How the US can address the tragedy of veteran suicide | Charles P. Smith

Reviewer: Intan Andini

Pada 6 Mei 2019,

matahari bersinar terang, langit biru,

awan menggantung ringan.

So on May 6 of 2019,

hari musim semi yang sempurna.

the sun was shining, the sky was blue,

Saya sedang dalam perjalanan pulang,

ketika telepon saya berdering.

clouds were that puffy white.

Yang menelepon adalah letnan saya.

It was a perfect spring day.

Saya berkata, "Hai, John,

I was walking back to my office,

apa kabar?"

dan dia menjawab, "Saya baik, Pak.

and my phone rang.

Tapi saya ada kabar buruk.”

And it was one of my lieutenants.

Dia berkata pejabat eksekutif kami meninggal pekan itu.

I said, "Hey, John.

How are you?"

He said, "Sir, I'm good.

Kami terlibat pembicaraan

But I've got some bad news."

“Apa maksudmu, apa yang kau bicarakan?”

He said our executive officer died that weekend.

Saya bertanya apa yang terjadi.

Dia menjawab, "Pak, dia bunuh diri."

We went back and forth,

"What do you mean, what are you talking about?"

I asked him what happened.

Saya berkeliling ruangan beberapa jam dalam kebingungan

He said, "Sir, he killed himself."

mencoba memahami apa yang baru saja terjadi.

Saya dan si petugas baru berkomunikasi beberapa bulan lalu.

I walked around my office for a couple of hours in a complete fog,

Saya tak menyangka dia punya masalah.

trying to understand what had happened, why.

Saya merasa bersalah karena sebagai pemimpin saya tak menyadarinya.

I had just communicated with him a few months earlier.

And I had no idea that this officer was in trouble.

Saya sedang mempelajari

And I fault myself as a leader for not having known that.

mengapa, apa yang terjadi pada para veteran,

mengapa hal ini bisa terjadi.

Saya membaca laporan dari Departemen Urusan Veteran,

I went on this process of trying to figure out

Departemen Pertahanan,

why, what's happening in the veteran community,

saya membaca penelitian nasional tentang kesehatan mental

why are these things going on.

dan isu yang berhubungan dengan kejadian ini.

I read reports from the Department of Veteran Affairs,

Saya akan berbagi pada Anda informasi yang saya pelajari.

Department of Defense,

I've read national studies on mental health

Departemen Urusan Veteran mempelajari kasus bunuh diri veteran,

and the issues associated with it.

I'm going to share with you some of the things I found out.

dan menjadikannya prioritas.

Berdasarkan laporan mereka dan angka yang saya hitung,

Department of Veteran Affairs has taken the lead on veteran suicide,

antara 2001 sampai 2019,

and it's actually their number one priority.

selama masa Perang Melawan Teror,

Based on the reports they have and the numbers that I've calculated,

saya perkirakan ada 115.000 veteran

between 2001 and 2019,

yang meninggal di tangan sendiri.

during the time of the Global War on Terror,

Saya juga membaca laporan Departemen Pertahanan

my approximation is there's 115,000 veterans

tentang korban perang.

who have died by their own hands.

Laporan ini khusus mencatat

korban perang dari Oktober 2001

I also looked at the Department of Defense report

that lists casualties.

sampai 18 November tahun lalu.

This particular report

lists the casualties from October of 2001

Selama masa itu dan Perang Melawan Teror,

ada 5.440 petugas yang gugur dalam tugas.

specifically to November 18 of last year.

During that time frame and the Global War on Terror,

Jadi kira-kira ada 115.000 petugas bunuh diri,

there have been 5,440 active duty members killed in action.

dan 5.440 petugas yang gugur dalam tugas.

Apa artinya angka-angka itu bagi saya?

So by my numbers, 115,000 approximate suicides,

Artinya, kita punya sekitar 21 veteran yang mengakhiri hidup di tangan sendiri

5,440 killed in action.

untuk tiap orang petugas yang gugur karena musuh di medan perang.

What does that mean to me?

We have approximately 21 veterans ending their lives by their own hand

Angka yang benar-benar mengejutkan.

for every one that is killed by an enemy combatant.

Penelitian nasional

yang membahas kesehatan mental menuliskan

It's a staggering, staggering number.

bahwa jika Anda memiliki riwayat penyakit mental

These national studies

that deal with mental health tell us

yang diturunkan dari keluarga

atau jika Anda mengalami kejadian traumatis ketika kecil

that if you have any type of genetic mental health issue within your family

kemampuan menghadapi gangguan stres pascatrauma

that can be passed on,

atau PTSD (Post-Traumatic Stress Disorder)

or if something has happened to you in your childhood that was traumatic,

akan menurun.

Penelitian itu juga mengungkapkan

your ability to deal with post-traumatic stress disorder, or PTSD,

bahwa jika Anda ingin mendapat hasil tes

significantly decreases.

untuk mengetahui apakah seseorang mengidap PTSD,

They also tell us

Anda perlu melakukan minimal satu jam wawancara

that if you want to have a full evaluation,

dengan psikolog

yang dilatih untuk mendeteksi PTSD

determine if somebody has PTSD,

dalam diri Anda.

you need to have a minimum of one hour interview

Izinkan saya bercerita apa yang terjadi saat Anda bergabung dalam militer.

with a mental health expert

that's trained to detect what PTSD is

Ketika Anda bergabung dalam angkatan bersenjata,

to determine if you suffer from it.

Anda harus melalui serangkaian tes kesehatan,

Now let me talk about what happens when you enter into the military.

Anda akan melalui tes fisik,

Anda akan melalui tes narkoba,

When you join the armed forces,

Anda akan melalui tes kemampuan,

you're going to go through a medical exam,

agar mereka bisa mengetahui kemampuan Anda

you're going to take a physical fitness test,

dan menempatkan Anda dalam gugus tugas yang sesuai.

you're going to take a drug test,

Tapi dapatkah Anda percaya

dengan perkiraan 115.000 kasus bunuh diri selama 20 tahun ini,

you're going to take a vocational test

so they can figure out what you're good at

dan dengan data dari penelitian nasional

and hopefully place you in that type of job category.

But would you believe

tentang cara menentukan mampu tidaknya seseorang

that with approximately 115,000 suicides over the last 20 years,

menghadapi gangguan stres pascatrauma,

kita masih belum memiliki tes kesehatan mental

and the data that we know from the national studies

untuk mereka yang baru memasuki masa tugas.

on how to determine if somebody is going to be able to cope

Hal inilah yang perlu diubah.

with post-traumatic stress disorder,

we still don't have a standardized mental health evaluation

Nomor dua,

ketika Anda selesai masa tugas --

for our recruits entering into the service.

Saat saya menyelesaikan masa tugas pada 2003,

That's something I think that needs to change.

saya harus mengikuti kelas-kelas wajib

selama dua hari,

Number two,

baru saya benar-benar bebas tugas.

when you leave the service --

When I left the service in 2003,

Sekarang, sedikit berbeda.

I had to attend some mandatory classes,

Sekarang, Anda akan ditelepon

jika Anda sedang proses terminal leave atau masa Anda

about two days' worth of classes,

and then I was on my way.

menggunakan akumulasi cuti yang belum terpakai

sebelum Anda sepenuhnya pensiun.

Today, it's a little different.

Today you'll actually get a call

if you're on what we call terminal leave

Saya bicara dengan veteran yang ditelepon.

or paid time off that you're trying to use up

Dia dalam perjalanan pulang,

yang dia pikirkan hanyalah,

before you actually are fully discharged.

"Seberapa cepat telepon ini selesai?"

Rasanya telepon itu berlangsung 10 sampai 15 menit.

I talked to one veteran who got a call.

Tetapi penelitian nasional menyatakan

He was on his way home from work,

itu perlu 1 jam wawancara langsung.

and the only thing he could think of

was, "How quick can I get off this?"

Saya pikir hal inilah yang perlu kita perbaiki.

And I think the call lasted maybe 10 or 15 minutes.

But yet the national studies tell us

Ada hal lain yang Departemen Urusan Veteran

it needs to be an in-person, one-hour interview.

tulis dalam laporan.

I think that's something that we can improve upon.

Mereka bilang anggota yang merawat diri tanpa bantuan medis

There's another thing that the Department of Veteran Affairs

memiliki risiko bunuh diri yang lebih tinggi.

talked about in the reports.

They said that our service members that are self-medicating

Jadi para veteran yang merawat diri dengan alkohol,

atau obat terlarang --

tend to be at a significantly higher risk of suicide.

dan faktanya, Departemen Urusan Veteran menetapkan

penyalahgunaan opioid, OUD,

So those veterans that are self-medicating with alcohol,

sebagai salah satu epidemi.

or drug abuse --

Maka ketika saya bicara dengan seorang marinir

and in fact, the Department of Veteran Affairs has classified

dan mencoba mempelajari masalah ini,

opioid use disorder, OUD,

saya mulai menemukan fakta yang sungguh mengejutkan.

as one of the epidemics.

Saya kenal seorang marinir yang baru kembali dari Iraq

So as I talked to marines from my unit

and tried to learn more about it,

dan dia pergi ke rumah sakit untuk mengobati “sakit punggung”

I started to find out some really, really alarming things.

I had a marine who came back from Iraq

dan dia dapat izin menggunakan opioid.

Dia juga menderita gangguan stres pascatrauma.

and he went to the hospital for a "back pain"

Lambat laun dia ketagihan obat itu

and he was prescribed some opioids.

karena tak hanya menghilangkan sakit punggung,

He also suffered from post-traumatic stress disorder.

opioid juga membantunya menghadapi

hal-hal menyeramkan yang telah dia lihat, alami, dan lakukan

He became addicted to these painkillers,

because not only did it mask the pain in his back,

selama di Timur Tengah.

but it helped him to cope

Lalu dia overdosis.

with some of the horrific things that he had to see, experience and do

over in the Middle East.

Tantangan lain yang kita miliki adalah,

ketika Anda bertugas,

And he eventually overdosed.

Anda berada dalam naungan Departemen Pertahanan.

Jadi semua dokter, semua layanan medis Anda

Another challenge we have

is that when you're on active duty,

berada dalam naungan yang sama.

Ketika Anda selesai masa tugas,

you are under the Department of Defense.

Anda kini dalam naungan Departemen Urusan Veteran.

And so all of your doctors, all your health care

Maka para anggota yang bertugas ini

is in that category.

yang mencari pertolongan untuk masalah kesehatan mental

When you leave the service,

you are now part of the Department of Veteran Affairs.

dan terdiagnosis PTSD atau masalah kesehatan mental lain,

So these active duty members

saat mereka selesai masa tugas,

tidak ada peralihan rekam medis pada dokter

that seek help for their mental health issues

yang ada di Departemen Urusan Veteran

and are diagnosed with PTSD or other mental health issues,

atau mungkin dokter rumah sakit umum

when they leave the service,

karena Undang-Undang Privasi.

there's no transition to a doctor

Namun ada kabar baik tentang isu ini.

Baru-baru ini, terdapat peraturan

that's in the Department of Veteran Affairs

or perhaps out in the civilian world

yang mengatur pembuatan basis data

because of privacy acts.

yang menghubungkan rekam medis dari Departemen Pertahanan

Now there's some good news in this.

Just recently, it was legislated

dan rekam medis dari Departemen Urusan Veteran.

that a database will be built

that will house both Department of Defense health records

Tapi saya ingin melangkah lebih jauh.

Perusahaan saya memiliki 204 marinir dan pelaut yang tangguh.

and Department of Veteran Affairs health records.

Ketika saya berbicara dengan marinir dari unit saya,

kami menyadari bahwa kami kewalahan dengan

But I want to take that thought a step further.

My company was 204 marines and sailors strong.

jumlah anggota kami yang melakukan bunuh diri.

As I looked at and I talked to my marines from my unit,

Saat saya bicara dengan pimpinan senior di batalion,

what we came up with is we are well in excess of a dozen

yang terdiri dari sekitar enam sampai tujuh ribu marinir,

of our members that committed suicide.

mereka memperkirakan ada ribuan marinir yang melakukan bunuh diri.

When I talk to senior leadership in the battalion,

and battalion is about six to seven hundred marines,

Maka mari gunakan basis data yang kita buat

dan membahasnya lebih dalam.

they estimate that we're in the hundreds who have committed suicide.

Bagaimana jika ketika seorang veteran meninggal dunia,

So let's take this database that we're building,

entah karena sebab alami,

and let's go a little bit further with it.

overdosis atau bunuh diri,

What if when a veteran passes away,

kita mampu gunakan data itu dalam Urusan Veteran

yang dapat mengakses catatan Departemen Pertahanan,

whether it's natural causes,

overdose or suicide,

untuk melacak tipe dan unit yang mereka masuki,

we're able to feed that into the Veteran Affairs

grup dan operasi apa yang pernah mereka lakukan,

who is then able to access Department of Defense records,

lalu buat data untuk mengetahui

identify what type of units they were in,

apakah ada unit yang lebih rentan terkena PTSD

what contingencies and operations did they participate in,

agar kita dapat merawat mental mereka

and let's build the data points to try to figure out

sebelum mereka bertugas,

are there units that are more susceptible to develop post-traumatic stress disorder

sebelum mereka tiba di lokasi tugas.

Jika sedang bertugas,

beri mereka akses perawatan mental di lokasi tugas,

so that we can get them the mental health

dan beri mereka konseling dan bantuan

prior to going on deployment,

sebelum mereka pulang dari lokasi.

prior to being in theater.

If they're in theater,

(Tepuk tangan)

get them the mental health while they're in theater,

and get them mental health counseling and help

before they even come home out of theater.

Omong-omong,

jika kita bisa membuat data untuk sistem pencegahan itu,

(Applause)

kita tidak hanya akan menerapkannya di militer,

kita juga bisa menggunakannya untuk kepentingan umum.

And by the way,

if we can build those sets of data points to be able to do that,

Jika kita berpikir bersama

we don't just apply them to the military,

dan bekerja sama,

dan mendiskusikan hal ini secara terbuka

we can also use that for the general population.

dan mencoba mencari solusi

If we put our minds together

untuk epidemi yang menyebar di Amerika,

and our resources together,

mudah-mudahan kita bisa menyelamatkan seseorang.

and we openly talk about this,

and try to find solutions

Begitulah pikiran dan ide saya.

for this epidemic that's going on in America,

Saya harap pembicaraan ini bukanlah akhir dari diskusi kita

tapi justru awal dari perubahan.

hopefully we can save a life.

Saya ucapkan terima kasih untuk waktu Anda hari ini.

Those are my thoughts, my ideas,

(Tepuk tangan)

I hope that this talk is not the end of this discussion

but rather the beginning of it.

And I want to thank you for your time today.

(Applause)