag the other one into their world. Whether it is the service member serving abroad that tries to drag the spouse at home into his or her world or conversely, the spouse back at home that tries to get an individual that is going out to look at the Devil in the eye every single day, involved in the daily home activities and challenges.
Some soldiers and families handle it better than other soldiers and families, and I think we can do a better job of helping folks understand how to use that connectivity that we have today in a more positive fashion. That’s absolutely critical. I also think that we have to look at innovative programs when folks come back and have that dwell time, be it 24 months or less, where we make sure that the training follows a predictable pattern. As we bring in new leaders, because the Army Force Generation (ARFORGEN) model brings in new leaders normally 60 to 90 days after a unit returns, those leaders who are gearing up for that next deployment need to realize that a large portion of the units they are leading are composed of individuals who just got back. And although the soldiers have probably been “taking a knee” for a period of time, they need to do everything possible to give predictability about how much time at home soldiers who have just returned from a deployment and are getting ready for another one are going to get.
Is that issue of predictability versus uncertainty really in your mind a big issue that can give you some real traction in this situation?
It is a huge issue, bigger than you can imagine. And I hear that from spouses all the time. I have heard from spouses that tell me, quite frankly that, “I see more of my husband on the Internet or a Skype picture of him when he is deployed, than I do when he is back home. He comes back, we have that 30-day period where we kind of reconnect, but then, as soon as he returns back to work, he is in Reset, or may have to go to a non-commissioned officers’ education course and be gone for an additional four to six weeks. He comes back off of the training course only to find that his unit is back in the field training up for the next deployment. The soldier then grabs his rucksack and out to the field he goes. To them, there is no predictability. The only predictability they have is that they are going to see less of their husband or their spouse when they come home, and spend even less quality time with them than sometimes when he is deployed. So we have got to find a way to have the duty day end at a predictable time, say 17:30 to 18:00, and no training on the weekends unless absolutely necessary and approved by a general officer somewhere in the chain of command.
Training holidays where possible?
Exactly! And training holidays that are predictable, where we know that the time is going to be off and no one is going to come and say, “We have an added requirement that is going to cause us to take this training holiday away from you.” We also need to have opportunities to take leave when it is best for the family and ensure that in the summer months, when kids are out of school, even if you are at the height of your training period, that you give folks the opportunity to make use of that time and have a real “no kidding” family vacation.
You did not know that you were going to be a family counselor when they gave you the fourth star, did you?
Well, you know, these are things that good leaders have known, and that’s not to say that I am a good leader, but leaders have known this, not just in the eight years of this war but prior to that. Little things, like the ability for service members to be more a part of the family make a difference. I’ll give you a great example; Lt. Gen. Bill Caldwell because he can out at Fort Leavenworth, has delayed the beginning of the duty day for his soldiers. And it is not to accommodate instructors or himself, but to accommodate the students, so they can have breakfast with their children at home and take them to school. Just a little thing like delaying a class start from 8:15 in the morning to 9 o’clock allows them to have family interaction, and that’s a wonderful thing. The ability to go to baseball games, birthday parties, to family events, not to have training on Super Bowl weekend, all these things are huge, and leaders really need to think about them. You know, the one that always got me is that when you are four and five years old one of the most looked forward to holidays is not necessarily Christmas as much as it is Halloween. And the ability to go with your kids as they trick or treat.
All right, having talked about what you see; now it is statistic time. It presently is last quarter of 2009, and what are all your numbers telling you about the state of your force right now? What are the personnel indicators telling you about your soldiers?
The personnel indicators, except for those things I look at as “stressors,” are looking better than they ever looked before, and that’s based on a combination of a whole bunch of things. I think one of the huge things, and I have no empirical data to prove this, is the state of the economy and the unemployment rate. We have a Delayed Entry Program now that is filled with 97.8 percent high school graduates. That is absolutely an unbelievable number. Last year we came in, I believe for the entire year, at 81 to 82 percent that were high school graduates. We are at 97.8 percent right now in our delayed entry program. Those are soldiers we are going to pull in now based on the fact that we just got authority for a temporary 22,000-soldier increase.
They are going to be your pipeline increase?
They are my pipeline folks, and quite frankly, it could be a hundred percent high school graduates except that we have certain soldiers that, while not high school graduates, have language skills that are absolutely critical for us – people we want because they speak some of those critical languages that we need downrange. High school graduate or not, we want them in the force because of that special skill that they already have.
And correct me if I am wrong, you can teach them how to be a high school graduate?
That’s exactly right, but these are unbelievable numbers. In addition, our retention rates are very, very high. In fact we had to do a little adjusting for who we would allow to remain in the Army to try to get our authorized end strength numbers on target. We shot right past 547,400 and ended up somewhere in the vicinity of 550,000. We originally had a requirement to bring it down to 547,400 by 30 Sept. 2009. Now that’s going to be eased with the authority to add up to an additional 22,000 soldiers. So those numbers are very high. While I am not seeing any critical retention issues right now, I am watching very, very carefully the mid-grade officers. Even with the multiple deployments, we are seeing them, along with our non-commissioned officers, remaining with the force.
Now, that’s one set of numbers. At the same time, I am concerned with the stress numbers that I am seeing. I am concerned with the unacceptable rate of suicides in the Army. We are tackling and working this very, very hard. I am concerned about, and it’s documented, that we have an increase in the break-up of marriages. That concerns me, and I think that’s a direct result of multiple deployments. I am concerned with what I believe is an increase with alcohol abuse. I am not saying that everybody in the Army is an alcoholic, but I think that after eight years of war, and based on the conditions that I described for you, you can see that when soldiers come home there will be a greater number of them than before who will turn to alcohol as a way of getting some kind of temporary relief from some of the stresses that they’ve faced. When you add that to relationship problems, financial issues, and problems with alcohol abuse and drug abuse as a whole, it causes folks to get in trouble with the law. Those are the kinds of stressors that have me concerned right now.
In terms of your initial efforts, based on what you have seen with these personnel indicators, how do you view the recent efforts that you have been able to implement? Do you feel like you are getting traction with your earlier efforts? Are you looking for a short-term program that you can scale up later? What is the vector you have taken and how is it working so far?
Well, first of all, and I think, as you well know, we have decided this is not as much about the mission that I was put on in January of suicide prevention, as much as it is about improving the mental wellness of soldiers and their families. To do that, we have had to adopt a multi-disciplinary approach. One of the things that we’re doing is taking a look at those programs that are available to commanders, and you might make an argument or think that there are not a lot of programs that are available to commanders, when exactly the opposite is true. The fact is that there are too many support programs available to commanders. When you have that short period of dwell when commanders are coming in and preparing to go back into the theater, you don’t help a commander if there are “a thousand flowers,” and he has got to pick the prettiest one when they all look the same to him.
One of the things that my task force is doing is trying to winnow down those programs, move from 32 different agencies that are involved with suicide prevention, down to one agency that is working in concert with all the folks that have to help. I mean everybody from financial assistance and Army substance abuse counselors, chaplains and behavioral health folks, to general practitioners and marriage and family life counselors – all those folks that you have to pull together to provide these needed services. Now, there are two big ideas that we’re working that are going to have tremendous long-term benefit. The first of them is the National Institute of Mental Health (NIMH) $50 million study, and this is huge. We have got a study team together from both inside DOD – we have some of the experts in suicide, PTSD, and TBI – who are partnering with Harvard, Columbia, and the University of Michigan in a cooperative effort that will be, we think, as big as the Framingham Study was to heart disease back in the ’60s and ’70s.
I am unaware of anything done by the Army as big as this on any health issue in its history.
This is huge, and not only is it going to help the United States Army and the Department of Defense, it’s going to have a tremendous impact, I believe, on the U.S. and probably the world population as a whole, in understanding what some of the reasons are that people commit suicide. That’s a huge idea. The other big idea that is going to revolutionize the way we do this is to move us from being very reactive to people showing symptoms of stress, to very proactive. The key to this is the Comprehensive Soldier Fitness program and the resiliency training that we are going to give soldiers, not when they have been in for 20 years or 10 years or 15 years, but from the day they enter the Army. Our soldiers are going to be given this resiliency training that will be part of their initial entry training and will stay with them, and be part of their career throughout their time in the United States Army.
I guess my follow up to that is: Are you doing anything for commanders’ stress? They are soldiers too.
Yes, and the fact of the matter is they should be at the front of the line for a number of reasons. One, because they are soldiers too, but two, because there is no greater symbol that anybody can give to reduce the stigma of reaching out and getting the help than when commanders show a willingness to do it themselves. You probably followed what Gen. Carter Ham said he did when he returned from Iraq about his need to get some help. His so-called “coming out” to tell his personal story has had a huge impact on the force. I want to see the day when a brigade commander, because we are a brigade centered force today, is the first person who goes in to get that post-deployment evaluation and all of his soldiers see it. I think that you are today finding enlightened commanders understand that they have got to erase the stigma of asking for help in their units, and [encouraging] people who have fought for over eight years to reach out and get the help they need without worrying that it is going to affect their career. The enlightened commanders are the commanders that are doing just exactly that, setting the example.
Including corps commanders, like you when you returned from Iraq?
Including corps commanders.
Tell me a little bit about your work on behalf of the wounded warriors and the structure of the Army Wounded Warrior (AW2) Program?
Well, that’s a very, very important initiative. What we have done with the publication of FRAGO 3 just over a year ago, which basically said, “Listen, we are putting too many people into Warrior Transition Units [WTUs - Battalion-sized units at 35 locations used to transition wounded personnel back to their home units]. They were being used to put non-deployable soldiers who had minor medical problems in with soldiers who were seriously wounded, and we decided that if we allowed that to continue, we were going to have unsustainable populations in the WTUs. So we went back and basically stated that the WTUs are for anyone who requires comprehensive medical care for six months or more. If their care and rehabilitation needs are less than six months, we leave them in their home unit and leave it up to the individual and the rear detachment commander to make sure the individual is getting to the appointments they need.
Do you find your units embracing compliance with this new policy and doing a better job?
Oh yes. They do, because want to get these folks back into the fight as quickly as they possibly can. What that has meant is that our WTU or Warrior Transition Battalion (WTB) total population has dropped from a high last year of over 13,000, to today somewhere in the vicinity of 9,000. We did not pull anyone out of the WTU, but rather, we “grandfathered” everyone who was already in one of the WTUs, but after the publication of FRAGO 3, we did not accept anyone with minor medical problems that did not meet the six-month criteria.
While the population is now smaller, it is now made up of much more high risk/difficult cases. One of the things we are looking very hard at is whether or not we need to decrease the leadership-to-soldier load and make it so that squad leaders are in fact taking care of fewer soldiers than the original ratio of 1 to 10, because the cases are much more complicated and difficult. We have been able to, with the establishment of Brig. Gen. Gary Cheek’s command, ensure we do a better job, and we are still building up the capability to provide personnel services to soldiers that are in WTUs.
Now, within the WTUs, you have two kinds of soldiers. You have the soldier who has made the determination that he/she is going to leave the service, and we respect that, and will help him/her get settled in civilian life. We have made a commitment to do that. But then we also have soldiers who want to remain in the service, and we have got to make sure that we have special care personnel down there that, as they progress through their rehabilitation program, are ready to provide them the job options that they want.

You have to love a soldier who has lost an arm or a leg or an eye, and the only thing they want to do is to get back to their unit and get back in the fight….
Did you know that we have more than 30 soldiers that have returned to the theater who lost an arm or a leg? We see that. Right now, I’ve got a young armor captain who’s lost a leg but has a dream of commanding an armor company, and there is no reason why he can’t do that, if he sticks to his rehabilitation program and makes the progress we know he is going to make.

One of the things you have talked about – and this is something that caught my ear when you first started to talking about the suicide problem – you talked about not only wanting to keep your soldiers from deciding to end their lives, but trying to back them up a couple of steps and to eliminate the pressures and circumstances that make them ask that question in the first place. Where is your thinking going on trying to back them up on asking the question?
Well, we want to move further to the left on the timeline with them. We have four major categories of suicide support in the Army: we have assessment programs, we have training programs, we have intervention programs, and we have treatment programs. In the past, we have focused on the intervention and treatment portion of this, which is reactive; that’s waiting for the problem to occur before you’re helping a soldier. And then in many instances, I found that we did not have the Army substance abuse counselors we needed, so that when a commander referred someone who was having a drug or alcohol problem to that program, sometimes it would take in excess of two months for them to get their first appointment. This was because we the Army had not kept pace with the number of counselors that we needed.
So when I say move to the left, what we want is to get into the “assess and train” portion of this problem, so we can help folks avoid having to need an intervention or enter a treatment program. What we’re really counting on to help us with that is Comprehensive Soldier Fitness – this idea that we can train soldiers to do difficult things and come out stronger, not weaker, because of those difficult things.

And you are not just talking physically, but you are talking mentally as well?
We are talking mentally; that is the key and critical piece here. We have always had a good physical training program for our soldiers. Now we are talking a mental training program for our soldiers, so they can be more resilient throughout their career in the United States Army.
The Army has long been credited with a culture of personal responsibility. I know more soldiers than not who came to the Army looking for the structure that would let them become personally responsible for their lives. And yet, from that comes in the minds of some soldiers the idea that asking their fellow soldiers, their units, to support them in times of crisis is a sign of weakness. Is that a culture that you have encountered, that you now feel like you have to fight today?
Well that, in its purest form, which you just described, leads to stigma – the idea that somehow I am not as worthwhile a human being if I have to seek, ask for help for something that is not physical. We all understand that when someone cuts himself or breaks an arm, that we need to get them to the doctor, and there’s not a person who would pass a buddy in that kind of distress that wouldn’t stop and get him to a hospital. There’s not a soldier in the world who wouldn’t do that. But we’ve got to teach the forces that after eight years of war and the experiences that our soldiers have been going through, that there is mental distress as serious as a broken leg or cut arm, that needs to be taken care of. And from that reality, there should be absolutely no stigma attached to those seeking that help.
Sometimes, buddies have to help their buddies realize they are suffering from that, because it’s not something you can see. You can see it if you understand what signs to look for in them, and get the help they need. Now the key to this is commanders: commanders who set the tone in their units and tell their subordinate leaders at all levels that the elimination of stigma is absolutely critical in their command. And from that, those leaders counsel subordinates and make sure their subordinates understand that soldiers who need help, need to get help, and we need to support that effort.
So you are trying to mitigate the fears of soldiers, show them that admitting “I need help” not only is not going to hurt their careers, but in fact, it’s a positive thing.
Exactly!

Well, that’s pretty simple. I know that probably is more than a minor cultural change.
I can’t say it any better than you did.
This is not something that you just go out and do. You’ve obviously got a team. Who are your warriors in this mental fitness effort?
Well, leading the effort is Brig. Gen. Colleen McGuire. She is running our task force and is doing an absolutely magnificent job. She has representation from throughout the Department of the Army staff that sits on the Board that is looking through these programs and trying to make sense of what we’ve got out there and improve what is available for commanders. By doing this, we can winnow down the number of support programs out there and show commanders the ones that really, really have payback in the limited time that they have.
But the real key to this whole [effort] is getting the message out to the force, because this is not a problem that is going to be fixed from Washington, DC with a process. How this is going to be fixed is that we make the impression on individual soldiers and leaders at the lowest levels, to watch out for their buddies, to watch out for themselves, and to recognize the signs that are apparent. And that when they realize someone needs help, they don’t just tell them to go get help, they take them to get that help and make sure the soldier is seen.
Can I assume that you are using some of the more traditional Morale/Welfare/Recreation sets like chaplains and such as resources in your effort?
Yes, but we are changing all that, and our Army chaplains have a critical role in this. Now, the Army doesn’t have behavioral health specialists down at the battalion level, but we do have in our tables of organization and equipment a chaplain assigned to each battalion. That chaplain is the front-line individual who’s working many of these issues, and what we are having to do is better prepare our chaplains so they can handle these things. They are treating a totally different force than they were eight years ago.
So spiritual welfare is taking on a broader and deeper meaning?
Exactly, exactly. Chaplains today find themselves in very difficult situations, doing counseling that they never were trained to do. Even though Army chaplains are trained in counseling, some of this is very difficult counseling. We are also using new tools that apply to this generation of soldiers. I will just call your attention to the Beyond the Front video we used when we had our suicide prevention “stand down.” It is an interactive video that takes you through two superb vignettes where you go through and make decisions about the soldier’s actions. One of them is about a soldier who is downrange, who begins by getting a “Dear John” letter, compounded by the fact that the ATM card he left at home with his girlfriend has been used by her new boyfriend, who not only cleaned out his bank account but also got his girlfriend pregnant.
The video helps you work your way through that situation, and then you think ‘we’ve got him back moving in the right direction,’ only to have him go out on patrol and have his best friend killed in an engagement with the enemy. You are forced to make decisions along the line here, which either allow this young man to get the help he needs and make it through, or if you make the wrong decisions along the way, the last scene will find you at his memorial service. We also have another one where two senior NCOs, essentially peers of the same rank, are interacting and you have to make choices along the way. One of the senior NCOs is definitely displaying symptoms of PTSD, and if you make the right decisions along the way, you save him and his career and his life. If you don’t, again you end up at a memorial service. So, these kinds of things are new, are innovative, and are ways that people are beginning to grasp the things you have to address to reduce the rates of suicide and other problems we are working on.
Within the context of what you just talked about, are there roles for Non-Governmental Organizations (NGOs) in your organization and in what you are trying to do?
We are reaching out to everybody we possibly can.
Fisher House, USO, whatever? I mean, are you literally saying: Come one come all? We need your help?
We are doing our best within the ethics rules we work under, to incorporate as many of the ideas and services offered by folks as possible. Organizations like the USO and the Fisher Foundation, where Arnold Fisher has done so much for soldiers who have lost arms and legs by building the Center for Intrepid in San Antonio. He is doing the same thing for PTSD and TBI at Bethesda, which will be the new Walter Reed in a few years. He now is looking at providing satellite centers to the Center for the Intrepid for TBI and PTSD at key and critical posts, camps, and stations for both the United States Army and Marine Corps around the country. So, we are reaching out to everyone we possibly can to get the help we need, like veterans organizations that are willing to sit down and talk to soldiers who have had some of the same experiences. We will listen and steal the good ideas from anybody who is willing to give them to us.
You sound like a veteran pitcher who’s got three outs to get to the end of the game, in this case the end of FY 09. What results have you seen? Have you seen any of those key metrics move in the right direction?
I hate to talk about that because it is really early in this entire process and there is so much more work still to be done. That said, we really started to see suicides go up in August of ‘08, and really reached a peak in February of ‘09 and January of ‘09. In those two months we had 41 suicides in the United States Army, which is just absolutely through the roof from what we normally see. What we have seen February through July 2009, is the rate come down except for a slight spike in May 2009. I believe that’s because of the involvement of Army leaders and soldiers at all levels in taking care of their buddies out in the field, and I want to sustain that. I want to continue to see the numbers come down over time, and hopefully get to zero. But if not zero, at a number that is far better than it is today. So, I am starting to see some hopeful early signs, but as to your analogy of in the ninth inning, I still feel like I am in the first inning and trying to get to the last out in the ninth.
Well then, one final question. Did you General Chiarelli ask for help when you returned from Iraq?
You know, I didn’t, but I should have. I think that I should have gotten off the plane and led my soldiers through. It’s a leadership thing. Knowing what I know today, I wish I had been more out front in getting and showing my soldiers that there is no stigma attached to this.

Photo Credit:

• U.S. Army photo

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