The flag is flying at half mast until noon. The cookout plans are being finalized. A parade may be starting down Main Street. Now it is time to visit the graves of those who have fallen. This is how we remember the men and women who died in all wars. It’s Memorial Day.

And while many of us have lost loved ones in the service of our country, there is another war taking our soldiers lives as well. It’s war against hopelessness and depression. The VA reports that from 1999-2010, approximately 22 veterans die by suicide a day. That is one veteran every 65 minutes.  And the U.S. military’s most recent report showed the highest number of suicides among active-duty personnel in the past 3 years.

In 2013,  the AP reported that the 9th U.S. Circuit Court of Appeals said it took an average of 4 years to fully provide the mental health benefits owed veterans. It also noted that is took weeks for a suicidal veterans to get a first appointment. Obviously, suicidal people can’t wait weeks to be seen for help. Additionally, the report mentioned the flood of post traumatic stress disorder that were handled with “unchecked incompetence.”

So why are we seeing this rise in suicide?

1) Suicide is still a stigma in the military where you are not supposed to be weak. The message is suck it up and do your job. We have to help the military de-stigmatize mental health problems.

2) A report by the Pentagon on suicide noted that half the troops who killed themselves in 2011 had a failed intimate relationship and about a quarter experienced substance abuse. The military offers counseling. Encourage a veteran or active duty person to take advantage of it.

3) During war, recruitment changes. You tend to get those who really want to fight or those who are desperate for a job. The two groups are very different with the latter being more at risk. Better screening needs to happen. With constant war, recruitment standards are lowered because you need more people, thus, you get a more at risk population. A study (JAMA Psychiatry) showed that almost 1 in 5 soldiers had a mental illness like depression, panic or ADHD before they joined the military. The question is how did these recruits get past the screening?

4) Another JAMA study found those with multiple concussions were more likely to report suicidal thoughts. Are we identifying those with TBI and neurological conditions?  Untreated Traumatic Brain Injury (TBI) and PTSD are risk factors.

5) The strain of war takes a toll, especially when there are extended tours.

6) Rapid deployment and exposure to combat act like a catalyst to worsen existing problems.

7) Delay in services and treament. The federal government does not have a handle on how to deliver prompt and efficient services. When is this problem going to get fixed?

8) Officers are busy and do not always pay attention to their soldiers, especially first-termers. Thus, the signs of suicide can go unnoticed.

The military has initiated suicide prevention programs. Soldiers are taught to “Ask, Care and Escort” anyone who talks about suicide. The idea is to get those at risk to a provider and not leave them alone. There is also a prevention lifeline, 1-800-273-TALK.

We have to do better when it comes to the care of our soldiers. They risk their lives for us and defend our freedom. We need to be there to help when they need us. We don’t need them dying at their own hand.