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A suicide epidemic has soldiers killing themselves in record high numbers. Some months this year saw more American soldiers die by suicide than in combat. Hawaii has sent a vast number of troops to Iraq–more, at times, than any other state. Now, with a flood of soldiers now returning from Iraq, the ramped-up U.S. presence in Afghanistan and some local units preparing for their fourth and fifth deployments, Honolulu Weekly examines the toll that war is taking on our soldiers and their families, and what the agencies designed to serve them are doing about it.

The letter began, “Hey babe, if you get this, I’m no longer around.” It came in a package from Iraq, along with a miniature American flag, stained with blood and tucked into the pages of a book. Jeffrey Lucey, a then-22-year-old lance corporal in the Marine Corps Reserve, said he had found it in the hands of a four-year-old Iraqi boy who was lying dead in the street. He sent it, along with the letter, to his girlfriend Julie back in Massachusetts before he died.

But Lucey was still alive when she received it. It wasn’t until later, nearly 6,000 miles away from Baghdad, that the war finally killed him.

“We still have the video of his return,” said Jeff’s father, Kevin Lucey. “He was smiling, a little bit thinner, but so happy to be back.”

Five years ago–and nearly a year after Jeff’s homecoming–his father found him hanging from the basement rafters of their home in Belchertown, Mass., a garden hose double looped around his neck.

In the years since Jeff’s suicide, concern about the rising number of suicides across all branches of the military continues to grow. In the Army alone, including cases still being investigated, the Pentagon finds that 117 active duty and reserve soldiers killed themselves from January through May. That’s just 11 fewer suicides than the at least 128 confirmed in all of 2008–already a three-decade high.

“Army leadership is very concerned about the increased suicide rate we’ve seen within the Army the last four or five years,” said Col. C.J. Diebold, chief of psychiatry at Tripler Army Medical Center and psychiatry consultant to the surgeon general. “The geographic separation, the inherent dangers of the combat zone and we now have soldiers in their fourth and fifth deployment. If you look just at the history of the 25th [Infantry Division] in the past five years, they’re now getting through their second full deployment and ramping up toward their third. That’s certainly stressful.”

Already there have been months this year in which more soldiers killed themselves than were killed in combat. And as the National Institute of Mental Health and the Army scramble to jump-start a collaborative five-year $50 million study aimed at better understanding and preventing military suicide, local military entities, as well as agencies devoted to caring for veterans, are implementing new programs and promoting outreach in an effort to save the lives of service members across the Islands.

On the homefront

Here in Hawaii, where the military makes up nearly 10 percent of the population–that’s more than any other state–the threat of suicide looms large. An employee at Honolulu’s Department of the Medical Examiner who asked not to be named says that in addition to noticing a significant increase in military suicides on a local level, she suspects that more than half of those who kill themselves on Oahu are military servicemen and servicewomen.

In an e-mail obtained by the Weekly, Tripler Army Medical Center public affairs officer Les Ozawa wrote to Lt. Col. George Wright, an Army spokesman at the Pentagon, that there have been two “recent” Army suicides in Hawaii. Ozawa says an Army directive prevents discussion or confirmation of any specific cases.

And while the Army has set an example for other branches of the military with relative transparency on the issue, the extent to which information is safeguarded, undisclosed or otherwise convoluted–the Department of Veterans Affairs tracks the number of suicides among Hawaii veterans as part of a larger group that includes cases throughout California–creates startling distance from the reality of what’s actually happening.

“There’s no doubt that there’s an agenda there,” said Kevin Lucey. “You don’t want to really have the complete knowledge because if you do, aren’t you going to have to do something about it?”

Losing the battle

The spike in suicide among enlisted soldiers also raises concerns about an already overburdened U.S. Department of Veterans Affairs system. With estimates that as many as one-third of soldiers return from Iraq and Afghanistan with diagnosable post-traumatic stress disorder or PTSD (not to mention the mental health needs of countless veterans of previous conflicts), there simply aren’t enough resources to get every solider the help he or she needs in the time that he or she needs it. Hawaii has its own set of regionally-specific challenges.

“What’s different about our community is that we’re spread out,” said Susan Bass, suicide prevention coordinator at the Honolulu Department of Veterans Affairs. “We cover Guam, we cover American Samoa, all of the neighbor islands, even sometimes the Philippines. Some of these places don’t have the community resources for outreach. Some are in rural places.”

In addition to covering a wide region, the local VA has fewer amenities for its large military population than its counterparts in other areas of the country.

“We don’t have a VA hospital,” said Michael Kestner, a suicide prevention case manager at the VA in Honolulu. “Many times we have to rely on Tripler or other hospitals in the community, so it’s a little more difficult for us to access services. We try to work around those difficulties. The police department has occasionally done health and welfare checks on our veterans.”

Tripler Army Medical Center is home to one of the National Center for PTSD’s seven sites across the country, but many active duty soldiers and veterans have mental health needs that fall outside of the realm of PTSD. Just last year, Tripler paid $800,000 to settle a lawsuit that charged it failed to adequately treat a bi-polar veteran who jumped to his death from the hospital roof after twice pleading for help and expressing suicidal ideations in the Tripler emergency department.

Nationwide Veterans Affairs centers, too, have faced criticism repeatedly in the years since it was revealed that the Army’s flagship medical center, Walter Reed, was deteriorating and failing to meet its patients’ needs. A five-month CBS News investigation in 2007 found that across the 45 states for which records could be obtained, there were 120 veterans who killed themselves per week, which amounts to at least 6,256 suicides in 2005 alone.

On the floor of the U.S. Senate last September, Chair of the Veterans’ Affairs Committee U.S. Sen. Daniel Akaka (D-Hawaii) addressed the rising suicide rate among veterans.

“Suicide among Iraq and Afghanistan-era veterans is at an all-time high,” said Akaka. “The number of veterans found to have service-connected PTSD is not just rising, it is rising several times faster than service-connected disabilities overall…Veterans are committing suicide at a higher rate than their civilian counterparts. A recent RAND study found that nearly three out of four veterans in need of mental health care receive inadequate care or no care at all.”

Warning signs

In the six months leading up to his death, the Luceys knew that Jeff was in desperate need of help. But for months before that, Jeff’s family thought his behavior was just part of the readjustment period they’d been told to accept. For example, Kevin says his son refused to go outside on a trip to the beach with his girlfriend.

“He always loved the ocean, but he said to her he had seen enough sand to last him a lifetime,” said Kevin. “These comments, we knew something was going on, but we thought it was just minor readjustment.”

By the following winter, it became clear that something was seriously wrong. Jeff was drinking more and more, bowing out of family events like the Luceys traditional Christmas dinner and lashing out, calling himself a “murderer.”

“Jeff would start talking and his voice would become very monotone and he would get that thousand-mile gaze, like he wasn’t talking to anyone,” Kevin said. “He told his mother about how he had to throw grenades up on the roof of a building because there were snipers. He spoke about how the rules of engagement had been called off and he saw some elderly people get killed. And then he spoke about shooting two unarmed Iraqi soldiers. Now the Marines did an investigation and said they never found anything to support this, but I believe him. He said he was ordered to shoot them and as he was holding up his gun, it was shaking. He looked into the kid’s eyes and started wondering if this kid was there like he was–maybe he didn’t want to be there either–and whether he was somebody’s father or brother or son. He described the sound of the shooting and that burned its way into Jeff’s heart.”

Jeff was also throwing up every morning, which the Luceys later learned to be an indication of PTSD, and suffered frightening hallucinations.

“While he was in Iraq, he wrote about the camel spiders–these big five-inch spiders that he could hear climbing on the tents,” said Kevin Lucey. “Even as a little boy, Jeff was terrified of spiders and he would call for his mother. So when he got home from Iraq, he could hear the camel spiders in his room and he would look for them with a flashlight. Jeff would also hear voices. He never said what they were saying or if they were even in English. He was tremendously scared to go to sleep.”

Too little, too late

“I don’t know why I am going fucking crazy,” Kevin Lucey remembers his son saying in the last weeks of his life. Jeff had applied for a job with the Massachusetts State Police and was afraid that seeking mental health services would disqualify him from the applicant pool.

It was Memorial Day weekend and Jeff had been drinking heavily the day he finally agreed to go to the VA. Frustrated, he punched a hole in the wall before leaving the house, and when he got to the VA, he didn’t want to stay. A breathalyzer recorded his blood-alcohol level at .328 some four hours after his last drink.

“There was this male nurse there and as it turned out, he was also in the Marine Corps,” remembered Kevin Lucey. “That made a huge difference. Jeff immediately started cooperating. We may have strong feelings about the VA system but there are some very good people who work there. This nurse stayed with Jeff the entire evening.”

A week before his death, Jeff agreed to go to the VA a second time.

“Jeff was going to try to get into a PTSD unit but the VA hospital said he was going to have to be sober for three to six months, which infuriated me,” said Kevin Lucey. “On the way back home, though, he was talking. He hadn’t been drinking the past four nights. He really felt there was hope.”

But days later, Jeff came unglued again. The night after father’s day, he flew into a rage. After two calls for help to the VA, Jeff finally relaxed.

“He calmed down and we talked, watched the Red Sox, and Jeff came over to me and said, ‘Dad, can I sit in your lap?’ And we rocked there for 45 minutes in total silence. I was scratching the back of his neck. He loved steak and we talked about going to a steakhouse, we planned it for the next night.”

But the next day, Jeff killed himself. Kevin Lucey found him hanging above a stack of photographs–most of them of his family, and one of himself wearing his Marines uniform.

“I remember screaming and running over to him and putting my knees underneath him to get him down,” said Kevin Lucey. “That was the last time he would be in my lap.”

Erasing the stigma

Kevin Lucey said it’s now obvious to him that his son was battling severe PTSD, but that he hadn’t known what symptoms to look for. This is part of the reason that military leaders–particularly in the Army–are emphasizing family education as a tenet of suicide prevention.

“In the old days, people only used to go to the doctor because they were sick,” said Diebold. “From a medical model, we’re doing primary prevention, giving people information. When you look at heart disease, that’s telling people to eat right, get blood pressure checked, exercise, things like that. Well it’s the same thing when you’re trying to reduce the risk in people before they get to a point where they get so desperate that they are contemplating hurting themselves.”

And in the Army at least, leaders are making an effort to normalize mental health needs. All enlisted soldiers are required to watch a series of DVDs about suicide prevention and are required to carry an ACE card–a playing-card sized shortlist of instructions on how to intervene when a fellow soldier may be suicidal. Army leaders are also working to give soldiers more ways to seek help–both at home and during deployment.

“Each unit has a chaplain,” said Schofield Barracks Chaplain Maj. Victor Richardson. “When they go to the field, we go. When they eat, we eat. Where they sleep and under the conditions they sleep, we do the same. That connection is invaluable because someone may not want to come to the chapel, but if you’re walking down the street with them, or eating in the same mess hall, doing the same training, they are more apt to come to you and start talking.”

But the suicide rate continues to go up–Richardson says there’s still a strong stigma against talking to a chaplain, despite the assurance of confidentiality–and the stigma against seeking help doesn’t seem to be going away.

“We work in a macho organization,” said Tripler’s Diebold. “For the longest time, unfortunately, the direct message was that if you admit you can’t do something you’re viewed as weak. But we need to continue to send the message that we’re human and we’re in a stressful environment and it may get to the point where you need to ask for help. We want you to get the help you need so that you’re fully functioning, enjoying what you’re doing, enjoying your family, enjoying your life.”

Earlier this year, the Luceys accepted a $350,000 settlement from the Justice Department in a wrongful death lawsuit they brought against the VA. They still live every day with memories of the son they sent to war. They remember a time when Jeff was happy and the light they used to see in his eyes.

“He was your everyday kid,” said Kevin Lucey. “He was a rascal and an imp–he added many white hairs to my head. Everybody still talks about his smile. He just loved life… I guess his mother said it best: The body of our son came back from Iraq but his soul didn’t. It was the shell of Jeff but our little boy wasn’t there anymore.”

Today, Jeff’s mother wears her son’s dog tags. He had worn them until the day he died, when he left them lying on his bed. The Luceys had Jeff buried in his dress blues, that tiny, blood-stained American flag resting on his chest.

24-hour suicide hotline (press 1 for military): 1-800-273-TALK (8255)

How to help

If someone you love has displayed suicidal tendencies or expressed a desire to hurt him or herself, call 911 right away.

• Take it seriously. Suicidal behavior is a cry for help.

• Listen

• Ask: Are you thinking of killing yourself?

• Do not leave him or her alone

• Urge professional help

More resources:

The Mayo Clinic on suicide


National Center for PTSD


The VA is also in the midst of developing a 24-hour suicide computer chat-line.

Countdown with Keith Olbermann–12000 Iraq Veteran Suicide Attempts in 07

Rep. Braley on Joshua Omvig Veterans Suicide Prevention Act

The House debates the Joshua Omvig Veterans Suicide Prevention Act, which directs the Department of Veterans Affairs (VA) to develop and implement a comprehensive program to reduce the incidence of suicide among veterans. The bill is named for an Iraq veteran who took his own life, and recognizes the special needs of veterans suffering from Post Traumatic Stress Disorder and elderly veterans who are at high risk for depression and experience high rates of suicide.