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Thursday 28 March 2024

2024 Malvinas Suicides


  THE MALVINAS SUICIDES

 

                    EDUARDO C. GERDING

 

Studies have consistently demonstrated that there is increased risk of accidental death in military populations exposed to war and trauma. Many of the accidental deaths occurring in war veterans may actually be suicidal deaths.” The psychological toll of war is very heavy

                                                                                       Leo Sher MD

 

Departament of Psychiatry -Columbia University-New York.USA


Introduction

 The problem of suicide involves thinking about terms of complexity and multicausality. It's a phenomenon of great magnitude both globally and in our country. Its effects are wide-ranging. 1

 

According to data from the Directorate of Statistics and Health Information (DEIS) published in the yearbook Vital Statistics-Basic Information”, in the year 2021,

2,865 suicides occurred in Argentina, 80% corresponding to men (n=2,280) and 20% to women (n=570).

 

In this article we will focus exclusively on the suicides linked to the Malvinas Conflict providing reference to suicides in the military as well.

 

  

Manifestations Associated with Suicide in War Veterans 12

 

These are the factors commonly cited that lead to an increased risk of suicide in veterans and other groups:

 

• Anger, rage, mood swings and episodes of anxiety and agitation.

• Express feelings of having no reason to live.

• Increased alcohol and/or substance abuse.

• Self-destructive and risky behaviors such as drunk driving.

 

Emotional Precursors of Suicide 24

 

Certain emotional precursors may precede suicidal events, including feelings of loneliness, isolation, hopelessness, and depression.6

 

In a summary of multiple studies, the US Veterans Administration found:

• Acute psychosocial stressors.

• Have low cholesterol.

 .Higher doses of opioid medications to control pain.

•Insomnia.

• Anxiety disorder, manic-depressive disorder, depression, post-traumatic stress disorder (PTSD), and traumatic brain injury (TBI).

• Substance abuse, especially excessive alcohol consumption. Veterans who abuse drugs or alcohol are more than twice as likely to die by suicide as other veterans.

 

Addictions and war veterans

 People who abuse drugs and alcohol are more likely to:

•Be depressed.

• Have social and economic problems.

• Adopt impulsive and high-risk behaviors.

More than 1 in 10 veterans are diagnosed with a substance use disorder. Veterans are more likely to consume alcohol; many also opiates 12

  

Post Traumatic Stress (PTSD)

 Many veteran suicides are related to depressive symptoms and/or PTSD. The risk of suicide among populations with EPT is six times higher than in the general population. 3. 4

 

Suicidal ideation and previous suicide attempts correlated significantly with diagnosis of EPT. 25

 

Veterans with a diagnosis of PTSD and major depressive disorder (MDD) or dysthymia were also more likely to report suicidal thinking and behaviors than veterans with only one of the diagnoses. 25

 We speak of chronic EPT when six months have passed.

 

PTSD Myths 15

 Myth 1: Only military veterans and people in combat zones get PTSD

Fact: Anyone who experiences or witnesses a traumatic event can develop PTSD

Myth 2: Everyone who experiences trauma develops PTSD.

Fact: Traumatic events do not automatically lead to PTSD and everyone reacts differently to trauma.

 Myth 3: Post-traumatic stress disorder occurs immediately after a traumatic event.

Fact: Symptoms of PTSD can take months or even years to appear.

Myth 4: PTSD is a sign of weakness and people with PTSD are broken.

Fact: There is no evidence that people living with PTSD are unable to improve if they receive the right type of treatment and support.

 

For some people, normal-type reactions quickly turn into stronger reactions that negatively affect everyday life. For others, these reactions only begin to affect them later in life. Some adults do not experience PTSD symptoms until retirement. Work may have helped distract them or bury their feelings about the trauma for years.

 

 Research in Argentina 28

 There is a law which dates back to 1983 which established  that every Argentine war veteran had to be reviewed by the provincial public health system of their birthplace.  That was not fully observed . Only in the last 10 years   specialized centers were created, driven by the war veterans´ struggle. In 1990 the Argentine war veterans´ assistance was achieved through the INSSJP (PAMI). 28

 The professionals of the Malvinas Argentinas Mental Health Center, dependent on the Army Health Command ,  reported that the PTSD was recognized as an entity nosology only in the 80s and its treatment was developed in recent years, especially after the September 11 attacks and natural disasters such as tsunamis. 17

 

The conflict generated a deep feeling of defeat and  frustration among the Argentine society. The defeat in war and the loss of the Malvinas islands impacted the national pride and generated deep psychological unrest.

  

Many Argentines felt humiliated and embarrassed by the defeat, which led to a crisis of identity and self-esteem .

 After the Malvinas conflict, there was silence and taboo around the subject. Many families of soldiers who participated in the war did not speak openly about their experiences and feelings, which made it even harder for the healing and recovery process. Furthermore, the Argentine society as a whole avoided discussing the topic, since it was considered painful and shameful.

 

This silence and taboo had a negative impact on health mental health of war veterans and their families. The lack of support and understanding from society made most difficult their recovery process and left them feeling isolated and alone in their suffering. 6

There is an exhaustive study by Lolich et al published in the 2014 titled Autobiographical Memory, Senses and Phenomenology: Traumatic Memories in Former Soldiers and Veterans of Malvinas War 14

  

Research in the United Kingdom

 In 2020, a group of 280 former military personnel sued the UK Ministry of Defense in the largest class action of its kind seeking compensation for post-traumatic stress disorder.

 The veterans, who served in almost all recent military actions involving British forces, including Bosnia, the Gulf, the Falklands and Northern Ireland, claimed the Ministry of Defense failed to diagnose and treat those suffering from post-traumatic stress disorder (PTSD). .

 The war veterans claimed they were poorly trained for the conflict outcome, exposed to unnecessary dangers and that the ministry failed to diagnose and treat their condition or apply adequate support systems. 10

 The claimants included 40 Welsh Guards who were trapped in the burning hull of the warship Sir Galahad after it was attacked by Argentine aircraft during the Falklands War. 10

  

Suicide prediction

A newly developed risk calculator that is based on 11 key social, demographic and clinical factors can correctly predict the risk of suicide in those who have self-harmed in the following 6 to 12 months.

Self-harm is associated with an increased risk of suicide in the following 12 months, which is estimated to be 20 times higher than that of the general population, Around 16 million people self-harm each year, so the population impact of preventing future suicides is potentially large, 9,20

  

Argentine Experience

 During the Malvinas conflict, 649 Argentines died.

 According to the Argentine Army Malvinas War Veterans Department there were 38 suicides of veterans while the Navy had 14. The Air Force said they had no data because they only recorded the death but not the cause. 26



Slipzuk, Martin y Martinez,Lucia-A 37 años del fin de la   guerra de Malvinas, sigue sin saberse cuantos ex combatientes se suicidaron. El Explicador-Salud-Chequeado.14 de junio, 2019

According to the INSSJP, Argentina's main social and health services organization, almost 40% of former combatants of the Malvinas war have attempted suicide. Another 78.2% suffer from sleep pathologies, while 62.5% have at some time thought "it was better to be dead" and 69.5% still remember "with great intensity" events experienced in the Malvinas during the war.

 By Resolution 191/05 DE, the National Assistance Program for War Veterans and their families was created and by Resolution 622/05, War Veterans Areas were created in each PAMI delegation.

 

The report also reflects that 47.8% of those interviewed admitted that when drinking alcoholic beverages they normally drank more than a liter, although experts point out that the percentage is higher "when the data is analyzed by direct observation."  "Many of them, upon returning and not being able to find adequate social reintegration, without therapeutic support, did not find that alcohol helped them forget or mitigate their anxiety and tormented existence,"

  

According to the survey, 65.2% admitted to having ever consulted a
 psychologist or psychiatrist, while 86.9% usually felt much more 
irritable than others in their group, whether family, friends, etc.
 Regarding the symptoms of Argentine ex-combatants, the report 
listed: anxiety, fear, survivor guilt , anger, sleep pathologies, panic 
attacks, feeling of suffocation, unmotivated crying and nervousness.

 

 The report also analyzes people who live or share with veterans, and 53.3% of wives admitted to being afraid of violent reactions from their husbands.

 

In addition, the report shows that two out of five children of Malvinas veterans have behavioral and learning difficulties. According to Malvinas´ veterans associations, more than 350 of their colleagues have committed suicide since the end of the conflict in 1982. Other sources indicate that the number could be even higher. 16

  

Miguel Boyero, survivor of the cruiser ARA General Belgrano and father of two children hanged himself .It was his son who discovered the body hanging from a clothesline in the yard his house in the suburb of San Martin. Boyero left a letter to his wife: ¨Thank you for everything, I love you. Miguel." His wife  stated that he was going through a depressive state.. 7.18

 

British experience

 During the Malvinas Conflict, 255 soldiers died and 777 were injured. The deaths are divided into 237 uniformed, 4 members of the Royal Auxiliary Fleet, 6 of the Merchant Navy and 8 sailors from Hong Kong. 3,4,8

 In 2002, the Atlantic Medal Association South (SAMA) representing British veterans of Malvinas said that “they were practically sure” that the number of suicides exceeded combat deaths.  They blamed the authorities for the lack of care of those veterans who suffered from post-traumatic stress (PTSD) 8

  

The associations of ex-combatants assure that they were between 350 and 500 veterans who took their lives. 26

 McDonnell of the Los Angeles Times published in the 2007 that at least 352 veterans commited suicide. 18

 

Thirty years after the conflict ended, the British Ministry of Defense investigated the circumstances of 21,432 Malvinas veterans. It found that as of December 31, 2012, some 1,335 had died.

 

This figure was compared to the 2,079 deaths that would have been expected for men of similar age and background who did not serve in the military.

 Of those Falklands veterans, 7% of the deaths - or 95 people were due to "intentional self-harm and events of undetermined intent (suicides and open verdict deaths)."

 That finding means that, on average, over the entire 30-year period, veterans were actually 35% less likely to commit suicide than the equivalent group of British men with no military background. 8.22

  

Of the 1,335 deaths linked to the Malvinas, 140 were produced while in service. The rest died after leaving the Armed Forces. 8

 This study was dismissed by Denzil Connick who served with the Paratroopers, was seriously wounded in Mount Longdon and founded the SAMA. 2

 The rest of the studies also ruled out the validity of this study. British war veterans claimed it was a “smoke screen” to “hide” the lack of assistance given to military personnel. 2,30,31,33

 In its defense, the Ministry of Defense announced that would allocate £7.2 million to ensure that there would be adequate support for the mental health of all those

veterans who needed it. This included assistance personalized by the mental health services of the National Health Service (NHS) and a telephone line 24 hours with the Combat Stress service. 2

  

Since 1984, British military personnel have suffered 802 combat deaths linked to Northern Ireland (171 inside and 53 outside), the first Gulf War (24), the Balkans (13), Sierra Leone (1), Afghanistan (405) and Iraq (135). There were 905 staff suicides while in service.27,33

 The British Ministry of Defense reports that, in the last five years, the Army´s male personnel went from a suicide rate of 6 per 100,000 in 2014 to 15 per 100,000 in 2018. The average number of suicides is less than 2 per month and represents less than one death every 1000 soldiers. 27

 However, since 2017 the number of suicides in the British male military personnel has increased and for the first time since the mid-1990s, the figure is equal than that of suicides in the general population .33

 

 The entity Action on Armed Violence reports that  since 1984 more

 British military personnel have died by suicide than by combat. 27

 10 years ago, 11% of medical casualties in the Army British were due to mental disorders corresponding 10% to the Royal Navy and 15% to the Royal Air Force. In 2021/2 this figure increased to 46% (20% and 43% respectively).27

 UK military charities think that the country is facing a "time bomb ¨of former military personnel who potentially suffer mental disorders after being in intense conflicts. 5

Major General Julian Thompson accused government ministers of ignorance in closing military hospitals. "This ignorance," says General Thompson, "extends to veterans suffering from post-traumatic stress disorder. They fought for us and are ignored or sent to National Health Service hospitals among people who do not understand what they went through or what they suffer. ". 29

 

 Commodore Andrew Cameron, executive director of the Combat

 Stress Mental Health service said: “The number of suicides after the

 Malvinas conflict is very high. In fact, any suicide linked directly at

 the service of the Armed Forces is already too much¨5.11

 

Former paratrooper (2nd Battalion) Stephen Hood ,who  participated in films (This is England and the Lady of Iron) celebrating victory at Green Goose (smiling and drinking a bottle of Bacardi) and, father of two children, was found dead 6 miles from their home in Rhyl, North Wales. He committed suicide inside his car inhaling carbon monoxide.  5.21

 Military personnel who do not receive help for their disorders mentally faces other problems such as lack of housing, social exclusion, alcohol and drug addiction and many of them even commit crime.

 

Was it worth it? I think it was for Mrs Thatcher and the arms trade. It certainly wasn't worth it with regard to the 250 soldiers who The South Atlantic Medal Association – the Falklands veterans group – estimates have committed suicide since they returned from the Falklands. As for me, the experience has made me a lifelong opponent of war.

                   Wade Tidbury Served as an able seaman (radar) on HMS 'Alacrity'  32

  

Chris Howe MBE, was seriously injured when HMS Coventry, the ship on which he was serving as a petty officer, was sunk after being bombed by Argentine aircraft on 25 May 1982.

 

Howe, 64, SAMA administrator, who joined the Royal Navy as a 16-year-old in 1972. "As far as I know, I was severely burned, hit by a bomb on the Coventry and was the most injured on the ship, had 27 percent burns and I lost a third of the skin on my body and was seriously ill. I just got off the boat. It has affected me so much that not a day goes by that I don't think about it." 19

 


The USA experience

 US war veterans make up a quarter of suicide figures. In 2020 there were 6,146 suicides of veterans that represents 16.8 veterans per day.

In the case of Vietnam, it is estimated that from the moment of discharge until the early 1980s, 8000 and 9000 combatants had committed suicide..23

 Two-thirds of the 446 war veterans of American war veterans  who committed suicide since 2005 did so during the deployment or upon return from Iraq or Afghanistan. 13

 Between 2001 and 2020, the prevalence of mental disorders or drug abuse among patients of the Administration of Veterans Health rose from 27.9% to 41.8% 12

 

 

The suicide rate for war veterans

 The suicide rate for American war veterans is 1.5 times that of the general population. 12

 

A few last words about a myth that says that people who talk about committing suicide seek care as those who really want to commit suicide say nothing. This is not true. All suicide threats must be taken seriously. The behavior can be sign of deep depression requiring professional assistance.While it may be an act of manipulation it may also be an act that can end in death.

 

 

Suicide Assistance Center in Argentina

0800-345-1435

 

National Suicide Prevention Helpline UK

0800 689 5652


Bibliography

 

 

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 21-Nicol,Mark-Iconic hero of Goose Green kills himself hours after Argentina reignites hostiklities: ´Sabre-rattling´may have triggered Para´s post-traumatic stress-The Mail  on Sunday 95 Jun 2013.

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