Article:Vets' growing suicide rate worries officials:/c/a/2008/05/11/MNE810FAIK.DTL

John Koopman, Chronicle Staff Writer

Sunday, May 11, 2008

(05-11) 19:26 PDT -- Tim Chapman hit bottom on a trip to Reno.

He had been a soldier and served in the Middle East. But after his discharge for mental health problems, he returned to his home in Manteca, and started a rapid descent. He joined a gang, sold and used drugs. His wife left him.

He wanted to commit suicide. And almost did.

The number of veterans who commit suicide is growing, and it is causing major concern among veterans groups and lawmakers. A recent report by CBS News, now supported by the U.S. Department of Veterans Affairs, indicates that an average of 18 veterans commit suicide every day nationwide.

In California in 2006, 666 veterans committed suicide - 21 percent of the 3,198 suicides committed that year, according to the California Department of Public Health. Yet that year, the 2.1 million veterans in the state represented only 6 percent of the state's 37.1 million residents.

The suicide figures among veterans have caught congressional attention. Two senators have demanded the resignation of Ira Katz, the VA official who wrote "Shh" at the top of the e-mail dealing with suicide attempts and disputed the statistics in public testimony while confirming them in internal documents. A House committee has scheduled a hearing on veterans' suicides this week.

Kerri Childress, a VA spokeswoman, said the department has more than 17,000 mental health workers and is hiring 3,700 more, making the VA the largest mental health provider in the nation. The VA has also created a veteran suicide hot line, which is available 24 hours a day, seven days a week, and the agency has suicide prevention coordinators at each of its medical centers.

The VA has not disclosed what proportion of suicidal veterans served in Iraq and Afghanistan. But testimony in a lawsuit - brought by veterans groups seeking an order to force the VA to promptly screen and treat those at risk of suicide and set timetables for handling claims for medical benefits - indicated there was evidence that returning troops are taking their own lives in greater numbers. Witnesses and plaintiffs said there has been a steady increase in the veterans' suicide rate since 2001, and a comparatively high rate among veterans ages 20 to 24. The suit was heard by federal District Court Judge Samuel Conti, who has yet to make a ruling.

During the trial, witnesses testified the suicide rate for those veterans was anywhere from two to 7.5 times the rate among the general population.

The causes for this increase in veterans' suicide rates aren't well understood, but mental-health professionals say the biggest problem is post-traumatic stress disorder. The ailment, better-known as PTSD, is thought to afflict up to 30 percent of the troops who have served in Iraq and Afghanistan.

Dr. Frank Schoenfeld, assistant chief of mental health at the San Francisco VA Medical Center, said suicidal impulses and PTSD are two distinct afflictions, but that the stress and trauma of war, or serving during war-time, can exacerbate suicidal impulses.

"We've seen this throughout military history, whether Vietnam or the first Gulf War and earlier," he said. "There are increased mental-health problems and a corresponding increase in suicide rates. That this is happening with veterans returning from Iraq is not surprising."

Schoenfeld said the issue might affect younger veterans more, because they are less likely to seek treatment and they don't have strong family ties, as do older veterans. They might be more likely to seek solace in alcohol or drugs, which only make matters worse.

Dr. Mel Blaustein, an expert on suicide and a former army therapist, said some veterans can feel isolated and helpless. If those feelings spiral out of control, the individual feels intense emotional pain, and might believe the only way to relieve it is to commit suicide.

For troops in Iraq and Afghanistan, the conditions are ripe for mental health problems.

All service in the war zones is not the same. Many live comfortably on bases with all sorts of amenities, including base exchanges as big as department stores and access to Burger King. Others live in tents or old buildings with no running water, and get ambushed or shot by snipers while on patrol in dirty, filthy neighborhoods.

But they all share one thing: the ever-present possibility of instant death. Anyone in a convoy on a roadway might be blown up by a roadside bomb, what the military calls "IEDs" or improvised explosive devices. Even on the most secure base, insurgents lob mortars and rockets, and people die in their sleep, or walking to the post office.

Romeo Horvath returned from Iraq with a bad case of PTSD, and while he is not suicidal, he said, that's not uncommon even in Iraq.

A military police officer, Horvath was on watch in a guard tower one night and heard a gunshot from within the compound. Over the radio, someone announced that a Marine had just shot himself.

"A lot of people get this feeling of helplessness," he said. "Some guy has a girlfriend, and she's cheating on him. Can't call home, can't go try to work things out. You just sit there and think about it over and over again. You can go crazy."

Janie Patterson, the suicide prevention coordinator for the VA Medical Center in Palo Alto, said much of her job involves training VA personnel how to identify and offer help to veterans who might be thinking of killing themselves. The trick, she said, is finding those veterans and convincing them that it's all right to have those problems and it's all right to seek help.

"Everyone thinks a mental problem means you're nuts," she said, "instead of, you just need help. It's like drinking or gambling or any disability. There are avenues to help you function."

Chapman, who is 24, started suffering from depression after he was sent to the Middle East. He was having trouble at home, and his grandfather was dying. He said he just needed to go home to straighten things out, then he would have returned to his unit.

But the depression hit hard, and the army discharged him for mental-health reasons. Disillusioned, he somehow figured a trip to Reno would help. Chapman found himself facing the edge of a steep cliff, revving the engine and contemplating whether to kill himself.

"I was sitting there, crying so hard, I felt like my eyeballs were melting," Chapman said.

As he sat and pondered the end of his life, Chapman said, a ball of light appeared to him and slowly settled over his head. It might have been the drugs he'd been taking, he realizes. Or it might have been God speaking to him. In either case, he woke from his stupor and looked up. Just ahead was a blue highway sign that said, "Hospital."

Chapman lived through his ordeal. He is now in recovery at San Francisco's Swords to Ploughshares and living in an apartment on Treasure Island.

Chapman likes the place a lot. He smiles, and he's put on some weight. He lives with other veterans, and the people who run the place were in the military, too. They understand, he said.

"It's a little easier to talk to these guys," he said. "I can work on my issues."

E-mail John Koopman at jkoopman@sfchronicle. ... 10FAIK.DTL