22 is 22

Though the author is a man of letters, he is not an academic. If you are offended by the tone, demeanor, or language of the article, the author is indifferent.

This article is in response to “Examining the Narrative of 22” on OAFNation.com. My initial reaction was one of shaking my head. I felt the same way Neil deGrasse Tyson must feel about idiots blathering on about Super Moons — wishing people would STFU and leave educated topics to educated people. When the article was originally published, my gut instinct was to ignore it and internally retort with my bastardized version of an argument from The Princess Bride’s Inigo Monotoya: You keep using words. I do not think they mean what you think they mean.

In the first few paragraphs of Blonde’s article, Mr. Blonde tries to make sure that you know that when people talk about “22 veterans a day committing suicide” that they are talking about him and his friends. The article’s arguments are filled with so many cognitive distortions and biases, one wonders where to begin with refuting the article or whether to even continue reading. But let’s read on and start with Mr. Blonde’s assertion that any reference to veterans committing suicide refers only to veterans who served between September 12, 2001 and today. This argument appeals to the fallacy of personalization. Mr. Blonde believes that any reference to veteran suicide is a direct, personal reference to himself and veterans of his generation. He further personalizes his arguments by narrowing it down to the veterans of his generation that served in Iraq and/or Afghanistan. Nothing in the published medical literature indicates a specific reference to veterans that served in these two countries. The article provides no evidence that any organization or individual has specifically referenced Mr. Blonde, GWOT veterans, or veterans who served in Iraq and Afghanistan. Mr. Blonde further compounds his poor argumentation by stating that anyone who disagrees with his assertions of self-reference are lying and that people can only be talking about him, because he knows what they are thinking. Illusion of asymmetrical insight anyone?

Given the author’s first few paragraphs, the article further goes on to make the confusing argument that indeed, when published articles discuss veteran suicide, they are talking about veteran suicide. Veterans (a person who has had long service or experience in a particular occupation or field[1]) who commit suicide (the act of intentionally causing one’s own death[2]). The author wants to have it both ways: I want to complain about you exclusively talking about me and I want to point out that no one is talking about me exclusively. Perhaps Mr. Blonde suffers from the myopic understanding of the world he lives in and fails to realize that there were veterans who came before him, who served before 2001. And yes, there were Viet Nam veterans, but some of us served between April 1975 and September 2001. Furthermore, some of us served before 2001 and continue to serve today. Shocking I know, but I am here to educate and sometimes that requires getting the pupil to open their eyes and look around. Bright lights can hurt, ask Gizmo[3].
 Mr. Blonde goes on to point out that the bulk of veteran suicides are Viet Nam veterans and that only one GWOT veteran commits suicide a day. No further thought or analysis is given. Let me provide some food for thought for Mr. Blonde. The Viet Nam war ended in 1975, large numbers of the veterans that are committing suicide are in their 50s and 60s. Fifteen years from now (remember some of us started serving pre-9/11) most of the GWOT veterans will be in their 50s. I’ll let that sink in. We’ll return to this later.

Mr. Blonde then goes on to whine about how he and his generation of veterans (no concern on the author’s part regarding veterans of other eras who he admits are killing themselves at a rate of 21/day) are being stigmatized by a negative association with suicide. I have already addressed the author’s obsession with self-reference and will address the stigma with suicide later. But first we must address the author’s last two whines.

The most egregious error in Mr. Blonde’s thinking and argumentation comes from his “issue of self-fulfillment.” I will flat out state this: discussing suicide does not increase suicide risk for anyone. Ever. Science bitch[4]. Trotting out misguided tropes of the uneducated does nothing to have an honest dialogue and promote mental health.

Mr. Blonde’s final whine is regarding entities profiting by exploiting the unfair stigmatization of his generation of veterans by making money. We’ve already addressed the flaws regarding the author’s persistent belief that everyone is always talking about him and his generation, but as for the exploitation? Get used to it. Two words: pink ribbon[5],[6],[7].

My reply to Mr. Blonde’s flawed article is a call to action. I ask three things:

1) You as an individual need to stop stigmatizing depression, suicidal ideation, post traumatic stress, traumatic brain injuries, and suicide.

a. If your co-worker or team mate came into work with their arm in a cast due to a skiing accident you wouldn’t treat them differently and you shouldn’t treat mental health/TBI issues differently.

b. The body’s biochemical responses to stressors are out of everyone’s control. Just because you are a badass operator doesn’t change your body’s mixture of dopamine, serotonin, cortisol, norepinephrine…Your body is going to do what is going to do and those chemicals influence your mental and physical state.

c. Treat mental health the same way you respond to physical health.

2) Insurance companies need to stop stigmatizing depression, post traumatic stress, and traumatic brain injuries.

a. Insurance companies need to stop making coverage and receiving psychiatric and psychological treatment a pain in the ass.

i. Need mental health care? You need to get special approval for that

ii. Need more than 12 visits in a year? Need approval for that

iii. Need neurocognitive therapy? Need special approval for that

iv. Need hospitalization? We’re going to call your treatment team daily to make sure you need care[8].

b. Going back to #1 above, insurance companies need to treat mental health no differently than they handle diabetes or a broken arm.

c. Cover mental health the same way you cover physical health.

3) Health care providers and institutions need to stop stigmatizing depression, suicidal ideation, post traumatic stress, and traumatic brain injuries

a. We (I’ll use we to refer to health care providers and institutions) stigmatize patients taking mental health-related medications

i. Come into the emergency department with a stubbed toe and your medication list includes anti-depressants? You either receive extra attention to make sure you aren’t self-harming or you get dismissed as a “nut job.”

b. We have separate buildings for mental health

i. Stop putting the mental health center separate from the rest of the institution. There is no reason that the mental health department can’t be next to Ortho or the Cardiac Center. In fact, it probably should be embedded in those centers[9].

c. Treat mental health the same way you treat physical health.

As a final thought for Mr. Blonde: when GWOT veterans are in their 50s and committing suicide at a rate of twenty-one per day and the next generation of warriors is only killing themselves at a pace of one a day, will you be so complacent and ill-informed?

Some may ask why the author didn’t politely respond with a well-documented reply with sources. Because the stupid shit Mr. Blonde wrote needed an in-kind response — a swift kick to the nuts. Believing and embracing Mr. Blonde’s “examination” is dangerous, it puts men and women at risk. If shit were to go sideways, the author would carry Mr. Blonde’s ass and his gear over hill and dale, resuscitate him, then remind him to never write about shit he doesn’t know about.

[1] Veteran Merriam Webster Dictionary Accessed March 25, 2008.

[2] Stedman’s Medical Dictionary (28th ed.). Philadelphia: Lippincott Williams & Wilkins. 2006. ISBN 978–0–7817–3390–8.

[3] https://en.wikipedia.org/wiki/Gremlins

[4] Psychol Med. 2014 Dec;44(16):3361–3. doi: 10.1017/S0033291714001299. Epub 2014 Jul 7

[5] http://www.huffingtonpost.com/pandora-young/the-pink-ribbon-marketing_b_760696.html

[6] https://thetruthaboutcancer.com/susan-g-komen-pink-ribbon-facade/

[7] http://www.thinkbeforeyoupink.org/

[8] http://www.cbsnews.com/news/mentally-ill-youth-in-crisis/

[9] https://archive.ahrq.gov/clinic/epcsums/midepsum.htm