Suicides among civilians who work war zones

 

Foreignpolicy.com

WASHINGTON – On Aug. 15, the U.S. Agency for International Development announced that one of its employees had died suddenly. The agency didn’t mention that Michael C. Dempsey, a senior field program officer assigned as the leader of a civilian assistance team in eastern Afghanistan, killed himself four days earlier while home on extended medical leave. However, the medical examiner in Kent County, Mich., confirmed to Foreign Policy that Dempsey had committed suicide by hanging himself in a hotel-room shower. His death is USAID’s first known suicide in a decade of work in the war zones of Afghanistan and Iraq. And what makes the suicide particularly striking is that it came a year and three days after Dempsey’s close friend and colleague was killed in an improvised-explosive-device attack in Afghanistan.

After a decade of development and reconstruction work in two of the world’s hottest war zones, USAID now has hundreds of Foreign Service officers who are potentially at risk for post-traumatic mental-health issues. While an enormous amount of resources and attention has been paid to military suicides, comparatively little focus has been given to civilians’ struggles. And it’s a sign that it’s not only members of the armed services who shoulder the emotional burdens of war.

Dempsey’s friend and USAID colleague, Ragaei Abdelfattah, an American of Egyptian descent, was killed along with three military escorts and an Afghan civilian in the attack in eastern Kunar province. Abdelfattah, who, like Dempsey, had an urban planning background, was on his second voluntary tour in Afghanistan. Dempsey was not part of the attack, but could have easily been on the mission. The death of his friend, who left behind a wife and children, may have contributed to Dempsey suffering from “survivor’s remorse,” say individuals outside the agency who were close to the matter. Dempsey had been receiving counseling up until the time he died.

USAID dispenses civilian economic and humanitarian assistance in Afghanistan through a number of programs, typically working alongside U.S. military service members. Since fiscal year 2002, USAID has been appropriated about $17 billion for economic, health, education and infrastructure programs in Afghanistan. USAID also typically works in concert with the military’s own stabilization efforts to counter extremism across the country.

Dempsey, 33, headed the provincial reconstruction team in Nangarhar, Afghanistan, and was himself on his second tour in the country. He had worked closely with USAID’s Land Reform in Afghanistan initiative, designed to help Afghans create a locally owned and managed land market. He’d also worked with the USAID office in Kabul as well as with local contractors in Jalalabad to monitor infrastructure projects like upgrading drainage systems and paving and widening streets. In March, Dempsey had been quoted in local Afghan news outlets upon USAID’s announcement that it would suspend work on the Daronta Hydroelectric Power Plant in Nangarhar after the agency said that the local governor had failed to fulfill his pledges to finance his part of the project.

“When Mike arrived in Afghanistan, he was immediately recognized as a leader,” USAID Administrator Rajiv Shah wrote in a memo to staff a few days after his death, noting that Dempsey took on management responsibilities and drove progress on a range of issues, from land ownership to power delivery. “He impressed his colleagues with a sense of dedication and desire to always do the right thing, as well as his ability to present solutions to his counterparts in a way that empowered them,” Shah wrote.

Shah left unspoken the issue of suicide that USAID must now confront. With Dempsey’s death as the first known suicide from either of USAID’s Afghanistan or Iraq programs, the suicide forces the agency to deal with an inescapable problem: how to help its employees who deploy to the same war zones as the military but who don’t always have access to the same kind of assistance. Civilian culture may not have the military’s taboo against seeking mental-health assistance, but unlike the Defense Department, which has struggled to arrest the vast suicide problem within its ranks, civilian agencies such as USAID and the State Department are governed by different privacy rules that hamstring those agencies as they try to help employees who may be suffering from post-traumatic anxiety, depression, or worse.

Larry Sampler, who heads USAID’s programs in Afghanistan and Pakistan, traveled to Michigan in August to attend the memorial for Dempsey. Sampler said Dempsey’s suicide means USAID must now look at how best to help those who have deployed to war zones for the agency. “The physical and emotional resilience of our staff is of paramount importance to us: To me personally as the leader of the Afghanistan and Pakistan effort,” he said in a statement to FP. “In our experience, returning staff often may not even know they’re having difficulty adjusting until they’ve been out of Afghanistan for awhile – and we want them to have and to know about the extended and enduring support network we offer.”

USAID has deployed more than 2,000 “direct hires” through Iraq and Afghanistan since 2003. Many of them, like Dempsey, are considered “foreign service limited” (FSL) officers. That means they enjoy many of the same benefits of Foreign Service officers, but can’t be promoted or moved to other offices or departments. About 150 FSL officers are in Afghanistan currently. After each deployment, each one gets a “high-stress outbrief,” but due to privacy concerns, USAID isn’t able to contact any of them after they leave federal service to ensure that they aren’t suffering from deployment-related issues or other maladies, like alcohol abuse or depression. After a deployment, supervisors may only hear about those kinds of problems unofficially, through the bureaucratic grapevine, because of the way privacy regulations govern civilian agencies. And even then, if a problem is identified, USAID, unlike the Defense Department, can’t force an employee to undergo treatment.

That has sparked some soul-searching within the agency, and in light of Dempsey’s death, Sampler and USAID are trying to find a way to reach back to those past workers for the agency to make sure they know there are services available to them should they need them. “We’re doing everything we can to reinforce that there are resources available to help people who are at risk of substance abuse or suicide and that there is no stigma attached to taking advantage of these resources,” Sampler said.

That’s not to say the agency doesn’t offer help to those who have served in war zones. All USAID staff members selected for the Afghanistan program are required to go through mandatory training and support sessions prior to their departure and after they arrive home. The agency also offers free, confidential counseling, available 24 hours a day by phone or in person, before, during, and after the deployment.

Suicide rates have rocked the military in recent years as the burden of deployments has apparently come at an alarming human cost. In 2011, the last period for which there is complete data, there were 301 suicides among service members (Air Force, 50; Army, 167; Marine Corps, 32; and Navy, 52), according to data provided by the Pentagon. These numbers include deaths that are “strongly suspected to be suicides” but whose final determination is pending. In 2011, 915 service members attempted suicide, according to the data. About half of those who died by suicide had been deployed to support the wars in Afghanistan and Iraq – about 47 percent. Eight percent had a history of multiple deployments. “Direct combat experience” was reported in connection to 15 percent of the suicides and 17 percent of the attempted suicides, according to the data.

It’s tricky to tie war deployments directly to military suicide rates, but it’s clear there’s some connection. Suicide prevention has now become a staple concept of military preparedness before and after deployments, and commanders are now required to create a command climate in which individual service members can get help without suffering setbacks to their careers. Mostly, it’s a question of changing the mindset: “Seeking help is a sign of strength” is the military’s mantra now.

Still, the stigma of seeking help remains, especially for career-oriented service members who still can believe that if counseling is documented on their records, it could make it hard to be promoted or receive choice orders. As a result, some service members seek help outside the military health-care system to avoid being documented for obtaining counseling.

That kind of counseling didn’t help Dempsey, for reasons that aren’t entirely clear. But Sampler said he was remembered in Michigan by friends and family for his “commitment to making the world a better place.” But, he said, “Mike was also part of USAID’s family, and now we will take care of our family, many of whom are still serving in difficult and dangerous circumstances far from their homes.”

Gordon Lubold is a national security reporter at Foreign Policy and author of Situation Report. He tweets at glubold.

© 2013, Foreign Policy

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