April 6, 2022 - TAPS Statement for the Record

Before the Committee On Armed Services United States Senate Subcommittee On Personnel "Suicide Prevention and Related Behavioral Health Interventions In the Department of Defense"

View the Full Hearing

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The Tragedy Assistance Program for Survivors (TAPS) is the national provider of comfort, care, and resources to all those grieving the death of a military loved one. TAPS was founded in 1994 as a 501(c)(3) nonprofit organization to provide 24/7 care to all military survivors, regardless of a service member’s duty status at the time of death, a survivors’ relationship to the deceased service member, or the circumstances of a service member’s death.

TAPS provides comprehensive support through services and programs that include peer-based emotional support, casework, assistance with education benefits, and community-based grief and trauma resources, all at no cost to military survivors. TAPS offers additional programs including, but not limited to: a 24/7 National Military Survivor Helpline; national, regional, and community programs to facilitate a healthy grief journey for survivors of all ages; and information and resources provided through the TAPS Institute for Hope and Healing. TAPS extends a significant service to military survivors by facilitating meaningful connections to other survivors with shared loss experiences.

In 1994, Bonnie Carroll founded TAPS after the 1992 death of her husband Brigadier
General Tom Carroll, who was killed along with seven other soldiers when their Army National Guard plane crashed in the mountains of Alaska. Since its founding, TAPS has provided care and support to more than 100,000 bereaved military survivors. In 2021 alone, 9,246 newly bereaved military survivors came to TAPS for care. This is an average of 25 new survivors coming to TAPS each and every day. Of the survivors seeking our care in 2021, 27% were grieving the death of a military loved one to suicide.

As the leading nonprofit organization offering military grief support, TAPS builds a community of survivors helping survivors heal. TAPS provides connections to a network of peer-based emotional support and critical casework assistance, empowering survivors to grow with their grief. Engaging with TAPS programs and services has inspired many survivors to care for other more newly bereaved survivors by working and volunteering for TAPS.

Chairwoman Gillibrand, Ranking Member Tillis, and distinguished members of the
Senate Committee on Armed Services, Subcommittee on Personnel, the Tragedy Assistance Program for Survivors (TAPS) is grateful for the opportunity to provide a statement on issues and concerns of importance to the families we serve.

The mission of TAPS is to provide comfort, care, and resources for all those grieving the death of a military loved one regardless of the manner of death, the duty status at the time of death, the survivor's relationship to the deceased, or the survivor's phase in their grief journey. Part of that commitment includes advocating for improvements in programs and services provided by the U.S. federal government, Department of Defense (DOD), Department of Veterans Affairs (VA), Department of Education (DoED), Department of Labor (DOL), and Department of Health and Human Services (HHS), and state and local governments.

TAPS appreciates the opportunities provided by the quarterly VA and DOD Survivors Forum, which serves as a clearinghouse for information on government and private sector programs and policies affecting surviving families. Through its partnership with the VA and DOD Survivors Forum, TAPS shares information on TAPS programs and services that support all those grieving the death of a military loved one.

TAPS President and Founder, Bonnie Carroll serves on the Secretary of Defense Roundtable for Military Service Organizations and the Department of Veterans Affairs Federal Advisory Committee on Veterans’ Families, Caregivers, and Survivors where she chairs the Subcommittee on Survivors. The Committee advises the Secretary of the VA on matters related to Veterans’ families, caregivers, and survivors across all generations, relationships, and veteran statuses. Ms. Carroll also serves as a PREVENTS Ambassador for the VA’s suicide prevention initiative. 

 

Strengthening Military Suicide Prevention and Awareness

Since TAPS was founded in 1994, our nation has lost more than 7,000 (DCAS Reports - Active Duty Deaths by Year and Manner) active duty service members to suicide. Of the more than 100,000 military survivors TAPS now cares for, 19,670 are grieving the death of a loved one to suicide. Each day, TAPS works with seven to eight new suicide loss survivors calling for support. At 27%, suicide is one of the leading causes of death grieved by new survivors seeking TAPS services and support.

It was not that long ago when the topic of suicide was not openly discussed or addressed. There was a time when there were no suicide-specific positions within the DOD or VA, no Veterans Crisis Line, no programs, no task forces, no committees, no social media support, and no collaborative dialogue on this topic. As we know from long-term survivors who finally found a place of connection and support, TAPS was a pioneer in welcoming military suicide loss survivors with compassion and care, turning no family away, and has been instrumental in bringing about historical change needed to address military suicide prevention.

In 2009, TAPS President and Founder, Bonnie Carroll co-chaired the DOD Task Force on the Prevention of Suicide by Members of the Armed Forces. The first field hearing was at the annual TAPS National Military Suicide Survivor Seminar, where Task Force members heard from impacted survivors, professionals in support roles, and military leaders. This work led to the eventual formation of what is now the Defense Suicide Prevention Office (DSPO) and expansion of the National Veterans Crisis Line, among other countess initiatives and programs acknowledging the need to make suicide prevention in the military a top priority. This was one of the first times that collective voices of suicide loss survivors were being acknowledged by military leadership as lending valuable insights to contribute to prevention efforts.

 

Suicide Is Preventable, Not Inevitable

Suicide is a complex, multi-factored event, very rarely caused by a single contributing issue, and prevention efforts require a holistic, public health approach. Messaging must instill hope and be encouraging. In many cases, suicide is preventable, not inevitable. Help is available, it works, and with it, people can stabilize during an emotional crisis and go on to live healthy and fulfilling lives.

The overwhelming majority of people who struggle with thoughts of suicide do not die by suicide, but instead access the resources and learn the skills needed to live full lives. The answer, which cannot be a single approach, must consider long-term prevention strategies and comprehensive crisis responses, including postvention after a suicide. The Department of Veterans Affairs National Strategy for Preventing Veteran Suicide, 2018-2028 report stressed the need for collaboration with partners and communities nationwide to increase suicide awareness and prevention efforts as part of a comprehensive public health approach.

Recent findings and updated data underscore that while suicide does not discriminate, some populations are at higher risk, such as within the military community. This may seem counterintuitive as military members are screened through recruiting, stress tested at basic training, employed, housed, provided medical care, and have social connection with mission focus so they should be a lower risk than the civilian population, yet due to contributing factors such as undiagnosed traumatic brain injury, chronic nerve pain and tinnitus from deployments, sleep deprivation that is pervasive in the military culture, hazing, harassment, or bullying, and commands with toxic leadership, the risk for this population is higher.

There must be continued research to support strategies and develop programs that reach and support these populations. While some groups are at higher risk, we must avoid stereotypes, unsafe messaging, or misinformation of groups by generalization, or by implying that all members of a particular population are suicidal and have PTSD or other mental health issues.

 

Military Culture and Command Climate

Messaging from the highest level of leadership, all through the ranks, must endorse “help seeking” behavior as a sign of courage and strength, as something that makes a person that much more operationally ready, healthier, capable, and fit. How we talk about and treat those who are struggling with mental health issues or thoughts of suicide, or fail to do so, is critical. Actions, as well as language, matters. Those in leadership positions have the responsibility to understand and deliver safe messaging around suicide to help destigmatize issues surrounding mental health and promote help-seeking opportunities.

How mental health and suicide is addressed is essential when considering prevention. Misinformation, myths, stigma, and lack of confidentiality can be just some of the contributing factors that actually perpetuate suicide behaviors or result in suicide deaths. Shaming, harassing, hazing, or bullying someone for mental health concerns or seeking care can exacerbate a crisis for those who are vulnerable. Such negligent, incompetent behavior must not be tolerated under any circumstances.

• MAJ (Ret) Orpah Mervene Polk, Surviving Mother of SPC Nicholas T. Polk
  

  “My name is MAJ (Ret) Orpah Mervene Polk. I’m a critical care RN, and want to tell you about my son, SPC Nicholas T. Polk who died while on active duty March 14, 2021. The investigation, such as it was, concluded that he died by suicide.

  Nicholas was an extremely motivated and happy U.S. Army Cavalry Scout when he graduated from Basic Training and AIT at Fort Benning in April 2019, and was deployed afterwards to Poland with the 1st Infantry Brigade in Europe. It was there that the intimidation and bullying began from NCOs in his unit. He would call me from Poland in tears and didn’t understand why they treated him so badly. He would say, “I know I’m green and the newbie Mom, but I’m doing my best and everything they tell me to do”.

  I felt so helpless being so far away, and couldn’t help except to encourage him. He thought it would get better after they deployed back to Fort Riley, but it didn’t.

  Nick was constantly told by a particular NCO that his goal was to get rid of Nick one way or another. Four of Nick’s fellow soldiers confirmed with me that this NCO often called him names like “Lard-ass Polk”, “Piece of Shit Polk”, and told Nick, “Polk, why don’t you do the Army a favor and kill yourself”. In formation just a week before Nick died, he said “Ignore Polk, he’s just a waste of space”. Nick tried to hide his humiliation. He talked to the chaplain several times about it, but I think the Chaplain didn’t really think it was a problem. I learned this from the text messages I reviewed on Nick’s phone, after receiving his personal belongings back from CID."

  I spoke with Nick the Friday night before he died. He was going out with friends and wanted me to call him the next morning so we could take care of his W2 and taxes. His last words were “I’ll talk to you tomorrow Mom, I love you”. I couldn’t reach him all weekend and his body was found Sunday. They notified me Monday. The medical records I received said that his MD and mental health clinician said they saw no signs of him wanting to hurt himself or anyone else, and if he did take his life, they felt he wasn’t in his right mind.

  His autopsy showed no illegal drugs or alcohol, but his hands and feet were bound together. He had told me and several of his friends that he felt like he was being followed, felt unsafe, and his truck had been vandalized several times in the months prior to his death. He had been very depressed, was having frequent ‘night terrors’, and had been seeing a mental health counselor for some time, but he told me he would never take his own life.

  I don’t know what really happened to my son that night, but I do know that his NCO bullied him relentlessly. My son had a beautiful heart, always tried to help anyone who needed it, wanted to stay in the Army (in a different unit) and serve his country.

  The Army I knew, loved and served in, didn’t treat their soldiers the way my son was treated.  Nick’s CO was great and brought his platoon from Fort Riley, Kansas to Gainesville, Florida to his funeral to honor him. They had a very nice memorial service for Nick at Fort Riley a month later. That doesn’t bring back my only child or make up for his death, which I feel strongly was caused by the gross mistreatment he was subjected to by his NCOs. This should not happen in our Army or to any other family!”

Recommendation: As part of leadership development skills, ongoing training should be mandated around suicide prevention and supporting service members with mental health issues.

Recommendation: Leaders should encourage, support and acknowledge self-help. Those who stigmatize, haze, harass, bully, isolate or unfairly punish service members entrusted in their care must be held accountable.

 

Destigmatize Help-Seeking Behavior

Through years of aiming efforts towards reducing the stigma surrounding suicide, TAPS recognizes that the most alarming concern is the pervasive fear that seeking mental health care will negatively impact career development and advancement opportunities. It can be tremendously powerful for those in leadership positions to share “success stories” of how seeking help did not negatively impact one's career, but made the individual stronger and more successful because of it.

Evidence supports the importance of safe messaging and language in terms of suicide prevention, where antiquated language can cause harm and lead to increased suicide rates. Examples of such terms may include, but not be limited to: “committed suicide” which should be replaced with “died by suicide”; “failed attempt” or “unsuccessful suicide attempt” should be replaced with “suicide attempt” or “attempted suicide”; and “suicide epidemic” should be replaced with “concerning rates of suicide.”

The DOD Task Force Report included a strategic initiative calling for the military to “develop effective postvention programs to support families, service members, and unit leaders after suicide.” The Task Force also stated the following on unit memorials, “The death of a service member from suicide should not stymie the honoring of the decedent’s life and service.” This resulted in an important shift in direction because it began to connect suicide to illness and injury, not bad behavior or selfishness. Commanders, chaplains, and other leaders began to talk about mental health as an illness that needed treatment.

Another key recommendation from the Task Force was to “Keep suicide prevention programs in the leadership lane and hold leaders accountable at all levels for ensuring a positive command climate that promotes the well-being, total fitness, and ‘help seeking’ of their Service Members. A significant focus on developing better tools to assist commanders in suicide prevention must be undertaken.”

TAPS strongly believes the recommendations from the Task Force are as relevant today as ever. Leaders must create a command climate that destigmatizes “help seeking” behavior, and promotes mental health and wellness as critical components of suicide prevention. Many surviving families of suicide tell TAPS that they were afraid to tell anyone about their loved ones’ struggles, with the deceased suffering, sometimes for years, before a crisis propelled them into care– unfortunately, too late for these families.

Recommendation: DOD must work with the Services to destigmatize “help seeking” behavior among service members, break down barriers to treatment, and normalize and improve access to mental health services.

Recommendation: Leadership and all key personnel should have training around safe messaging, guidelines, language, and reporting as pertaining to suicide.

 

Prioritize Mental Health and Wellness

Mental health care is a vital part of wellness and readiness. Survivors consistently share that there is not enough downtime to care for mental health in the military, daily readiness does not incorporate mental wellness, and access to mental health care can be a difficult obstacle. A holistic approach to treating mental health care contributes to overall health and readiness.

Service members may be more likely to seek help for medical or physiological concerns, as with exhaustion, sleep disturbances, injury or pain, before seeking mental health care, and therefore offers opportunities for screenings and to identify certain exposures that could increase risk, as with occupational specialties. Service members may be hesitant about or even prolong seeking care out of fear it could interfere with their work performance or delay military orders and/or deployments. A sense of trust and connection to their medical providers contributes to positive experiences while receiving care during their time in the service.

TAPS survivors relay that the care their service members often received, when marked by uncertainty, confusion, and sudden changes, caused them to lose trust in the process. Talking about thoughts of suicide with an established provider, when they are not necessarily intent or have a plan for suicide, should be seen as positive in that the service member is trusting a professional enough to share some of their deeper struggles.

After serious concerns over recent significant increases in soldier suicides in Alaska, the Army has mandated wellness checks with behavioral health counselors for all soldiers stationed in Alaska. In an epidemiological study conducted by the Army Public Health Center’s Behavioral and Social Health Outcomes Program, the findings identified multiple risk factors to include contributors such as sleep deprivation and chronic pain. Alaska’s Army leadership, led by Major General Brian Eifler, has made suicide prevention a top priority, and has had conversations with subject matter experts including TAPS to gain insight on prevention efforts as well as postvention response for unit stabilization and family care. We applaud these positive efforts to save lives.

Additional variables that might contribute to the psychological well-being of service members needing specialized care include, but are not limited to: military sexual trauma; changes in identity, especially during transition periods as with discharge or retirement from the military; substance use concerns often leading to self-medication of underlying issues; and grief-related concerns, such as losses related to the death of military comrades or battle buddies.

Recommendation: Embed qualified and specially trained mental health providers in units to normalize mental health and ease of access to care, just as with physical health medics and sick bays.

Recommendation: Mental fitness should be held in as high regard as physical fitness, with an emphasis on total wellness, making overall health, nutrition, and especially sleep, all priorities.

Recommendation: Encourage social integration and healthy lifestyles. Examples include making adequate sleep a priority and removing hard alcohol from convenience stores on base, or at minimum, make it less accessible.

Recommendation: Specific exposures as with Military Occupational Specialties (MOS) are critical to evaluate, such as those exposed to environmental toxins while deployed, experiencing hearing loss or tinnitus, suffering from injury or chronic nerve pain, exposed to concussive blast trauma and/or with Traumatic Brain Injury (TBI) and extensive combat exposure.

 

Postvention Is a Critical Component of Suicide Prevention

TAPS has learned from working with suicide loss survivors that postvention is a critical component of any comprehensive suicide prevention strategy. Survivors often tell us their service member who died by suicide was “grieving” a loss of some kind: a friend, a comrade, a job, their identity, or their very sense of meaning and purpose in life. Helping service members grieve losses can reduce their suicide risk. Suicide postvention care and suicide prevention care are equally important for families who have lost a military loved one to suicide.

Now in its 14th annual year, TAPS has hosted the National Military Suicide Survivor Seminar and Good Grief Camp. This is the only event of its kind in the world for military survivors bereaved by suicide. This signature TAPS event has provided tens of thousands of military suicide loss survivors with support and resources to inspire healing. While the program has numerous benefits for our families, stories and testimonials shared have taught TAPS, DOD, and the VA, and many others how to better prevent suicides through postvention as a resource.

The TAPS Suicide Postvention team has developed a research-informed, best-practice based TAPS Postvention Model^TM for survivors that decreases isolation and risk for mental health issues such as suicide, addiction, anxiety, and depression, and therefore increases social connection, peer support, and growth that all promote healing following the suicide death of a service member or veteran. The publication, “TAPS Suicide Postvention Model^TM: A comprehensive framework of healing and growth,” provides more information about TAPS’ approach in caring for survivors bereaved by suicide loss. Reference to the TAPS model and supporting evidence can be found on the Defense Suicide Prevention website as cited in the Postvention Toolkit for a Military Suicide Loss for commanders and leaders.

 

Supporting Suicide Loss Survivors and Military Families

Each survivor brings a unique and devastating story of loss with multiple contributing factors of their loved one’s death. The same is true for suicide loss survivors who often face compounded loss. Not only have they lost their service member or veteran, but they may have also lost their connection to the military community, critical military support services, financial stability, and their sense of identity, purpose, and future.

Before the death of their service member, an active duty family may not have been connected to their local community, depending on how recently the family changed their duty station. A veteran’s family may have already lost ties with the military during the transition from active duty or National Guard and Reserve status to veteran status. As such, compounding factors can contribute to a sense of isolation for suicide loss survivors, placing them at greater risk for mental health issues from the lack of a sense of belonging and the lost connection to support.

The emotional crisis their loved ones were experiencing did not simply disappear with their suicide; but rather, is often transferred and absorbed by those coping with the death. As the following personal testimonial addresses, postvention for survivors is imperative to reduce risk and increase prevention.

• Carolyn Colley, Surviving Sibling of SPC Stephen Colley, Maj. Alan Colley, and Matthew Colley
  

  “Since leaving the military as a Disabled Veteran and graduating from law school, my career has centered around advocating for military and veterans’ issues, working for the VA, and volunteering as a peer mentor for TAPS.

  In 2007, months after returning from Iraq, my brother SPC Stephen Colley, US Army, died by suicide at his home on Fort Hood. Ten years later, my brother Major Alan Colley, U.S. Army, also died by suicide after twenty years of military service. And just last year, the unimaginable happened again when my brother Matthew Colley also died by suicide.

  Beyond the massive loss of our service members and veterans, we must acknowledge the ripple effect of each loss. I know countless siblings, parents, children, and loved ones who themselves now experience suicide ideation and/or major depression due to their suicide loss. Those who experience the loss of a fellow service member also experience feelings of survivor’s guilt. For those who are still here, but suffering - we need to invest in efforts that focus on their health and their survival.

  Having experienced suicide loss three times and having been immersed in suicide prevention as a non-clinician, I have observed suicide within the military community as largely approached from a medical and mental health or clinical, standpoint. With countless organizations that do grassroots outreach and engagement with the military community, we must accept their offers to help, and invest in filling the obvious disconnect between services for our service members, veterans, and military families.

  We MUST do more to go beyond suicide prevention awareness and focus on changing how we think and act around suicide. We should promote positive leadership and uphold standards of care. We must begin implementing more concepts that save lives."

Survivors report that getting helpful information from the DOD about suicide risk factors, including lethal means and addiction issues, creating safety plans, and offering a network of support and resources might have made a difference in saving their loved ones. TAPS believes that encouraging service members to include loved ones of all relationships, whether family members or friends, as part of their support system is also important. Loved ones often notice behaviors of concern and can encourage or escort service members into care.

Recommendation: Proactively offer information and trainings to military families on topics related to mental health, suicide awareness and prevention.

Recommendation: Suicide loss survivors must be offered the highest level of care and services after the death of the service member.

Recommendation: Acknowledge disenfranchised survivors who are often overlooked, such as service members or military comrades who suffer a suicide loss of a battle buddy, and provide them with quality postvention response.

Recommendation: After a suicide within a unit, leadership should promote and provide immediate, quality postvention care with trained responders to help with unit stabilization and identifying those who may be at risk or in need of care.

In addition to providing care for the service member, special consideration must also be given to addressing the mental health needs of military family members and their own possible risk for suicide. Coping with mental health challenges within a military family can add stress for the service member, as well as other members within the family, who may need additional support and care.

DOD recently released its Calendar Year (CY) 2020 Annual Suicide Report (ASR), the third year of reporting military family data. The report included key statistics on military family members who died by suicide:

• Military spouses who died by suicide: 53% male, 47% female, 79% under the age of 40, and 29% were currently serving at the time of their death.
• Military dependents, ranging from 12 to 23 years old, who died by suicide: 76% male, 63% under the age of 18, and 6% were also service members at the time of their death.

Recommendation: Include the mental health needs of military family members among prevention initiatives.

Recommendation: Upon the death of a military family member, provide immediate, comprehensive postvention care.

 

Addressing Lethal Means Safety

TAPS has supported nearly 20,000 bereaved survivors of military or veteran suicide loss. We know from thousands of cases how serious the issue of lethal means safety is to addressing military and veteran suicide, and why awareness campaigns and training are so critical for prevention efforts. Here is one personal testimonial:

• Carla Stumpf Patton, Surviving Spouse of Marine Corps Drill Instructor Sgt. Richard Stumpf
  

  "My husband, Richard Stumpf, an active duty U.S. Marine Drill instructor, died by suicide in 1994 with his service-issued weapon in the workplace. My life and the lives of all those exposed to his death irrevocably changed that day. I was pregnant full-term at the time of my loss and gave birth several days later after being rushed to the hospital at the same time as his funeral.

  As a young military spouse, I did not have the resources or situational awareness to navigate a suicide intervention, let alone a discussion about lethal means safety. However, 26 years later, I have devoted my professional life and career to suicide prevention and caring for survivors of suicide loss. As with most devastating experiences, we usually do not learn the valuable lessons until long after we have had time to reflect upon what might have changed things or made for a different outcome.

  One of the many things I have learned through my experiences in terms of preventing suicide, which research supports, is that lethal means safety, particularly with safe use and safe storage of firearms, is as critically important today as it was when I lost my husband in 1994, given the exponential lethality and high rates of firearm-related suicides in the military and veteran communities."

Many TAPS survivors wish they had been provided proactive counseling on lethal means safety planning before their loved one died. The time for learning about these issues is right now, not in a moment of crisis. Prior education and awareness, during service time as well as in transition periods, make everyone better prepared to respond when faced with a situation requiring a potential intervention. Discussions on lethal means safety can be challenging when firearms are a large part of military identity, but these critical conversations must happen because they have the potential to save lives.

Recommendation: DOD should provide standardized training on the topic of lethal means safety to be shared with service members and their families through support services, social media campaigns, and public service announcements.

Recommendation: DOD should ensure lethal means training is included in the Transition Assistance Program (TAP) curriculum.

Recommendation: DOD should help train civilian providers on lethal means safety to strengthen suicide prevention efforts.

 

Increase Awareness and Education

How we respond after a suicide is critical in preventing future suicide. Using the TAPS Suicide Postvention Model in response to a suicide offers such a lens to this approach.

Over the years, TAPS has developed many powerful partnerships within the Government and Civilian sectors, providing valuable contributions of what we have learned in providing postvention care. This has helped reduce risk and keep survivors safe while encouraging adaptive grieving after suicide loss.

Based on the Model and its approach, some of these collaborations include but are not limited to, the DOD’s Suicide Postvention Tool Kit, the “After a Suicide” eCourse, currently offered on millifelearning.com through Military OneSource, and several proprietary trainings provided to military installations who have requested our postvention support. Additionally, TAPS has provided individual consultation and training to both military leadership and government contractors for emergency postvention response for unit and/or workplace stabilization after a suicide.

Recommendation: DOD should continue collaboration with TAPS to partner on Suicide Postvention Resources and trainings for service providers, clinicians, chaplains, and leaders as part of mental health and suicide prevention efforts.

 

Conclusion

The Tragedy Assistance Program for Survivors thanks the leadership of the Senate Armed Services Subcommittee on Personnel and its distinguished members for holding this important hearing to discuss suicide prevention programs in the military community. TAPS thanks you for the opportunity to testify, on behalf of thousands of surviving family members grieving the death of their military loved one to suicide. It is our honor to share insights and actionable recommendations that will help save lives.

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If you have any further questions, please email policy@taps.org or call 800-959-8277 (TAPS).