One year after the high-profile and disturbing event, suicide remains the leading cause of military deaths

STORY BY RAINA BREWER / The Hubbard School of Journalism and Mass Communication

One year has passed since Aaron Bushnell, a 25-year-old U.S. Airman, stood before the Israeli Embassy and set himself on fire to protest the U.S. support for Israel’s acts of war against Gaza. 

His shocking and tragic act – streamed online to unwitting bystanders – was accompanied with an explanation that would soon go viral on social media: 

“I am an active duty member of the U.S. Air Force and I will no longer be complicit in genocide,” Bushnell said. “I am about to engage in an extreme act of protest, but compared to what people have been experiencing in Palestine at the hands of their colonizers, it’s not extreme at all.”

In the immediate aftermath, some social media users across the world rejected commentary about his mental health and extolled him as a hero with a steadfast moral code who, as activist Huma Zehra posted on X, recorded his death “just so the whole world would hear him scream, with his whole soul, “Free Palestine!”

But to soldiers like me, those of us who had been through so many of the military’s mandatory annual trainings on suicide prevention, assertions about Bushnell’s heroism weren’t convincing. We suspected Bushnell’s mental health decline had more likely slipped through the wide cracks in the system — as it has for thousands of soldiers in this century.

The numbers told the story: During the past 20 years, death by suicide has been the leading cause of death for service members, not combat.

Since 9/11, there has been 30,177 suicides among service members and veterans. During the same time, 7,052 U.S. service members were killed in war operations, according to a 2021 study conducted by the Watson Institute of International & Public Affairs at Brown University.

Veterans account for about 13.9% of all suicides among U.S. adults. “Between 2017 and 2020 veteran suicide rates were 1.57 to 1.66 times greater than nonveterans in the US, after adjusting for age and sex differences.”

“These numbers always hit me straight in the gut, but unfortunately they no longer shock me,” said Dr. John Lichtsinn, psychiatrist and PTSD specialist with the Minneapolis VA Medical Center. 

“At the core, I think we're dealing with the ongoing aftermath of exposing hundreds of thousands of humans to immense degrees of stress. Long deployments, repeated deployments, a military stretched across multiple major conflicts. Modern urban warfare, IEDs [improvised explosive devices], mortars, high powered weaponry, trying to distinguish an enemy between a civilian population who look and dress the same. Never feeling at ease or comfortable,” Lichtsinn said.

The military’s response

It’s 08:00. I and my fellow soldiers from the Army National Guard Bravo Company 2-136 CAB stand in formation at Camp Ripley on a February day awaiting the arrival of our commander and first sergeant.

“ATTENTION!” one soldier bellows. 

“It’s that time of year folks,” Capt. Tomas Hofman said. “Get ready for an admin-heavy drill weekend.”

Groans escaped from the formation — we all knew what “admin-heavy” meant. It was Suicide Prevention month, something nobody likes to talk about.

As suicide rates became an unavoidable problem for military readiness, suicide prevention training programs were sporadically implemented across the branches in the late 90s and early 2000s.

“The Army tries very hard to bring awareness to suicide and suicide prevention,” Sgt. First Class Matthew Levenhagen of Bravo Company said.

But Levenhagen said high suicide rates in the military reflect a broader mental health decline in U.S. society. That problem needs to be addressed before the military can achieve “full adequacy” of its BH, or behavioral health, efforts, Levenhagen said.

Suicide awareness trainings, like the one at Camp Ripley, are the most regular form of the BH effort. Soldiers filed into the sepia-lit auditorium, most of them with a coffee or energy drink in-hand. Soldiers who had been enlisted long enough knew to stash an extra beverage in their cargo pocket for later.

It was going to be a long day.

In the official PowerPoint presentation released by the U.S. Army titled, SUICIDE PREVENTION: LEADERSHIP IN ACTION, the opening line simply reads: “Suicide is not an acceptable option for soldiers.”

From 2018 to 2024, I sat through this same regurgitated presentation, and similar presentations, at least a dozen times — no matter which of the three units I served in over those six years was leading it. Bravo Company’s training was yet another carbon copy of the ones I attended.

Such Suicide Prevention briefings have been coined “death-by-Powerpoint” presentations and “check the box” events — which are mandatory and prioritize only completion, not care, according to Sergeant Devyn Margl of Bravo Company 2-136 CAB.

From my seat, the discourse around these briefings never changed much. To me, I always walked away with a similar message: Suicide in the military is a problem, yes. But above all, it is a weakness.

And of course, the military does not sanction messages of weakness. 

At the end of the briefings, presenters usually offer soldiers resources. But according to Staff  Sgt. Denver Heid, these resources don’t seem too helpful.

“I don’t think this was intended to solve any one’s problems,” Heid said. “It was more a catch all net for anyone at risk.”  

I knew if I were ever in a low place with my own mental health, I would not find these resources helpful.  The privacy of the briefings was also questionable. If it were me, I would constantly be evaluating the consequences of speaking up about my mental health.

‘Would it affect my promotion status,’ I might ask myself.

‘Would I lose respect from my colleagues?’

‘Would I get medically discharged?’

‘Would it affect my benefits?’

These matters would make me wary, as they might for so many other soldiers.

Apart from suicide briefings, soldiers also go through an annual “mental health risk assessment,” which includes a pre-assessment questionnaire followed by a short one-on-one screening.

These screenings are unit-wide and occur on a military base while on duty. They are often considered a mandatory burden, taking away from the work day and the “real mission.” Derisive comments about the process are common soldier-to-soldier. Some doze off during the presentation. Complaints are constant.

But with pressure from higher ups to complete the training, this is a box to check whether we liked it or not. So with manilla folders containing filled-out forms with their answers to standard questions such as: “Do you want to harm yourself or others?” “Do you have suicidal thoughts?” and “How often do you have six or more alcoholic beverages in one sitting?” soldiers stand in a long line and wait for their turn to sit inside makeshift offices and spew out their answers to facilitators.

One-by-one they cycle through. The facilitators don’t even bother to shut the door between patients. The screenings last no-more than five minutes per soldier before a facilitator will yell “NEXT!”

Soldiers fall through the cracks

According to Lichtsinn’s observations, suicide prevention handlings like that of Bravo Company 2-136 CAB are pretty standard for unit-level care and education.

“These programs make people feel better – makes the people above feel like they’re doing something,” Lichtsinn said.

However, he said, these handlings aren’t all that effective given the quick, impersonal structure. The sessions lack a “real debriefing” where soldiers feel free to share what they think and feel.

 “Soldiers need to emotionally engage in these conversations for them to be effective,” Lichtsinn said.

After serving my six years, I can only recall one time where the approach to suicide prevention training veered away from the standard format. It happened by accident.

My company was based out of Crookston, a rural Northern Minnesotan town near the North Dakota border. We always reported for duty at Camp Ripley, Minnesota’s main military installation in the central part of the state. One December, a scheduling conflict kept us in Crookston for the regularly scheduled suicide training. So we had to improvise. 

Our captain led small group discussions. Boilerplate was gone. Soldiers began to interact, tossing ideas in the ring. I could see the gears turning in people's heads. We weren’t just talking about soldiers. We were talking about our soldiers. Our family.

After Bravo Company 2-136 CAB’s 2023’s standard briefing, Specialist Lee Williams said that he “felt like it wasn’t enough” for him: “The event felt like something that was an obligation instead of actually being something to prevent incidents,” he said.

“The crazy thing is, I actually answered yes to one of the questions,” Williams said.  

The question was whether his concern was affecting his work performance, Williams said. When he replied yes, Williams said the facilitator then told Williams to reach back out if it got really bad for him. 

But in Williams’ view, he said, this was him reaching out.

One year later, his mental health had gotten “really bad” to the point where he was planning to end his life, he said.

“There was a time where I felt absolutely hopeless, and I mean hopeless,” Williams said.

For Williams, neither he nor his leadership were able to get a handle on the situation; no one seemed to really care or take him seriously.

“I’m just another number and I always will be,” Williams said. “I wouldn’t have planned a whole scheme to end my life if I felt like my life was worth something.”

A System Misguided

According to Lichtsinn, the military’s system for identifying at-risk soldiers is “return-to-duty-prescribing based.” In other words, a soldier’s fitness to serve is the priority and central  to their questions and screening process.

 Performance, not mental health, is the focus.

“My guy didn’t even open up my packet,” said Sergeant Kyle Oja, another soldier in the unit.

And another soldier, Alecxander Andrade, confessed that he wasn’t honest when answering the questions on the pre-questionnaire out of fear of getting “flagged.”

“Why bother?” Andrade said.

Fear, according to Lichtsinn, may be the crux of the whole issue.

In Lichtsinn’s experience working at the Minneapolis VA, he found that many soldiers don’t report their struggles with mental health or thoughts of suicide due to the fear of the Medical Evaluation Board, or “the MedBoard process.”

“Soldiers fear ‘the middle place,’” Lichtsinn said.

When soldiers are flagged, they’re put into a state of “‘purgatory’ of not being fully a member of the team, but still property of the military,” Lichtsinn said.

And when it’s not a matter of fear, it’s a lack of faith, according to Lichtsinn.

“Many soldiers don’t believe honesty will help,” Lichtsinn said.

For soldiers who have filed mental health claims, their claims often are denied, or go unanswered by the VA — the very system in place meant to help them.

The VA in general has long since received scrutiny for their claims process, detailing overwhelming reports of backlogs of records, not getting patients treated in a timely manner, and elongated review timelines for medical claims, according to Lichtsinn.

As of Dec 28, 2024, there are still 256,486 total backlogged VA medical claims of all types, according to the U.S. Department of Veterans Affairs.

“The process seems to be motivated by money, or rather saving money by denying valid claims,” Lichtsinn said.

A sense of desperation

Adjacently, as suicide rates have increased and mental health remains a common issue, the military has also faced falling retention rates.

“This younger generation just doesn’t want to serve anymore,” said one Air Force recruiter based out of Minneapolis who did not want to be identified for this story. “And we’re struggling getting people to enlist and stay in.”

“Recruiters everywhere are desperate to meet their quotas,” they said.

And the numbers show it, across all branches. According to data compiled by The Heritage Foundation, the U.S. Army ended the 2023 fiscal year 25% under their recruiting goal. Even worse, the Air Force, the Navy, and the Marine Corps were 50% under their 2023 goal.

In rare cases, the Minneapolis Air Force recruiter said he even witnessed other recruiters “turn a blind eye” to recruits who didn’t meet the mental or physical enlistment standards to help meet their quota.

After enlistment, new Air Force recruits will make their way to Basic Military Training (BMT), an immersive 7.5 week-long training requirement, which in the past, notoriously upheld rumors of being that of a grueling experience.

Now, military recruits experience a more-relaxed BMT, according to one Minneapolis Air Force recruiter.

While going through Air Force Recruiting School, they got the chance to tour modern BMT facilities and observe their conditions. With lessened physical fitness standards, less physical training, and newly-granted cell phone privileges — BMT has gotten much easier in order to get more people through, according to one recruiter.

When I attended Basic Combat Training in 2018, or BCT (the Army’s rendition of BMT), the biggest reason I observed recruits getting sent home, apart from injury, was for mental health. For some people, the pressure of such a high-strung environment was too much for them to handle.

Lt. Eren Roubal made a base-wide adjustment to their cell phone policy after observing a similar pattern within the Navy’s Recruit Training Command (RTC) during the first two to three weeks of training, according to the Defense Visual Information Distribution Service.

“We are hopeful that allowing Recruits continued but limited access to their cell phones and digital identities may help reduce this attrition,” Roubal said.

However there is still concern among some division commanders, like Capt. Ken Froberg, “to do better in this space to prepare our Sailors for a digitally austere operating environment at sea.”

Similar concerns stretch back across the branches. “Basic training is supposed to be hard for a reason, as one Minneapolis Air Force recruiter put it. “The training is no longer preparing people for the things they may need to face one day.”

Redefining “resilience”

You can see a lessening of military standards from the point of enlistment, according to one Minneapolis Air Force recruiter.

But according to  Lichtsinn, it’s at this very point that the screening process needs to be reinforced and revolutionized.

Lichtsinn believes we need to look at the point of enlistment more-critically and re-define the military’s understanding of resilience.

“We know people have different vulnerabilities to the effects of stress — be it inborn or gained through experience,” Lichtsinn said. “The concept of "resilience" is an imperfect term, but there is ample literature illustrating it as something we as humans do not have conscious control over.”

For example, two people could experience the same triggering stimulant, but only one of them may experience PTSD afterward, according to Lichtsinn.

“Exposing one less resilient person to increased stress usually does not make them more resilient in any demonstrable way,” Lichtsinn said. “It reliably can make their stress response worse.”

With a newly-emerging understanding of resilience in mind, Lichtsinn would “like to see a way to somehow use the growing knowledge base around this to more thoughtfully screen our volunteer military service or even better distribute roles.”

Apart from redefining the pillar that is resilience,  Lichtsinn believes the military needs to shift to prioritizing mental health above duty and performance.

Soldiers need an independant way of reporting and assessing; a system they can trust. One that has their best interest and is not money-motivated, according to Lichtsinn.

“But nothing will work without a genuine desire and priority system-wide to help service members that need mental health help, free of bias, free of motivators to downplay or ignore, and free of fear of repercussions to one's reputation, standing, or career,” Lichtsinn said.