Military Suicides Decline, But Continued Failures Hold Lessons for Future Wars

Wayne Telford did not lose his daughter on any of her four deployments over 17 years of service in the Air Force—not in Kuwait, not for two tours at Bagram Airfield in Afghanistan and not during her last, to Sather Air Base near Baghdad International Airport, just before the U.S. withdrawal from Iraq in December 2011. Brooke Leigh Caffrey, a tech sergeant three years shy of full retirement, committed suicide on Jan. 5, 2012, on leave at her home in Arizona. She was 35 years old.

All across the country there are families like Wayne Telford’s. The year his daughter died was one of the worst for suicides in military the since the Pentagon started closely tracking the data in 2002. In 2012, the Defense Department reported 522 service member suicides: 320 suicides among active-duty service members across the Air Force, Army, Marine Corps and Navy, at a suicide rate of 22.7 percent per 100,000; 72 Reserves suicides and 130 National Guard suicides. Eight hundred and sixty-nine service members attempted suicide at least once.

According to data obtained by Defense One, 475 service members committed suicide last year—47 fewer than in 2012. Among active-duty troops across the four branches, 255 service members committed suicide, at a decreased rate of 18.7 percent per 100,000. But 86 Reservists and 134 National Guard committed suicide, up from the year prior.

A Defense Department official told Defense One that while it’s difficult to determine trends, the past two years’ numbers indicate a small, continued improvement -- but the official noted that might just be because 2012 was so bad.

Suicides are slightly down in 2014, according to year-to-date data obtained by Defense One. As of Nov. 16, there have been 254 suspected and confirmed active duty suicides among all military services and components this year, compared to 258 at the same point last year, and compared to 327 at the same point in 2012, the defense official said. (See chart below.)

Suicides in the Army and Marines are down this year — but they are up in the Air Force and Navy. The Defense Department is expected to release its report for the second quarter of 2014, as well as its annual Suicide Event Report (DoDSER) for 2013, early next month.

Jacqueline Garrick, director of the Defense Suicide Prevention Office, said that the numbers of suicides have come down over the last two years to roughly 2008 levels – around 16.1 suicides per 100,000 active duty members. “We’re glad to see that trajectory change, but the complicated nature of suicide makes that very hard to attribute to one primary cause and effect,” Garrick said. “That’s part of remaining vigilant.”

According to the year-to-date data for 2014, that’s still roughly five active duty military members committing suicide each week, on average.

‘Not Just a Number’

At a dinner before last year’s State of the Union, Wayne Telford sat at a table with several senators, including his host, Colorado Sen. Michael Bennet and Minority Leader Mitch McConnell. Bennet stood up and introduced him.

“‘This is my guest, Wayne Telford,’” Telford recounted. “Then he said, ‘He lost his daughter in the war on terror.’ Everyone kind of lost the countenance on their face. ‘Share your story, Wayne,’ he said, and I did.”

“I don’t think they’re used to seeing it up front and personal, and putting a face to it -- it’s not just a number,” Telford said of his experience at the State of the Union. “I think it had a dramatic impact on them that they just don’t see back there in Washington. Yeah, they’ll go to a ceremony at Arlington, on Memorial Day, Veterans Day, but hearing one man’s story about the loss of a child …” he trailed off.

“I see Washington as out of touch,” he said.

Tech Sgt. Brooke Leigh Caffrey. (Courtesy of the Telford family)

Though lawmakers are always eager to tout their work for veterans and the military, and many were vocal in the run up to the resignation of former Veterans Affairs Secretary Eric Shinseki at the end of May, since then Congress has largely been focused on other priorities.

But on Wednesday, as Congress runs out of days to pass any legislation, including a handful relating to mental health and suicide among veterans and military, the House and Senate veterans affairs committees each held hearings on the issues.

Both the Senate and the House are considering versions of the Clay Hunt Suicide Prevention for American Veterans Act, named after an Iraq War veteran who committed suicide in 2011. The legislation requires suicide prevention programs in both the VA and also the Defense Department to be evaluated by a third-party, collaboration between government agencies and outside advocacy groups and improvement to the process of transitioning back to civilian life.

The House VA committee is expected to markup the legislation after lawmakers return from the Thanksgiving recess. But the Senate VA committee hasn’t held a single hearing this year to markup any legislation, according to Alex Nicholson, legislative director for Iraq and Afghanistan Veterans of America. “When we started to focus on the suicide issue this year, we knew many things could come up and divert attention, that we’d have to struggle to bring it back,” Nicholson said.

In March, Sen. John Walsh, D-Mont., the only Iraq War veteran in the Senate, introduced his own Suicide Prevention for America's Veterans Act with a bipartisan group of 15 sponsors, combined with a lobbying effort on the part of IAVA. When it became apparent Walsh wouldn’t be returning to the Senate in 2014 and that his legislation was effectively stalled in the Senate VA Committee, IAVA and a group of senators revamped it, introducing the Clay Hunt SAV Act on Nov. 17, now with the backing of heavy hitter Sen. John McCain, R-Ariz. But it remains unclear whether the legislation will be considered.

If the committees don’t take up the bills, Majority Leader Harry Reid, D-Nev., would have to agree to bring the measures, or their language, before the full Senate, but that would require a high level of support and cooperation. Given that unlikelihood, several sponsors of related bills are scrambling to include their proposals in the few must-do pieces of legislation that remain this year, such as the annual defense appropriations bill, expected to be taken up as part of a giant, trillion-dollar-plus omnibus bill to fund the government for the rest of the fiscal year beyond Dec. 11, or the annual defense authorization bill, the NDAA.

Days before the introduction of the Clay Hunt SAV Act, Walsh told Defense One he’d been catching senators on the floor to push for his legislation to be added to the annual appropriations bill. “I’m still hopeful,” he said.

Sen. John Walsh, D-Mont., currently the only Iraq War veteran in the Senate. (AP Photo/Charles Dharapak, File)

‘I’ll Never Know’

Telford has gone to his local veterans center twice a week for more than 25 years to treat the PTSD that has haunted him since Vietnam, where he led a river support force as a Navy officer just old enough to legally drink back in the states. For decades after, he said, “I became a non-veteran … I didn’t talk about it.”

But after Brooke joined the military at age 18, they began sharing stories about their service. She’d served nearly half her lifetime when she got the orders in 2011 to go to Iraq to advise the Iraqi Air Force. The U.S. was scheduled to withdraw by the end of the year but was still trying to come to a Status of Forces Agreement with Iraqi leadership to keep American troops in Iraq, and it was an uncertain, frustrating time, Lt. Col. Jim Borders, Brooke’s division officer in Iraq, told Defense One.

“Green on blue” attacks in Afghanistan by men dressed as Afghan troops were adding to the tension in Iraq. Part of Brooke’s job was base security, vetting mostly Iraqis for whether they posed a danger. Brooke, a young, female, non-commissioned officer, worked almost entirely with male Iraqi Air Force officers, Borders said. “She was not running convoy duty down Route Irish,” he said, referring to the dangerous road from the Baghdad airport. But, he said, “I was always really impressed with how well she handled it … she was not intimidated.”

Family and friends similarly describe Brooke as the tough type, holding things in to try and handle them on her own. But her deployment had affected her deeply.

“Her head was still in Iraq,” Telford said of Brooke when she came home for that holiday leave. “My wife and I discerned this huge change in her. She was very quiet, she was sad, she was self-medicating.”

“She started to let me know about her feelings and thoughts and basically they were that, 'Here I am in Iraq, but we're winding this whole thing down' … They had very little respect for her. And then there were times Iraqi officers would unload on her -- ‘How can you people leave us like this?’” he recounted.

“The other things she said that really clicked with me, with my Vietnam experience, is, ‘Dad, we've lost thousands of men and women killed in action, thousands of wounded, we’re leaving billions of dollars of aircraft that we so take care of’ … There was just this sadness. Brooke said it was kind of pervasive with the tail end of our military there.”

“It was just, ‘What the hell did we do?’”

He encouraged Brooke to get professional help, which he credits for saving his life after he got back from Vietnam, but she was concerned it would negatively impact her career. After spending Christmas with her family in Colorado, she returned to her empty house in Surprise, Arizona.

“A lot of times coming home can be just as stressful as the deployment,” Borders said. “Either things have changed while you were gone or you were hoping they changed, but they didn’t.”

But Brooke had begun considering life after the military, talking to her cousin about going to school for social work. She brought in the New Year with her son, who was visiting, and a few friends. In a photograph from that night, she is smiling broadly, with a glass of wine in one hand and her other arm around her friend Joe Birosak, a fellow airman. He said her mood changed abruptly when she said goodbye.

Brooke Leigh Caffrey and her friend Joe Birosak, a retired Air Force senior airman, on New Years in 2012. (Courtesy of Joe Birosak.)

On Jan. 5, 2012, a friend drove Brooke to mental health services on base. They made her an appointment to come back more than a week later. That same day, Brooke went to Home Depot, returned home, and sealed off her garage with the duct tape she bought in order to trap the carbon monoxide from her car. She left notes to her friends, her son, her sister, and her Mom and Dad.

“One of the worst thoughts,” Telford said, “is to put myself in her head the day she took her life. … It’s troubling, that aspect. That I’ll never know what those last thoughts were. At the end, was she trying to reach out and shut off that engine, saying, ‘Somebody help me. Somebody help me’ … what were you thinking? What were you thinking? I don’t know. I don’t know.”

Finding Answers

The Air Force Office of Special Investigations interviewed Telford and members of his family, along with Birosak and others who served with Brooke. When an airman dies, the Office of Special Investigations coordinates interviews and autopsy reports, and presents the completed investigation to the wing commander and the base legal team, which then make a determination into the cause, according to OSI spokeswomen Linda Card.

Telford said he believes the report was completed in April 2012, but he never received it.

On average, a report takes five to six months. “It's not like television. Death investigations are not completed in an hour! It takes days, months, weeks and sometimes years to conclude,” Card said.

Surviving family members have to formally request the report, and it is often heavily redacted for legal reasons. After months of repeated requests for his daughter’s death report, Telford reached out to Sen. Bennet’s office.

For families like the Telfords, the report can provide some closure. But for the military, the report also provides a wealth of data to track and study, giving a glimpse of the most common demographics of military suicide.

Among service members who died by suicide in 2012, still the most recent annual report to be released, more than 92 percent were male, and more than 93 percent were active duty. Nearly 40 percent were between the ages of 17 to 24; nearly 50 percent were junior enlisted. While just over 57 percent had deployed, 85 percent died in the United States, and more than 65 percent used a firearm to commit suicide. For 40.6 percent, family and relationship issues were psychological stressors; 28.6 previously indicated potential for self-harm; 61 percent accessed health or support services within 90 days before committing suicide; and more than 42 percent already had a behavioral health diagnosis.

Servicewomen tend to have a much lower suicide rate than their male counterparts. In 2012, Brooke was one of 6 servicewomen in the Air Force to take her own life. The rate of suicide also tends to go down with higher rank and age -- as a tech sergeant, Brooke was an E-6. But burnout is common -- among suicides in 2012, more than 22 percent had at least three deployments. Brooke did four.

U.S. Army Pfc. Amy Alexanders.(AP Photo/Stephen B. Morton)

Yet by many more standards besides her manner of death, Brooke’s service was unique. Though more than 280,000 women have deployed to Iraq and Afghanistan, according to Pentagon data, women remain a minority in the military, only comprising some 15 percent of the roughly 1.4 million-strong Armed Forces. Servicewomen face singular challenges in aspiring to a military career that often lead them to get out before serving as long, or earning as high a rank, as Brooke did. While combat exposure tends to be associated with PTSD and other mental health issues, in general, women returning from Iraq and Afghanistan report worse mental and emotional health, according to the Washington Post. One in three military women has been sexually assaulted, contrasted with one in six civilian women. And regardless of gender, those who report assaults are often victimized further.

But the Defense Department’s suicide reporting is often dangerously incomplete, according to the department inspector general. In a recent report, the DOD IG found that of a sample of DoDSER reports, nearly one quarter had at least 50 percent of data fields marked “don’t know/data unavailable” – “a particularly serious suicide prevention problem that presented a substantial and specific danger to public health and safety,” the DoDIG wrote. “Leaders must have reliable information on suicide risk factors to make appropriate decisions related to suicide prevention efforts.”