Not since the great military suicide epidemic of the American Civil War have we seen so many of our heroes, our soldiers and veterans, die by suicide. Why? War is violence. There is intent to cause death, or serious injury, or threat to the physical and psychological integrity of others. War stress is unforgiving. Suicide is an all too frequent response. Today, one member of the military dies by suicide every day. This is a new epidemic. This book addresses some tough questions: What do we know about suicides in the military? Are rates high? Or low? Is military suicide the same or different in the United States and Canada? Is military culture relevant? Do we know the causes, patterns, and associations? Is suicide among the armed forces similar to or different from suicide among civilians? Can it be altruistic? Through individual case studies and general/population approaches, we attempt to understand the cost of military service. It is especially through the personal stories of the great Civil War hero General Emory Upton, Admiral of the Navy Mike Boorda, and Hospital Corpsman Chris Purcell that we find answers. We learn there is a relative lack of understanding about military suicides, mainly due to the very complexity of suicide. The nature of suicide is not monolithic--it is multi-determined. Military service, we find, is a risk factor for suicide and suicidal behavior. Military veterans are twice as likely as civilians to die by suicide. Posttraumatic stress disorder (PTSD) and traumatic brain Injury (TBI) are especially noted to be huge risk factors, but so are other physical and psychological injuries. Sadly, the aftershocks of war include not only suicides but also incarceration, motor vehicle accidents, homicides, homicide(s)-suicides, and many more faces of violence. And there are many more, uncounted, wounded and dead. The families of traumatized soldiers and veterans, too, are indirect victims of their traumatic experience and, for some, their suicides; there is secondary traumatization. Yet, as this book shows, we must not forget that despite the unbearable pain of war, soldiers, veterans, and their military families, including children, are typically resilient. They can survive! Without question, our vulnerable heroes and veterans are at risk for suicide. But there is secrecy surrounding this, which may well be the biggest barrier. The government, the Department of Defense, the military, veterans groups, survivors, health providers, and other stakeholders need to develop and support more research, more programs, and more care for suicidal and disabled armed services personnel, veterans, and survivors. This war stress needs to stop.

Blending illustrative narratives from veterans with cutting-edge research, this book provides a model for a needed shift from treatment post-trauma to psychological training pre-trauma to prevent deep depression and resulting suicides. As suicides among members of the U.S. military and veterans continue at a rate higher than in the general population—nearly 20 each day—and their calls for help become louder, with three veterans waiting for treatment outside Veterans Administration hospitals in 2019 committing suicide, authors and former U.S. Marines Kate Hendricks Thomas and Sarah Plummer Taylor present a call for a new approach to help halt the needless deaths. Thomas, now a researcher and assistant professor of public health, and Plummer Taylor, now a social worker and adjunct professor, detail a plan to establish preventative training for mental fitness that will help psychologically "vaccinate" service members against depression and PTSD, the most common precursors to suicidal thoughts. Thomas and Plummer Taylor detail their mental fitness training program to shift from post-trauma treatment to pre-trauma prevention. Each topic addressed is illustrated with stories from veterans. Part of the solution, Thomas and Plummer Taylor explain, is to present prevention as something for all service members and as a positive, strength-building, challenging activity for champions, as opposed to a post-trauma treatment only for "weak and broken" warriors.

Part of the authoritative Oxford Textbooks in Psychiatry series, the new edition of the Oxford Textbook of Suicidology and Suicide Prevention remains a key text in the field of suicidology, fully updated with new chapters devoted to major psychiatric disorders and their relation to suicide.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

In an era when the global community is confronted with challenges posed by violent nonstate organizations--from FARC in Colombia to the Taliban in Afghanistan--our understanding of the nature and emergence of these groups takes on heightened importance. Julie Mazzei's timely study offers a comprehensive analysis of the dynamics that facilitate the organization and mobilization of one of the most virulent types of these organizations, paramilitary groups (PMGs). Mazzei reconstructs in rich historical context the organization of PMGs in Colombia, El Salvador, and Mexico, identifying the variables that together create a triad of factors enabling paramilitary emergence: ambivalent state officials, powerful military personnel, and privileged members of the economic elite. Nations embroiled in domestic conflicts often find themselves stuck between a rock and a hard place when global demands for human rights contradict internal expectations and demands for political stability. Mazzei elucidates the importance of such circumstances in the emergence of PMGs, exploring the roles played by interests and policies at both the domestic and international levels. By offering an explanatory model of paramilitary emergence, Mazzei provides a framework to facilitate more effective policy making aimed at mitigating and undermining the political potency of these dangerous forces.