Casualties of war

He’s threatening to kill himself, and I don’t know what to do. …”

Don Lipstein heard those words from his daughter-in-law on the phone as he left work on March 15, 2011. They didn’t ring true.

Joshua, Lipstein’s son, was finishing his Navy career in Norfolk, Va. His wife lived in Texas where they planned soon to start a new life. Don Lipstein worked in Pennsylvania. Maybe his daughter-in-law wasn’t reading the situation right, Lipstein thought. He called his son.

Joshua had endured hardships. After spending two tours in Iraq where his Navy Riverine Squadron patrolled rivers, Joshua planned on making the military his career. But the discovery of a brain tumor led to a 22-hour surgery and permanent hearing loss in his right ear. No longer medically cleared for regular missions, Joshua spent his shifts monitoring security cameras. An addiction to pain killers led to a stint in rehab where he met a heroin addict who soon got Joshua hooked. Then Joshua’s mother died of cancer. Still Lipstein had a hard time believing his son could be suicidal.

Those doubts vanished when he heard the pain in his son’s voice. Joshua was crying. Joshua never cried.

“Dad, I’m so sorry,” Joshua repeated over the phone. “I love you.”

“If we can get you off the drugs your life will look so much better,” Lipstein pleaded. He tried to think of ways he could keep his son on the line and call 911 at the same time.

“Do you have a gun with you?” he asked.

“Yes.”

“Can you do me a favor and take the bullets out?”

“I can’t do that, dad.”

Joshua did give his current location. Maybe that meant he wanted help, Lipstein hoped. Then his son’s voice grew strong. “Dad. I’ve got to go. I love you.” The line went dead.

Lipstein felt his heart rip out of his body. He called 911 and spoke to Joshua’s best friend, but help arrived too late. Joshua died of a self-inflicted gunshot wound to the head. He was 23.

AFTER NEARLY 12 YEARS of sustained military conflict overseas, the American casualties of war extend to the home front. A record 349 active-duty soldiers killed themselves last year, exceeding the number of combat deaths for the year in Afghanistan. The problem extends beyond current troops: A veteran commits suicide every 65 minutes, for a rate of 22 each day, according to a new study.

Soldiers return home still coping with old traumas only to face fresh anxieties as they leave the military and try to build new lives in a tough economy. The suicide numbers are rising despite the Pentagon and the Veterans Administration spending millions and introducing hundreds of suicide awareness programs. A culture that stigmatizes mental illness leads to many suffering in silence, not wanting to be seen as the weak link in their unit and fearful that counseling could stunt their careers. Yet the trauma of war is real.

Roadside bombs hit Marine Tom Bagosy’s convoy five times during a deployment to Iraq in late 2006. He manned a gun from his vehicle’s roof, his body exposed. He told his wife, Katie, how a sniper bullet once came so close he could feel it passing by his head. Katie worried, but at least he talked. The more grim Tom’s missions became, the more Katie heard from him.

At a military briefing for spouses, Katie spoke up, saying she already knew her husband would need help when he returned. Other wives looked at her like she was crazy. You don’t know that yet, they said. Give the guys down time when they return. Be patient.

Depending on the survey, anywhere from 2 to 14 percent of all troops develop Post Traumatic Stress Disorder. The number of veterans receiving mental health treatments has risen from 927,052 in 2006 to 1.2 million in 2012. That figure will likely continue to rise: The full manifestations of untreated PTSD often peak about a decade after the inciting incident.

For Katie Bagosy, the man she married died in Iraq. The person who returned in his place was distant, irritable, and impatient. He drank, played video games, and awoke from nightmares not knowing where he was. “He wasn’t anybody I would have chosen to marry,” Katie said. “But I made my vow, and I kept hoping he would get better.”

A year after he returned, Tom turned to Katie and said, “I think I am going to be one of those people who will have PTSD for the rest of my life.” Still he wanted to join the Marines’ special operations forces. Medications and mental treatment would be barriers to getting a coveted invite to the Special Operations Command training. But in the summer of 2009, Bagosy shipped out to Afghanistan, a newly minted special forces Marine. This time he wouldn’t talk to his wife about his missions. She braced for what he would be like when he returned.

The Pentagon and the Veterans Administration are investing $100 million to study suicides. To fight the stigma against mental illness, the Army began embedding behavioral specialists within units so soldiers have easy access to mental heath experts they can get to know. The Air Force is putting mental health professionals in the same clinics as primary care physicians. That way, its military personnel may not know what type of doctors their colleagues are seeing.

The Army has increased its mental health professional staff by 35 percent while the VA has a goal of hiring 1,600 new mental health providers by the end of June. (A January report showed that about 950 veterans receiving VA care attempted suicide each month between 2008 and 2010. Another VA study found that 30 percent of high-risk mental heath cases did not receive the promised follow-up visits.) The agencies bolstered the capacity of crisis hotlines such as Vets4Warriors and its collection of suicide prevention programs with acronyms like the Marines’ RACE (Recognize, Ask, Care, Escort).

They’ve thrown so many programs and initiatives at the problem that the Pentagon’s Defense Suicide Prevention Office, which opened in 2011, found 900 suicide fighting activities across all departments. This fall the office will finish its inventory and promises to streamline suicide prevention. Meanwhile, military families are confused about where to turn for help.

Soon after his second deployment ended, Tom Bagosy began having suicidal thoughts. Katie and Tom once fought in the kitchen over a gun. He won the struggle and drove off in his truck only to return later that night acting calm. The next day the family drove to the White House for the annual Easter Egg roll. As Tom battled suicidal thoughts, he argued with his doctors over treatment. He told Katie that he felt like nobody listened to him. When he caught Katie trying to hide his ammunition, he shrugged it off: “I have ammo all over,” he said. “So don’t even try.”

On Mother’s Day in 2010, Tom told Katie he had done what he was supposed to do by bringing his two children into the world and serving his country: “It’s time for me to step back and let some other man take over my family.”

The next day, Tom appeared calm and drove to Camp Lejeune, N.C. Katie called Tom’ base psychologist. Officials decided to put Tom in a treatment facility. Tom seemed cooperative while waiting for an escort to take him to the hospital. But those watching him let their guard down, and Tom bolted out the door. A group of Marines chased after him. Tom reached into his truck and pulled out a gun. He pointed it at them. As they backed off, Tom drove away. A few minutes later, with Military Police in pursuit, Tom stopped his black Sierra GMC truck in the middle of the road and shot himself with a pistol. He was 25.

“I don’t think he wanted to die,” Katie said. “He didn’t want to feel the pain. I probably wasn’t thinking the way I should have been thinking. It was a very intense, emotional time. To me it is still the war that killed him.”

SOME NON-PROFIT GROUPS are trying to help family members after suicides. The Tragedy Assistance Program for Survivors (TAPS) provides free peer-based emotional support groups, seminars, and retreats for adults and a “Good Grief Camp” for children. This Memorial Day weekend more than 1,000 survivors in different stages of grief will come to the nation’s capital for the TAPS’ annual conference.

The attendees will include Don Lipstein. The first three months after his son died, Lipstein felt frozen. He’d wake up, breathe, and, at day’s end, not recall much of anything he had done. But at TAPS events he found people who had experienced the same loss. They felt safe enough to laugh together one minute and cry the next. “People don’t look at you like you are crazy,” Lipstein said.

Determined to honor his son by finding something positive out of the tragedy, Lipstein became a peer mentor coordinator for TAPS. He matches those newly mourning a military suicide with those who lost a loved one and are farther along in their grieving journey. “Two years out from Joshua’s death I can say that I am able to put my story behind me and focus on other people’s stories,” Lipstein said. “The pain doesn’t go away, but it does become a little bit easier to deal with.”

Some groups are also joining the battle, determined to ensure that the spiritual element of healing isn’t ignored. Inside the military, Army chaplains set a goal of having 50,000 soldiers and family members attend “Strong Bonds” marriage retreats over the final three months of 2012. With the National Guard responsible for more than 50 percent of those who fought in recent wars, the Oregon National Guard is part of a pilot program, “Partners in Care.” It matches area faith-based organizations with Guard and reserve units.

Outside the Pentagon, Military Ministry, a division of Cru (formerly known as Campus Crusade for Christ) commissioned the biblically based Combat Trauma Healing Manual and a companion workbook for wives called When War Comes Home. “You can’t read through the Psalms of David without realizing that he was a sufferer of post-traumatic stress and cried out many times for God’s healing and support,” said Jeff Oster, Military Ministry’s executive director.

The organization also partnered with the American Association of Christian Counselors to produce a 30-hour training video for professional counselors on how to deal with PTSD using a Christ-centered approach.

But scores of hurting veterans are leaving the military and returning to their small hometowns, many in rural areas far from military bases and the nonprofits catering to soldiers. “What we need is lots and lots of churches that will take the plight of military families to heart,” said Chris Adsit, the lead author of Military Ministry’s two workbooks. “The good shepherd leaves the 99 sheep and searches for the one lost sheep.”

FIVE MONTHS INTO HIS 2004 DEPLOYMENT to Iraq, Josh Renschler, 21, stood on top of his vehicle when a mortar round hit a perimeter fence, hurling a four-foot long steel picket towards him. Renschler woke up three days later at a hospital in Germany. He spent two months in a military hospital in California recovering from head and back injuries. All he wanted to do was get back to his unit in Iraq. Instead he underwent more medical treatment at his home base in Fort Lewis, Wash. He struggled with seizures, migraines and numbness in his legs. When his old unit came back, he avoided them. Soon the unit redeployed to Iraq without him. Renschler became obsessed with watching news reports about the war.

One night in May 2007, Renschler recognized faces on his television screen. Six members of his old squad had been killed when an explosive device tore though their vehicle. The next morning Renschler put on his uniform and went to his unit’s rear detachment. They assigned him to escort the bodies to their final resting places. He followed his old battle buddies to funerals from Washington to Mississippi. Seeing the families grieve, Renschler felt guilty for not being in the vehicle with the rest of his squad. Six months later he left the army.

Renschler took a job at an island prison in Washington. It became a breeding ground for his anger and hate. Fights gave him such an adrenaline rush that he sometimes provoked the inmates. After breaking up a large melee about a year into his job, Renschler couldn’t calm down. When he slumped into a chair, his coworkers thought he was having a heart attack. Hospital doctors told him he had suffered a panic attack. Renschler lost his job.

Renschler and his family started attending Northwest Community Church in Lakewood, Wash. He went, but he didn’t understand how God could allow horrible things he had witnessed to happen. Matt Vanderfeltz, a church member and retired lieutenant colonel, latched onto Renschler. He wouldn’t take no for an answer when he invited Renschler to coffee or a meal. Unemployed, Renschler had no excuse when Vanderfeltz asked him to a men’s retreat. When Renschler began to talk about the issues he was having, Vanderfeltz promised to walk alongside Renschler to help him find the best solution. Without Renschler asking for help, members of the church began showing up at his doorstep with a car full of groceries. Unsigned cards with $200 in Safeway gift cards would arrive in the mail.

Renschler started going to a VA outpatient-counseling program, where he saw Vietnam veterans who had been coming for 30 years but were still broken. Renschler told Vanderfeltz that he didn’t want to end up like that. Vanderfeltz found a copy of the Military Ministry workbook. But Renschler, not much of a reader, hid it away.

With Renschler still jobless, the banks started to foreclose on his home and repossess his truck. He faced his third back surgery. Lying in bed one afternoon in the middle of 2008, with severe back pain and a migraine headache, Renschler looked up on the top of a shelf and saw his gun. He visualized putting it to his head and pulling the trigger and thought about the relief he’d feel when it was over. He pictured the bullet escaping the barrel and going through his head. He sat up.

Suddenly he saw an image of his wife finding him dead. He imagined her having to tell their children. The pain that he would cause them seemed greater than any physical pain he had endured. He decided at that point that it wasn’t a good solution, but he had to figure out something else fast. He was not in a good place. He remembered the workbook. When he opened it to the first step he saw in bold print: “Where Was God?” It was the same question he had been asking himself. He read through the book, learning about the spiritual component to his battles.

By the end of 2008 Renschler was sharing the gospel with others. He went back to the VA counseling session and gave his workbook to one of the older veterans. With his church, he started a retreat for soldiers called Operation New Normal. It led to weekly meetings where attendees could fight the trauma they felt together.

“I can relate to the brokenness inside of people,” Renschler said. “I have something I can give them, and that is the fact that this isn’t how it has to be forever. There is the hope that comes from believing that God has a plan, and no matter how we screw it up, He can make good out of the evil that we experience in our lives.”

Adsit, the workbook’s author, prays that more churches reach out to veterans: “Frankly if we are going to rely on the VA and the Department of Defense it’s a very difficult, and I would even have to say hopeless, situation. Not because the VA and DOD aren’t doing everything they can, but because they simply must cut out the most important element, and that is God.”

Renschler has spent the past year in full-time ministry as an area director for Men of Valor, a new faith-based military charity. He’s witnessed to numerous soldiers who have attempted suicide, seeing their lives renewed by the gospel: “You don’t have to be a psychologist to help a soldier.”