Suicide Prevention among Men Who Experience Military Sexual Trauma (MST)

Co-authored by Guest Blogger Katie Dorsey

 Photo Credit: Joint Base Myers-Henders

Photo Credit: Joint Base Myers-Henders

Military Sexual Trauma: What is it? How does it affect men?

Military Sexual Trauma (MST) is defined by the Veterans Health Administration (VHA) as sexual harassment that is threatening, or physical sexual assault that occurs while serving in the military regardless of location or gender, and has a prevalence rate among men of up to six percent (Klingensmith, et al, 2014).  While most studies about MST focus on women, “the VA reports that 54% of VA users who screen positive for MST are men” who may experience a higher burden of stigma resulting in overall lower rates of reporting (Klingensmith, et al, 2014). 

Why Should We Be Concerned about MST and its Link to Suicide?

Military sexual trauma is not a mental health condition, but can lead to mental health conditions like depression or anxiety. When a man has a part history of trauma and then experiences MST, the effects are compounded. When sexual trauma happens in the military, feelings of betrayal often emerge because the expectation is that those who serve alongside you are meant to protect, not harm you. The effects of this broken trust can be devastating. Given the social nature of the military and the likelihood that a victim of MST would have to continue to work or live near their assailant, the environment alone may create conditions for prolonged exposure, leaving an impact like that of on-going family violence (Kimerling, et al, 2007). 

A history of MST is linked to increased rates of Post-Traumatic Stress Disorder (PTSD), anxiety, depression, decreased cognitive functioning, decreased quality of life, a two-fold greater risk of suicidality, and increased past and present engagement with mental health services (Klingensmith, et al, 2014).  Because MST is underreported, there is a chance that someone who has experienced MST may engage in mental health services but not disclose the trauma, thus, not receive the appropriate care.

In general, Veterans are at a higher risk for suicide and those who experience MST have further elevated rates of non-fatal suicide attempts (Kimerling, et al, 2016).  MST can lead to intense feelings of isolation, confusion and anxiety. For many men the idea of talking about their sexual assault can be more terrifying than experiences in combat. While women are often trained to be on guard for sexual assault, most men are not, and this can lead to shame and thoughts that they should've been able to prevent it. Because of these connections, men who have experienced MST may be eligible for disability compensation. More here: https://www.benefits.va.gov/BENEFITS/factsheets/serviceconnected/MST.pdf

What Can Be Done?

First, men who have experienced MST should know that they are not alone. The Make The Connection program offers a number of videos of men and women sharing their stories of recovery: https://maketheconnection.net/conditions/military-sexual-trauma.

Second, we need to find a better way to identify men experiencing MST much earlier to alleviate unnecessary suffering. The link between MST and greater risk of suicide has prompted the VA to engage in further collaboration between mental health programs and suicide prevention efforts for those who screen positive for MST (Kimerling, et al, 2016).  This screening tool may provide an important first step in the process: http://afterdeployment.dcoe.mil/topics-military-sexual-trauma. 

Third, we need to train mental health service providers serving male in the military and Veterans to consider these experiences are more common than are disclosed and to be prepared to help. For example, each branch of the military has Sexual Assault Response Counselors that can be reached through Military OneSource (1-800-342-9647).

Efforts to increase suicide prevention include “ongoing training on MST-related mental health issues for staff at the VHA national suicide prevention crisis hotline; facilitating communication between MST coordinators and suicide prevention coordinators; and including MST in VA suicide prevention predictive modeling” (Kimerling, et al, 2016, p 688).  The VA model for suicide prevention offers a comprehensive approach that offers specialized MST coordinators, mental health care, a nationwide crisis hotline, and medical treatment as needed at no cost to the Veteran.  If the information available continues to reflect a significant underreporting of MST by men, it is likely that the VHA underestimates the severity of this issue, and may not be fully equipped to manage care for all men who have experienced MST.

The VA’s approach to comprehensive care focuses on access, and while men may see that there is access to care for MST, they may not consider it a possibility if it requires disclosure.  Additional programs that target men as the recipients of educational interventions focused on MST may help to take down some of the barriers to disclosure, allowing them to fully access the services provided.  While suicide prevention is a typical component of mental health interventions in general, if clinicians are unaware of the history of MST and how it impacts the development of other diagnoses as well as increasing the risk for suicide, suicide prevention methods may fall short for these men.  Continued screening for MST even when the man has previously denied such an experience, may present additional opportunities for disclosure, especially when screening questions might be asked by different providers.  Men make up the majority of population using VA services, experience rates of MST similar to women, but underreport at a higher rate.  

Support Resources

Anonymous Trauma Peer Support Support Groups: Providing trauma groups for men with a history of MST that are separate and different from those who experience PTSD because of combat may offer access to treatment that allows for more specific care, and potentially lowers the threat of disclosure and shame surrounding it. The DoD Safe Helpline hosts Safe HelpRoom sessions for military men every Sunday from 1:00 PM-3:00PM ET. HelpRoom sessions provide men with a confidential and anonymous opportunity to connect and share their experiences with other MST survivors. The sessions offer a secure, moderated group chat service where military sexual assault survivors can find peer support. For more information visit www.safehelproom.org. Download the official flyer here.

Crisis Support: Veterans can also access support through the Veterans Crisis Line and text https://www.veteranscrisisline.net/ or Safe Helpline at 1-877-995-5247.

Overall, the programs and services developed and implemented by the VHA appear to offer a comprehensive approach to minimizing suicide among Veterans who have experienced MST.  What may be more challenging moving forward is further engaging male Veterans by supporting disclosure, offering gender-specific interventions, and further implementing interventions that seek to decrease access to lethal means.

References

Kimerling, R., Gima, K., Smith, M.W., Street, A.E., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97, pp. 2160-2166.

Kimerling, R., Makin-Byrd, K., Louzon, S., Ignacio, R.V., & McCarthy, J.F. (2016). Military sexual trauma and suicide mortality. American Journal of Preventive Medicine, 50(6), pp. 684-691.

Klingensmith, K., Tsai, J., Mota, N., Southwick, S., & Pietrzak, R.H. (2014). Military sexual trauma in US Veterans: Results from the National Health and Resilience in Veterans study. Journal of Clinical Psychiatry, 75(10).

About the Author

Katie Dorsey

Katie A. Dorsey honorably served over 8 years in the Air Force as an Instructor Airborne Surveillance Technician aboard the AWACS out of Oklahoma City, OK.  She earned her Master of Education in Counseling Psychology from Teachers College, Columbia University in 2015, and is currently a third-year PsyD student at the University of Denver's Graduate School of Professional Psychology.  

Katie has provided mental health services as a Volunteer Hospital Advocate for the Oklahoma City YWCA's Sexual Assault Victims Advocacy Program, at the United States Air Force Academy, Denver County Jail, and soon at Federal Corrections Institute - Englewood, CO.  In her spare time she enjoys reading, hiking, and caring for her Great Dane.

Katie A. Dorsey, Ed.M., M.A., LPCC

SSgt, United States Air Force Retired

Denver FIRST Clinician

Doctoral Student, Clinical Psychology

Graduate School of Professional Psychology
University of Denver

Katie.Dorsey@du.edu

Sally Spencer-Thomas is a clinical psychologist, inspirational international speaker and an impact entrepreneur. Dr. Spencer-Thomas was moved to work in suicide prevention after her younger brother, a Denver entrepreneur, died of suicide after a difficult battle with bipolar condition. Known nationally and internationally as an innovator in social change, Spencer-Thomas has helped start up multiple large-scale, gap filling efforts in mental health including the award-winning campaign Man Therapy and the nation’s first workplace suicide prevention initiative. Because of these efforts, she was an invited speaker at the White House in 2015.

Her goal is to elevate the conversation and make suicide prevention a health and safety priority in our schools, workplaces and communities. Spencer-Thomas has also held leadership positions for the National Action Alliance for Suicide Prevention, the International Association for Suicide Prevention, the American Association for Suicidology, and the National Suicide Prevention Lifeline. She has won multiple awards for her advocacy including the 2014 Survivor of the Year from the American Association of Suicidology, the 2014 Invisible Disabilities Association Impact Honors Award, and the 2012 Alumni Master Scholar from the University of Denver, the 2015 Farbarow Award from the International Association for Suicide Prevention and the 2016 Career Achievement Alumni Award from the University of Denver’s Graduate School of Professional Psychology.

She has a Doctorate in Clinical Psychology from the University of Denver, Masters in Non-profit Management from Regis University, a Bachelors in Psychology and Studio Art with a Minor in Economics from Bowdoin College. She has written four books on mental health and violence prevention. She lives with her partner and three sons in Conifer, Colorado.

Connect with Dr. Spencer-Thomas by visiting her website: www.SallySpencerThomas.com and following her on Facebook @DrSallySpeaks, Twitter @sspencerthomas and LinkedIn. To learn more participate in her monthly podcasts, blogs and twitter chats!

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