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

譯者: Pui-Ching Siu 審譯者: Helen Chang

So on May 6 of 2019,

在 2019 年的 5 月 6 日，

the sun was shining, the sky was blue,

陽光普照，天空蔚藍，

clouds were that puffy white.

雲朵雪白蓬鬆。

It was a perfect spring day.

是個完美的春日。

I was walking back to my office,

我正在走回辦公室，

and my phone rang.

此時手機響了。

And it was one of my lieutenants.

是我一個中尉打來的。

I said, "Hey, John.

我說：「嘿，約翰。

How are you?"

你最近還好嗎？」

He said, "Sir, I'm good.

他說：「長官，我很好。

But I've got some bad news."

但是我有一些壞消息。」

He said our executive officer died that weekend.

他說我們的執行官週末去世了。

We went back and forth,

我們來回對話，

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

「這是什麼意思，你在說什麼？」

I asked him what happened.

我問他發生了什麼。

He said, "Sir, he killed himself."

他說：「長官，他自殺了。」

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

我迷茫地在辦公室 來回踱步了幾個小時，

trying to understand what had happened, why.

嘗試理解發生了什麼，和為什麼。

I had just communicated with him a few months earlier.

幾個月前我剛和他交流過。

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

我完全沒想到 當時這位軍官正深陷麻煩。

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

作為長官，不知道那件事是我的過失。

I went on this process of trying to figure out

我踏上了這個歷程，

嘗試找出退伍軍人團體怎麼了，

why, what's happening in the veteran community,

why are these things going on.

為什麼會發生這些事情。

I read reports from the Department of Veteran Affairs,

我閱讀了來自退伍軍人事務部 和國防部的報告，

Department of Defense,

I've read national studies on mental health

我閱讀了心理健康 和相關問題的國家研究。

and the issues associated with it.

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

我會和你們分享一些我發現的事情。

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

退伍軍人事務部帶頭調查 退伍軍人自殺事件，

and it's actually their number one priority.

並且是首要事務。

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

根據他們的報告和我的計算結果，

在 2001 和 2019 之間，

between 2001 and 2019,

during the time of the Global War on Terror,

在全球反恐戰爭期間，

my approximation is there's 115,000 veterans

我的估計是大約有 115,000 名退伍軍人

who have died by their own hands.

自殺了。

I also looked at the Department of Defense report

我也看過國防部的傷亡報告，

that lists casualties.

This particular report

這份報告列出了從 2001 年 10 月

lists the casualties from October of 2001

specifically to November 18 of last year.

到去年 11 月 18 日的傷亡人數。

During that time frame and the Global War on Terror,

在那段時間和全球反恐戰爭期間，

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

有 5,440 名現役軍人 在戰鬥中陣亡。

So by my numbers, 115,000 approximate suicides,

所以，根據我的數字， 大約有 115,000 人死於自殺，

5,440 killed in action.

5,440 人戰鬥中陣亡。

What does that mean to me?

那代表著什麼呢？

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

每當一位軍人死於敵軍手中，

for every one that is killed by an enemy combatant.

就有 21 位退伍軍人 結束自己的生命。

It's a staggering, staggering number.

這是怵目驚心的數字。

These national studies

這些關於心理健康的國家研究

that deal with mental health tell us

告訴我們，

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

如果你家中有可被基因遺傳的

心理健康問題，

that can be passed on,

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

或者你童年時發生過創傷性事件，

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

你處理創傷後遺症 或稱 PTSD 的能力

significantly decreases.

明顯下降。

They also tell us

它同時告訴我們，

that if you want to have a full evaluation,

如果你想要全面評估

determine if somebody has PTSD,

某人是否患有 PTSD 的話，

you need to have a minimum of one hour interview

需要和心理健康專家 進行至少一個小時的面談，

with a mental health expert

that's trained to detect what PTSD is

他們受過檢測 PTSD 的訓練，

to determine if you suffer from it.

可以判斷你是否患有 PTSD。

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

現在讓我講述 進入軍隊後接下來會怎樣。

When you join the armed forces,

在你加入武裝部隊之後，

you're going to go through a medical exam,

需要通過健康測試，

you're going to take a physical fitness test,

需要通過體能測試，

you're going to take a drug test,

需要通過藥物測試，

you're going to take a vocational test

還需要通過性向測驗，

讓他們知道你的特長，

so they can figure out what you're good at

派你去合適的工作崗位。

and hopefully place you in that type of job category.

But would you believe

但你是否相信

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

過去二十年大約 115,000 宗自殺，

and the data that we know from the national studies

加上國家研究的數據，

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

關於如何判斷人們 是否有應付創傷後遺症的能力，

with post-traumatic stress disorder,

我們依然沒有標準的心理健康測試

we still don't have a standardized mental health evaluation

for our recruits entering into the service.

給予進入軍隊的新兵。

That's something I think that needs to change.

這是我覺得需要改變的事情。

Number two,

第二，

when you leave the service --

當你退役的時候——

When I left the service in 2003,

我在 2003 年退役，

I had to attend some mandatory classes,

需要參加一些強制性的課程，

about two days' worth of classes,

那是大概兩天的課程，

and then I was on my way.

然後上路。

Today, it's a little different.

現在有點不一樣。

Today you'll actually get a call

你會接到一個電話，

if you're on what we call terminal leave

那是如果你在完全退伍之前 使用末次假期或者帶薪休假的話。

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

before you actually are fully discharged.

I talked to one veteran who got a call.

我跟一名接到電話的退伍軍人談過。

He was on his way home from work,

當時他正在下班回家的路上，

and the only thing he could think of

他腦中只想 「我能多快掛斷電話？」

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

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

我想那通電話持續了 10 到 15 分鐘。

But yet the national studies tell us

但是，國家研究告訴我們，

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

必須是一小時的面談。

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

我想這是我們可以改進的地方。

There's another thing that the Department of Veteran Affairs

退伍軍人事務部 在報告裡提到另一件事。

talked about in the reports.

They said that our service members that are self-medicating

它說選擇自我治療的軍人

tend to be at a significantly higher risk of suicide.

有明顯更高的自殺風險。

So those veterans that are self-medicating with alcohol,

也就是那些使用酒精或濫用藥物 來進行自我治療的退伍軍人——

or drug abuse --

and in fact, the Department of Veteran Affairs has classified

事實上，退伍軍人事務部 把鴉片類使用障礙（OUD）

opioid use disorder, OUD,

as one of the epidemics.

定義為一種氾濫疾病。

So as I talked to marines from my unit

當我和部隊中的海軍談話，

and tried to learn more about it,

並嘗試了解更多的時候，

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

我發現了一些令人震驚的事情。

I had a marine who came back from Iraq

有個從伊拉克回來的海軍陸戰隊員

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

因為背痛去醫院治療，

and he was prescribed some opioids.

被開了些鴉片類藥物的處方。

He also suffered from post-traumatic stress disorder.

他同時患有創傷性後遺症。

He became addicted to these painkillers,

後來他對這些止痛藥上癮，

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

因為它們不止掩蓋了背部的疼痛，

but it helped him to cope

同時也幫他應付

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

他在中東地區看到、體驗到 和做過的非常糟糕的事情。

over in the Middle East.

And he eventually overdosed.

最終他用藥過量了。

Another challenge we have

我們另一個挑戰是，

is that when you're on active duty,

現役軍人

you are under the Department of Defense.

隸屬於國防部。

And so all of your doctors, all your health care

所以，你全部的醫生和醫療設施 都屬於那個部門。

is in that category.

When you leave the service,

當你離開軍隊之後，

you are now part of the Department of Veteran Affairs.

你屬於退伍軍人事務部。

So these active duty members

因此，一些現役軍人 為心理健康問題尋找幫助，

that seek help for their mental health issues

and are diagnosed with PTSD or other mental health issues,

被診斷患有 PTSD 或其他心理健康疾病；

when they leave the service,

一旦他們離開軍隊，

there's no transition to a doctor

沒有辦法轉移給另一位醫生，

that's in the Department of Veteran Affairs

無論是退伍軍人事務部

or perhaps out in the civilian world

還是民間的醫生，

because of privacy acts.

這是因為保護隱私法令。

Now there's some good news in this.

現在有一些好消息。

Just recently, it was legislated

最近制定了一條法例，

that a database will be built

將會新建一個數據庫，

that will house both Department of Defense health records

以同時保存國防部的健康記錄

and Department of Veteran Affairs health records.

和退伍軍人事務部的健康記錄。

But I want to take that thought a step further.

但是我想再更進一步。

My company was 204 marines and sailors strong.

當時我帶領多達 204 名海軍陸戰隊和水手。

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

在和我單位的海軍陸戰隊 進行了解和交流之後，

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

發現當中超過 12 個成員死於自殺。

of our members that committed suicide.

When I talk to senior leadership in the battalion,

當我跟軍營中的高級領導談話後，

and battalion is about six to seven hundred marines,

軍營裡有六七百名海軍，

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

他們估計數百名海軍死於自殺。

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

所以，使用我們建立的數據庫，

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

我們可以再更進一步。

What if when a veteran passes away,

如果一名退伍軍人去世，

whether it's natural causes,

無論是因為自然原因，

overdose or suicide,

用藥過量還是自殺，

we're able to feed that into the Veteran Affairs

我們能把資料傳給退伍軍人事務部，

who is then able to access Department of Defense records,

然後他們可以存取國防部記錄，

identify what type of units they were in,

識別一下他屬於哪一個部隊，

what contingencies and operations did they participate in,

參與了哪些偶發事件和軍事行動，

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

然後我們可以根據這些資料，

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

判斷是否某些部隊 更容易患上創傷性後遺症，

so that we can get them the mental health

這樣的話我們可以 預先治理他們的心理健康，

prior to going on deployment,

在部署之前，

prior to being in theater.

在進入戰區之前。

If they're in theater,

如果他們正在戰區，

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

趁他們在戰區時治理他們的心理健康，

and get them mental health counseling and help

在他們離開戰區回家之前，

before they even come home out of theater.

給他們心理健康輔導和幫助。

(Applause)

（掌聲）

And by the way,

順帶一提，

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

如果我們能成功建立 這些數據點的話，

we don't just apply them to the military,

不單適用於軍隊，

we can also use that for the general population.

還可以用於普羅大眾。

If we put our minds together

如果我們同心協力，

and our resources together,

共用資源，

and we openly talk about this,

開放地討論，

and try to find solutions

尋找辦法，

for this epidemic that's going on in America,

解決這場美國的流行疾病，

hopefully we can save a life.

希望我們可以拯救生命。

Those are my thoughts, my ideas,

這些是我的想法、主意。

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

我希望這場演講不是最後的討論，

but rather the beginning of it.

而是討論的開始。

And I want to thank you for your time today.

最後，謝謝你們聆聽。

(Applause)

（掌聲）