关爱美国退伍军人心理健康的可行方案 Charles P. Smith: How the US can address the tragedy of veteran suicide

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演员: Charles P. Smith


台词
So on May 6 of 2019,
2019 年的 5 月 6 日,
the sun was shining, the sky was blue,
阳光灿烂,天空蔚蓝,
clouds were that puffy white.
云蓬松而洁白。
It was a perfect spring day.
这是春天里一个完美的日子。
I was walking back to my office,
我正在往办公室走,
and my phone rang.
突然手机响了,
And it was one of my lieutenants.
是我的一个中尉打来的。
I said, "Hey, John.
我说:“你好,约翰。
How are you?"
最近还好吗?”
He said, "Sir, I'm good.
他说:“长官,我很好。
But I've got some bad news."
但是我有一个坏消息。”
He said our executive officer died that weekend.
他说我们的执行长官 在那个周末去世了。
We went back and forth,
我们继续交谈着,
"What do you mean, what are you talking about?"
“这是什么意思?你在说什么?”
I asked him what happened.
我问他发生了什么。
He said, "Sir, he killed himself."
他说: “长官,他自杀了。”
I walked around my office for a couple of hours in a complete fog,
我茫然地在办公室里 徘徊了几个小时,
trying to understand what had happened, why.
尝试去理解究竟发生了什么, 以及背后的原因。
I had just communicated with him a few months earlier.
我在几个月前刚和他交流过。
And I had no idea that this officer was in trouble.
我完全没有想到这位军官 正陷入麻烦之中,
And I fault myself as a leader for not having known that.
也并不知道这件事 是我作为一个领导的失职。
I went on this process of trying to figure out
于是,我开始尝试弄清楚
why, what's happening in the veteran community,
退伍士兵群体中正在发生什么,
why are these things going on.
事情为什么会这样。
I read reports from the Department of Veteran Affairs,
我阅读了来自 退伍军人事务部
Department of Defense,
和国防部的报告,
I've read national studies on mental health
我读了关于心理健康
and the issues associated with it.
和相关问题的国家研究。
I'm going to share with you some of the things I found out.
我将和你们分享一些我的发现。
Department of Veteran Affairs has taken the lead on veteran suicide,
退伍军人事务部负责 带头调查退伍军人自杀事件,
and it's actually their number one priority.
这其实也是他们工作的重中之重。
Based on the reports they have and the numbers that I've calculated,
根据他们的报告和我的计算,
between 2001 and 2019,
在 2001 年到 2019 年
during the time of the Global War on Terror,
全球反恐战争期间,
my approximation is there's 115,000 veterans
据我估计, 大约有11 万 5 千名退役老兵
who have died by their own hands.
死于自杀。
I also looked at the Department of Defense report
我同时也阅读了记录伤亡者的
that lists casualties.
国防部报告。
This particular report
这个报告
lists the casualties from October of 2001
列出了从 2001 年 10 月 到去年 11 月 18 号的
specifically to November 18 of last year.
所有伤亡军人的信息。
During that time frame and the Global War on Terror,
在那段时期的全球反恐战争中,
there have been 5,440 active duty members killed in action.
有 5440 名现役军人 在行动中阵亡。
So by my numbers, 115,000 approximate suicides,
所以根据我的统计, 有大约 11 万 5 千人自杀,
5,440 killed in action.
5440 人在行动中阵亡。
What does that mean to me?
这对于我来说 意味着什么?
We have approximately 21 veterans ending their lives by their own hand
每当一位军人 在敌人手中牺牲,
for every one that is killed by an enemy combatant.
就有 21 位退伍军人 结束了自己的生命。
It's a staggering, staggering number.
这是个非常惊人的数字。
These national studies
这些关于心理健康的
that deal with mental health tell us
国防报告告诉我们,
that if you have any type of genetic mental health issue within your family
如果你的家族存在 有可能导致精神健康问题的
that can be passed on,
遗传基因,
or if something has happened to you in your childhood that was traumatic,
或者你在童年经历过创伤,
your ability to deal with post-traumatic stress disorder, or PTSD,
你处理创伤后应激障碍(PTSD)的能力
significantly decreases.
会明显下降。
They also tell us
他们也告诉我们,
that if you want to have a full evaluation,
如果你想要 一个全面的评估,
determine if somebody has PTSD,
判断某人是否患有 PTSD,
you need to have a minimum of one hour interview
你需要和一位心理健康专家
with a mental health expert
进行至少一个小时的面谈。
that's trained to detect what PTSD is
他们受过相关的训练,
to determine if you suffer from it.
可以判断你是否患有 PTSD。
Now let me talk about what happens when you enter into the military.
现在我来讲讲, 当你进入军队后会发生什么。
When you join the armed forces,
当你入伍之后,
you're going to go through a medical exam,
你需要通过一个健康检查,
you're going to take a physical fitness test,
你需要参加一个体能测试,
you're going to take a drug test,
你需要参加一个药物检测,
you're going to take a vocational test
你需要参加一个特长考试,
so they can figure out what you're good at
这样他们才能弄清 你善于干什么,
and hopefully place you in that type of job category.
然后有可能将你放在 合适你的工作岗位上。
But would you believe
但是你能相信吗?
that with approximately 115,000 suicides over the last 20 years,
得知过去二十年间 有超过 11 万 5 千起自杀,
and the data that we know from the national studies
以及根据国防报告的数据,
on how to determine if somebody is going to be able to cope
我们也知道了如何判断某人
with post-traumatic stress disorder,
是否有能力克服 PTSD,
we still don't have a standardized mental health evaluation
我们却依旧没有一个 用于服务新兵的
for our recruits entering into the service.
心理健康评判标准。
That's something I think that needs to change.
这是我觉得 需要改变的地方。
Number two,
第二点,
when you leave the service --
当你退伍的时候——
When I left the service in 2003,
我在 2003 年退伍的时候,
I had to attend some mandatory classes,
需要参加一些为期两天的
about two days' worth of classes,
强制性的课程,
and then I was on my way.
然后我才可以正式退伍。
Today, it's a little different.
现在,这一流程有了一些变化。
Today you'll actually get a call
现在,如果你在享受退伍前的
if you're on what we call terminal leave
终端休假,
or paid time off that you're trying to use up
或者剩余的带薪休假,
before you actually are fully discharged.
你会接到一个电话。
I talked to one veteran who got a call.
我曾和一个接到过这个电话的 退伍士兵聊过。
He was on his way home from work,
他当时正在下班回家的路上,
and the only thing he could think of
他唯一可以想到的东西
was, "How quick can I get off this?"
就是,“我如何才能尽快摆脱这件事?”
And I think the call lasted maybe 10 or 15 minutes.
我记得这个电话持续了 大概 10 到 15 分钟。
But yet the national studies tell us
但是国防报告告诉我们,
it needs to be an in-person, one-hour interview.
这应该是一个一对一, 持续一个小时的面谈。
I think that's something that we can improve upon.
我认为这也是我们可以改进的地方。
There's another thing that the Department of Veteran Affairs
退伍军人事务部还在报告中
talked about in the reports.
提到了一件事。
They said that our service members that are self-medicating
他们说选择自我治疗的军人们
tend to be at a significantly higher risk of suicide.
有更显著的自杀风险。
So those veterans that are self-medicating with alcohol,
也就是那些选择用酒精 或者滥用药物
or drug abuse --
来进行自我治疗的——
and in fact, the Department of Veteran Affairs has classified
事实上,退伍军人事务部已经将
opioid use disorder, OUD,
阿片类药物使用障碍 (OUD)
as one of the epidemics.
定义为一类流行疾病。
So as I talked to marines from my unit
所以当我与我所在的 海军陆战队的士兵聊天,
and tried to learn more about it,
想要获取更多信息时,
I started to find out some really, really alarming things.
我发现了很多绝对需要 引起重视的事情。
I had a marine who came back from Iraq
我有一个从伊拉克回来的士兵,
and he went to the hospital for a "back pain"
他曾经去医院治疗背痛,
and he was prescribed some opioids.
然后他使用了一些阿片类药物。
He also suffered from post-traumatic stress disorder.
他也同样患有 PTSD。
He became addicted to these painkillers,
他变得对这些止痛药上瘾,
because not only did it mask the pain in his back,
不仅仅因为 它们可以消除他背部的疼痛,
but it helped him to cope
也因为它们可以帮助他应对
with some of the horrific things that he had to see, experience and do
一些他在中东看到、 体验到和做过的
over in the Middle East.
非常糟糕的事情。
And he eventually overdosed.
结果导致了他用药过量。
Another challenge we have
我们要面对的另一个挑战是,
is that when you're on active duty,
当你还是现役军人的时候,
you are under the Department of Defense.
你隶属于国防部。
And so all of your doctors, all your health care
所以你能接触到的 所有医生和医疗设施,
is in that category.
都属于那个种类。
When you leave the service,
在你退伍之后,
you are now part of the Department of Veteran Affairs.
你隶属于退伍军人事务部。
So these active duty members
所以这些需要心理健康疏导,
that seek help for their mental health issues
并被诊断患有 PTSD 或其他心理健康疾病的
and are diagnosed with PTSD or other mental health issues,
现役军人,
when they leave the service,
当他们退伍的时候,
there's no transition to a doctor
因为需要遵守隐私法,
that's in the Department of Veteran Affairs
所以他们无法平稳过渡, 以顺利接受
or perhaps out in the civilian world
退伍军人事务部
because of privacy acts.
或者外界的医疗服务。
Now there's some good news in this.
现在我们有了一些好消息。
Just recently, it was legislated
就在最近,有新的立法提出,
that a database will be built
将建立一个数据库来容纳
that will house both Department of Defense health records
国防部和退伍军人事务部的
and Department of Veteran Affairs health records.
健康档案。
But I want to take that thought a step further.
但是我希望能更进一步。
My company was 204 marines and sailors strong.
我的公司由 204 名 海军陆战队队员和水手组成。
As I looked at and I talked to my marines from my unit,
当我们在一起聊天时,
what we came up with is we are well in excess of a dozen
我们意识到, 也曾有十几位我们的同伴
of our members that committed suicide.
选择了结束自己的生命。
When I talk to senior leadership in the battalion,
当我和这个营的领导 聊到这个话题——
and battalion is about six to seven hundred marines,
一个营大约有 600 到 700 名海军成员——
they estimate that we're in the hundreds who have committed suicide.
他们估计,我们有 数百个成员死于自杀。
So let's take this database that we're building,
那么,我们不妨赋予这套
and let's go a little bit further with it.
即将建立起来的数据库更多功能, 让它能关注更多的东西。
What if when a veteran passes away,
如果我们有一位退伍军人去世了,
whether it's natural causes,
不管是因为自然原因,
overdose or suicide,
用药过量或者自杀,
we're able to feed that into the Veteran Affairs
我们都可以将这一事实反馈到 退伍军人事务部,
who is then able to access Department of Defense records,
再由他们通过查询国防部的数据,
identify what type of units they were in,
分辨出这个老兵来自于哪个部门,
what contingencies and operations did they participate in,
他们参与过什么紧急行动和任务。
and let's build the data points to try to figure out
我们也可以建立数据点, 想办法弄清楚
are there units that are more susceptible to develop post-traumatic stress disorder
有没有更容易发展出 PTSD 的部门,
so that we can get them the mental health
这样我们就能让他们在被部署之前,
prior to going on deployment,
在进入战区之前
prior to being in theater.
得到心理健康方面的帮助。
If they're in theater,
如果他们身处战区,
get them the mental health while they're in theater,
可以就地给他们提供医疗服务,
and get them mental health counseling and help
在他们离开战区回家之前,
before they even come home out of theater.
给予他们应得的心理疏导和帮助。
(Applause)
(掌声)
And by the way,
另外,
if we can build those sets of data points to be able to do that,
如果我们能够成功设立这些数据点,
we don't just apply them to the military,
我们不会只把他们运用在军事领域,
we can also use that for the general population.
也可以用在广大公众身上。
If we put our minds together
如果我们团结一心,
and our resources together,
调动所有可用的资源,
and we openly talk about this,
开诚布公的谈论这件事,
and try to find solutions
并且尝试为当前
for this epidemic that's going on in America,
在美国肆虐的这一流行病 找到解决方案,
hopefully we can save a life.
我们也许就可以拯救一条生命。
Those are my thoughts, my ideas,
这些是我个人的一些想法,
I hope that this talk is not the end of this discussion
我希望这个演讲并不是 相关讨论的尾声,
but rather the beginning of it.
而是这个话题的起点。
And I want to thank you for your time today.
非常感谢大家的聆听。
(Applause)
(掌声)