Mental Illness, The Military and the Church's Ministry
Note: the typical civilian practice is to use all lowercase letters in the word “soldier.” However, in military contexts and writings, the Army now requires the use of “Soldier” instead as a sign of respect. The author uses this capitalized version throughout the article.
 According to the ELCA Social Message on The Body of Christ and Mental Illness, veterans are mentioned as a group in particular need of care and attention. I find that to be a positive step in dealing with the 12 plus years of war in Iraq and Afghanistan. But even as it is lifted up as a major concern, it gets dropped again. Certainly the premise of advocating for full funding for veterans benefits is important, but I believe ethically the church can do more. Lutherans have a long history of social service in America.  Numerous hospitals, schools, food pantries and many other facilities and programs continue that tradition today. Many of these facilities and programs deal with mental health concerns that include counseling. The question thus becomes, in an era of shrinking social service budgets in all areas of the public and private realms, what can we do to help our military deal with mental illness while not turning our backs on others in need.
 The study mentions that clergy are often the first stop for a person suffering from mental illness. That is usually correct and especially true in the military. Here at Ft Irwin in California, I am a key liaison between my unit, the Regiment and the inpatient care facility with which we have developed a special relationship. It includes an aftercare program for all who complete the original program of treatment. I and other chaplains helped develop and nurture this relationship for continued care of our soldiers. We escort sixteen soldiers to the facility 2-3 times a month for 2-3 hours of follow-up care. This leads to the logical next step, namely, that Lutherans often can be such liaisons because mental health is not a problematic subject in the denomination. The church understands that God’s healing includes both fervent prayer and the gifts of the medical community. This understanding highlights the continued need for more military chaplains, especially in the Army and Marines, since these two branches and their families have born the largest civilian and military burden during these prolonged wars.
Domestic Violence and Suicide
 The high rates of domestic violence and suicide have significant ties to mental illness. While we do not excuse the behavior of military men and women towards their families, or to themselves, it does highlight the depth of the situation and the resulting ripples of pain from each rock thrown. Often the assumption is made that the suicide rate is due to the long period of deployments, and sometimes it is assumed that lower entry standards increase the numbers of suicides and other manifestations of mental and emotional problems. Yet the statistics do not support those assumptions as a whole. Certainly the number of deployments, severity of the combat experience and the rapid surge of new recruits play a part in the larger story. Surprisingly the statistics point out that between a third and slightly less than half of all Army suicides in recent years occurred with soldiers that never deployed. Likewise of those soldiers who did deploy, between 75% and 86% did not see direct combat. Roughly half of these soldiers had been diagnosed with a mental health illness, and over 60% had received some mental health treatment from an on-post facility. A third of the soldiers were seen by an on-post mental health facility within 30 days of their death. There were a wide variety of factors contributing to their decision to commit suicide. But outside of the presence of mental illness, only one factor correlated with over half of the suicides. The ending of intimate relationships presented a common theme that seems to fit with general perceptions. Money, job issues and other commonly accepted reasons for suicide often were secondary or not present. Thus common assumptions and simple solutions fail to adequately address this complex matter.
 Neither does the assumption of deployments being the cause of the Army's surge in mental health illnesses address the larger issue of the high rate of suicide for veterans of all wars. The media is enamored with yearly suicide rates for active duty, reserve and National Guard units. However, the Department of Veterans’ Affairs recently released a report showing that a veteran kills himself or herself every 65 minutes on average, so that 22 deaths a day take place on average.
 Rather than being a new reality, suicide rates among veterans continue to be tragic occurrences. We see it more clearly because we have been at war for 12 years. Part of the challenge facing us as Christians is maintaining focus in order that once we re-deploy the majority of troops from Afghanistan that we do not re-deploy our focus as well.
[5} While maintaining our focus on veterans and mental illness, we must remember their families as well. Military spouses bear every bit as much of a burden as any soldiers or Marines, and 12 years of conflict weakens them and their children in ways that we do not always understand. But they are very real. Parents and siblings of single veterans also suffer greatly. Too many times, I have looked into the eyes of these family members and seen the entire scope of emotions. For they deal not only with the loss of their loved ones and the loss of dreams, but also with the noble efforts of loved ones serving their country and all of their pride going horribly wrong at their own hands. Our ministry to veteran families is twofold, care for those dealing with mental illness including suicide and strengthening families in an attempt to make a strong foundation for all veterans.
The Call to Serve
 Fighting the war on veteran suicide rates for both current and retired veterans calls for the church to be creative and sometimes to go beyond what it may find to be comfortable and safe. Opportunities for rostered leaders and members of congregations abound for those willing to step out of the boat. For instance, I find that increasing the knowledge base for future chaplains and pastors while still in seminary is a big need. It is mentioned in the ELCA social message, but to better equip both groups, it would be beneficial for both groups to encounter the subject of mental illness and the military in seminary. We do Clinical Pastoral Education (CPE), but given the large number of veterans who need care, pastors must be able to speak in their language or they turn away. I can get people to talk to me that refuse to talk to anyone else, including their hometown pastor, just because I have been in Iraq. The church cannot send all its pastors and other rostered leaders to Bagdad or Kabul, but the church can broaden their knowledge base by including experiences with chaplains in seminary and continuing education events at synod assemblies and synod pastor events. Involving the local VA chaplains or even a deployed chaplain to help build a common language would aid all first line responders. In addition pastoral care classes could add discussions about veteran issues including Post-Traumatic Stress Disorder (PTSD) and suicide.
 Synods and congregations could host a variety of events to aid in both awareness and in direct support for veterans. Hosting workshops on veterans’ concerns, suicide prevention classes and other informative events could help empower people to feel comfortable talking about their challenges, while also enabling them to act. Likewise having veterans share their stories on Veterans Day or Memorial Day, partnering with veterans groups and linking up with a military chaplain to co-develop programs and other efforts to assist veterans in your community would be beneficial. Knowing that people will be able to stay the course and not shrink away from their stories enables better communication and the beginning of hope. As Lutherans, we believe in incarnational ministry, and being among veterans on a regular basis is the only way to build the relationships needed for strong support networks. Otherwise the suffering vet may continue to suffer “because no one truly understands.”
 Another way that congregations could help both retired veterans and currently serving military service members revolves around the other variable connected to the high suicide rate. This is the failure of service member relationships. The military runs the highly successful Strong Bonds program for both single and married service members. Unfortunately, however, even before the drastic spending cuts, the program could not reach everyone. Its success in saving marriages points to a vital ministry congregations could provide, which is relationship mentoring and other forms of support. Small group ministry, relationship mentors, retreats, counseling and many other events could provide opportunities to build trust between the Church and military members while enhancing a vital support for the military members’ mental health and their families. Often the difference between a veteran with something to live for and one that believes they do not depends on whether they have someone to go home to during their service and after they leave the military. The ELCA potentially can influence this outcome if individual churches accept the call to serve those who serve them.
 Finally the service members’ families and friends need support as well. In response to the rough draft of the ELCA Social Message on The Body of Christ and Mental Illness, I suggested that the church develop a framework for dealing with the question of how and when to say no to a family member or friend who suffers from mental illness. The study acknowledged the burden, but doesn’t offer any grace in admitting that sometimes family and friends are not able to take care of their loved ones any more, not because they don’t love them but because they are not equipped to do so. In my mind, the church would not hold family members responsible if they took their loved ones with heart problems to a cardiologist, but their loved ones failed to comply with treatment. The church would, hopefully, grant them release because even though love bears all things it does not control all things nor can it force anything no matter how painful the alternatives may be. In ASIST Training, (Applied Suicide Intervention Skills Training – LivingWorks, Calgary, Canada), one of the programs the Army uses to combat the surge in suicides, we talk about making sure that we are on the bank securely before we try to get a person out of the river of suicide. The same is true here. It does no good if we jump into the river and both drown. As a church built on grace and faith alone, we share grace and faith by being able and willing to talk to service member families in helpful expressions of support. These families bear the burdens of war every bit as much as their loved ones do. Thus the church has an opportunity to explain and live out grace for them as they try to deal with the mental and emotional challenges of both themselves and their service members. The question of what to do if their loved ones refuse help and continue their path towards self-destruction is one that people in all walks of life face, but seems to be on the rise in the military. What would it be like if the church helped families deal with these dilemmas, and when possible, deal with the sometimes necessary step back, much like an enabler has to stop enabling? Likewise if families break apart while the church is supporting them, would the church be able to help restore them if service members developed a change of heart and got off the path of self-destruction? Taking the remnant and rebuilding as well as second chances flow throughout the Bible, and are desperately needed in the military community.
 In summary, the military community faces many in the world of mental and emotional illness. The most talked about issues, PTSD and suicide, reverberate through all the military branches. Families continue to be under siege, and their crumbling often plays a large role in being the final straw before current service members and veterans attempt suicide. Yet the Church has many opportunities to be a part of the solution, and many times the cost is time and energy, compassion and patience instead of always being exclusively a budget issue. Will we as the church live out our call to serve as agents of growth and grace-filled re-birth, or will we walk on the other side leaving the wounded in the dust?
Chaplain Joe Schrock, an active duty chaplain of the Southern Ohio Synod, is currently serving 2/11 Armored Cavalry Regiment, Ft Irwin, CA, but will report to 442 Signal Battalion, Ft Gordon, Augusta, GA in June. He is the senior pastor of the Ft Irwin Traditional/Liturgical Protestant Service.
 2012 ELCA Social Message on Mental Illness, line 190, page 5.
 The Rev. H. George Anderson. Alms and Advocacy: Lutheran Ministry with the Poor, Journal of Lutheran Ethics, Vol. 5, Issue 5. May 2005.
 DOD Suicide Event Report Calendar Year 2011.pgs. 145-6.
 Department of Veterans’ Affairs. Military Suicides: One U.S. Veteran Dies Every 65 Minutes, Huffington Post, FEB 1, 2013. http://www.huffingtonpost.com/2013/02/01/military-suicides-us-veterans_n_2602602.html
© May/June 2013
Journal of Lutheran Ethics
Volume 13, Issue 3