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Reducing Suicide Rates In The Military

Army Major General Mark Graham lost two sons who were serving in the military, one by suicide, and the other died when a roadside bomb exploded in Iraq. Graham was struck by the different ways his sons' deaths were regarded. He has since enacted measures to ensure that all soldiers from the base he commands in Fort Carson, Colo. receive full military funerals and memorial services, regardless of whether they died in combat or by their own hand.

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Other segments from the episode on May 11, 2009

Fresh Air with Terry Gross, may 11, 2009: Interview with Gretchen Peters; Interview with Major General Mark Graham.

Transcript

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Heroin, The Taliban And The 'Seeds Of Terror'

DAVE DAVIES, host:

This is FRESH AIR. I’m Dave Davies, senior writer for the Philadelphia
Daily News, filling in for Terry Gross.

Much has been written about the resurgence of the Taliban in Afghanistan
and Pakistan and the support a stronger Taliban provides to al-Qaida.
But my guest, journalist Gretchen Peters, believes far too little
attention is being paid to the growing source of cash for the Taliban:
the heroin trade.

She writes that in 2006, Afghanistan produced the largest illegal
narcotics crop a modern nation has ever cultivated in a single harvest,
most of it in areas under Taliban control. The Drug Enforcement
Administration now estimates that opium provides the Taliban with 70
percent of its funding.

Peters has covered Pakistan and Afghanistan for more than a decade for
the Associated Press and later for ABC News. Her new book, “Seeds of
Terror: How Heroin is Bankrolling the Taliban and al Qaeda,” explores
the ties between the two organizations and the drug trade. She also
looks at the conditions that have nourished its growth, including
corruption in the region’s governments and the mistakes and inattention
of U.S. policymakers.

Well Gretchen Peters, welcome to FRESH AIR. There’s been enormous
attention lately to the resurgence of the Taliban in the region, their
increasing level of military activity. To what extent does the Taliban
rely on the narcotics trade for their finances?

Ms. GRETCHEN PETERS (Author, “Seeds of Terror: How Heroin is Bankrolling
the Taliban and al Qaeda”): Well, that is an open question. It’s a very
difficult question to answer because, in part, the Taliban keeps, as far
as anyone knows, very few paper records.

I don’t know if there’s anybody who actually knows what percentage comes
from poppy, but the U.S. military and the U.N. calculate that the
Taliban earn about $400 million a year off the opium trade. I estimate
that they earn as much as half-a-billion dollars because I add in
donations of materiel: trucks, gasoline, medical supplies, weapons. So I
believe the real dollar figure is much higher.

Nobody has any idea how much al-Qaida earns off of the drug trade, but
what we can say is that the Taliban and al-Qaida are earning astonishing
sums of money off of criminal activity, largely the drug industry but
also other criminal activity like extortion, kidnapping, other forms of
taxation in the communities where they hold sway.

But nothing is being done to track that money, and nothing is being done
to try and cut off those profits.

DAVIES: All right, let’s talk about the drug trade specifically. Now,
does the Taliban actually grow the opium? Do they refine it and process
it? Do they deal it themselves, or do they simply tolerate it and make
money from those who do?

Ms. PETERS: It varies by region, their level of involvement. In the
southern part of Afghanistan, where most poppy is grown, in the southern
provinces of Helmand, Kandahar, Nimruz, Farah, in those areas you see
some Taliban commanders who are very much involved in the poppy trade.

In some districts, they will try and dictate the poppy output, how much
farmers are growing. They will tax the crops. They will tax trucks that
are leaving the areas. In other districts, they might just tax the
district leader of the area. They might just take money from the
traffickers as they leave.

So it does seem to vary region by region, but what I have tracked over
the last five years that I have been studying this issue is that their
level of involvement has deepened, and so we now see Taliban commanders
who are running their own refineries along the border.

We now see increased numbers of commanders, district-level commanders of
the Taliban, who are not just taxing shipments of poppy, but they’re
protecting shipments of poppy. They’re actually coming to the protection
of refineries when the NATO forces and Afghan anti-drug troops come in
to try and shut those drug labs down.

We see them expanding vertically through the drugs trade. This is a
pattern of behavior that has also been seen in places like Colombia,
with the Revolutionary Armed Forces of Colombia, better known as the
FARQ.

DAVIES: Now you mentioned refineries. When you say refineries, you’re
talking about, what, labs that process opium into heroin?

Ms. PETERS: I’m talking about labs that process raw opium usually into
morphine base, something that’s referred to locally as brown sugar, and
when I say refineries, I am not talking about particularly elaborate
operations. These are usually mud huts with some plastic drums in them
and some workers who are usually very, very high who are mixing
chemicals and cooking them with opium.

These are very, very rudimentary operations, and increasingly as NATO
troops have moved into southern Afghanistan, I’ve been getting reports
that the refineries are more mobile. They will be built into the back of
souped-up Toyota pickup trucks so they can move from one place to
another.

DAVIES: And some of these labs you mentioned are actually run by Taliban
commanders. They’re getting move involved. I guess the most well-known
Taliban figure in the West is Mullah Omar. You write that there were
rumors, reports, that he had a massive stash of opium himself, what
3,000 tons or something?

Ms. PETERS: Yes. There’s a common misperception in the West that the
Taliban was anti-poppy because of the one year that they banned the
cultivation of poppy while they were in power.

However from my research of their movement and how they came to power in
the first place, they were very, very close to major trafficking rings
that operated along the Afghan-Pakistan border. They continued to tax
the poppy trade and the opium as it was trafficked out of the country
while they were in power, and while they did ban poppy cultivation for
one year, they did not extend that ban to the trafficking of the
processed opium. So they continued to collect taxes off of that.

A lot of the Taliban commanders still today actually collect poppy in
kind. They don’t collect 10 percent of the value of the crop. They
actually, literally will collect five or seven or eight or 10 percent of
the crop itself. So they will keep these huge stashes of opium, and
there has always been this rumor that Mullah Omar himself had an opium
stash of several thousand tons. That would have been worth well over $1
billion, had it ever been smuggled to the West, and nobody’s ever found
it. However, there have been cases where NATO troops and counter-
narcotics forces have come across huge opium stashes when they have
broken up Taliban hideouts.

DAVIES: Now the Taliban that most of us got to know something about in
2001, you know, we thought of them as brutal and terrifying but as
motivated by their own kind of notion of religious piety. Is the Taliban
today, which as you said is becoming more and more integrated into
narcotics and criminal enterprises, has it changed? Is its sense of
piety diluted by its contact with the criminal world?

Ms. PETERS: I think the Taliban is becoming more ruthless. I think
they’ve becoming more violent. They’re more hated in the communities,
the rural communities where they operate. I am certainly not suggesting
that they were ever a particularly warm and cuddly bunch. I mean, it was
a very, very brutal time, and I traveled all over Afghanistan while they
were in power.

Things were very, very dire indeed across Afghanistan, but add that
point, you could travel across Afghanistan, anybody could. They provided
security. They ruled with an iron fist, but the country was very, very
safe.

Now there is just this incredible level of senseless violence. They
behead people who they believe are spies. There are people who get hung
in the main square of villages that they control and left there for days
as a sign of what will happen to anybody who doesn’t follow their
orders.

It’s much more like what we see happening in the drug wars of Mexico and
Colombia. And that’s a point that I try to make in the book, that the
war in Afghanistan often gets compared to the war in Iraq, but to my
mind, what’s happening there is much closer to what we see happening in

Latin America.

As this insurgent group and other extremist groups that also operate
along the border, al-Qaida and other Pakistani insurgent groups, as they
get sucked into crime, they become more and more violent, more and more
ruthless, and they seem to be losing their – the ideological roots of
their movement.

When I say that, I do not mean to suggest that I think al-Qaida and some
of these Pakistani extremist groups have put aside their intention to
attack the West and to attack the governments of Pakistan and
Afghanistan, far from it. They appear to be just as determined as ever
to wreak havoc in those regions and to try and take power and try and
increase the amount of area they control.

DAVIES: And what about the personal lifestyle of the leaders? I mean, do
they personally observe Sharia laws and customs, or do they live more
like the hedonistic lifestyle of a rich drug dealer?

Ms. PETERS: I haven’t found any evidence that people like Mullah Omar
are currently living like hedonistic drug dealers. However, certainly
the major traffickers who work with them certainly have very lavish
lifestyles and hardly behave like pious Muslims.

One of the chapters in my book is about a major smuggler who was
recently captured, whose name is Haji Juma Khan. He was widely known for
having wild and lavish parties that lasted late into the evening with
alcohol and prostitutes that were flown in from Russia and around the
world.

So this was a guy who worked very, very closely with the Taliban, with
al-Qaida and also with corrupt officials in the Afghan and Pakistani
governments, hardly somebody who sounds like your typical Taliban,
though.

DAVIES: Right. I mean, the scale of his empire and power were truly
breathtaking. I mean, he had a 15,000-man army, bought a town, is that
right?

Ms. PETERS: He at one point bought all the land in a small town in
southern Afghanistan. Yes, that’s correct.

DAVIES: And created an artificial lake, and this was a way-station for
his drug convoys, right?

Ms. PETERS: That’s correct.

DAVIES: Yeah, yeah. You know, we’ve been talking about the Taliban more.
Is al-Qaida’s involvement with the drug trade different from the
Taliban? Are they any more ideologically pure? Is Osama bin Laden – do
his principles about involvement or distance from the drug trade differ
from the Taliban?

Ms. PETERS: The story of al-Qaida’s involvement in the drugs trade is
very, very murky, and it’s very difficult to pinpoint, in part because
U.S. officials have flip-flopped on their opinions of it so many times.

Around the beginning of the millennia, around 2000, there were quite a
few statements that came out of senior U.S. officials who tracked this
issue, that they had clear evidence that Osama bin Laden was involved in
the drugs trade.

Later on, when the Bush administration decided to invade Afghanistan,
the way that officials spoke about the drugs trade and al-Qaida’s
involvement in it took a 180-degree turn, and it seemed to be something
they considered a distraction.

And so the decision that appeared to have been made, to simply deny that
al-Qaida was involved in the drugs trade at all, what my research
(missing audio) was that low-level al-Qaida operatives appear to help
move drug shipments for money as those drug shipments leave Afghanistan.

The Taliban is only involved in the drugs industry in Afghanistan within
Afghanistan’s borders. Once it leaves Afghanistan, into Pakistan, Iran,
central Asia, that’s when al-Qaida operatives appear to take over in
some circumstances.

In some circumstances, it’s simply smuggled by traffickers, but there do
appear to be cases where al-Qaida operatives move drug shipments for
money. And this is a point where you really stand to make the most
money. This is where the value of the drugs goes up about – anywhere
between five and 12 times in value.

What I have not been able to determine, if these are just cases of al-
Qaida operatives freelancing for money or if this is a sign that al-
Qaida as a movement is trying to earn money through the drugs trade.

DAVIES: We’re speaking with journalist Gretchen Peters. Her new book is
“Seeds of Terror.” We’ll talk more after a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you’re just joining us, our guest is journalist Gretchen
Peters. Her new book is “Seeds of Terror: How Heroin is Bankrolling the
Taliban and al Qaeda.”

You write in the book that the corruption of government officials is key
in many countries in allowing the drug trade and these other criminal
enterprises to operate. What’s the role of the government of Hamid
Karzai, the Afghan president, in all this?

Ms. PETERS: Well, the role that corruption plays in fueling the
insurgency cannot be underestimated. The Taliban are gaining ground,
both in Afghanistan and Pakistan, not because they are so strong or
because they are so well-loved – they are not in either country. They
are gaining ground because the governments there are so corrupt and so
utterly wretched at governing, and so the importance of trying to create
better governance in both countries is absolutely critical to fighting
this problem, and we’re not going to get anywhere in Afghanistan or in
Pakistan.

We often talk about the drug corruption in Afghanistan. I don’t think
anybody has looked into the extent to which Pakistan’s government has
been corrupted by the drug trade, as well, because you have to remember
that much of the opium that is grown in Afghanistan or produced in
Afghanistan is smuggled out through Pakistan, and there is a tremendous
corruption problem there, as well, and a whole lot more has to be done
to create clean governments in both of those countries if we expect to
increase the level of stability in that region.

DAVIES: I want to talk about the role of the opium farmers themselves.
You know, you begin the book by describing a trip that you took, I think
in 2006, with an opium eradication team from the Afghan military, I
believe, and as they set about destroying these poppy fields, the crops
in these poppy fields, you saw farmers standing by, these poor farmers,
you know, railing at the soldiers, invoking Allah to come and bring down
his wrath upon them, a pretty sympathetic picture to these folks. What
is the role of the farmers themselves? Do they have any option but to
grow opium?

Ms. PETERS: Well again, it depends where they are. I think that in areas
where there is no governance, where the Taliban is in control, in
southwest Afghanistan, a lot of the farmers really do have very few
options. Poppy is a crop that doesn’t rot. It’s easy to transport. There
is an unending demand for it. They can sell it for a lot more money than
most legal crops, and if they grow something like melons or grapes,
they’re likely to get bruised and completely destroyed by the time they
travel down Afghanistan’s bumpy roads to the nearest market.

So a lot of farmers will tell you that they have no choice. In some
areas, they have been threatened by the traffickers, by the Taliban,
that if they don’t grow poppy, they can expect to face dire
consequences.

I really feel a lot of sympathy for the farmers, and particularly what I
feel sympathetic with them about is the fact that so far, most strategy
to try to reduce Afghanistan’s output has focused on the cultivation
side of the drugs trade, and I really think that’s a mistake.

The farmers are the ones who make money, to what extent they do make
money, and that’s another very important question. A lot of them really
don’t profit very much from the poppy trade. Some large farmers do, but
the vast majority are just eking by because of the loan structure. It’s
a very, very difficult market for them.

But where the insurgents and the traffickers make money is on the
production side, where the opium is produced at the lab end of things,
protecting the trade as the convoys leave the region. I believe that
NATO and the U.S. government has done very little to try and hit this
side of the trade, and this is where it will hurt them in their
pocketbooks.

We’ve also done virtually nothing to try and trace the whole money side
of the drugs trade, where the money is laundered, where it ends up.
There’s been virtually nothing done to try and stop that side of the
drugs trade. In fact, we’ve pretty much only focused so far on the
production side of the poppy crop, and I think that’s a mistake. That’s
also turned thousands and thousands and thousands of farmers against
NATO and the United States.

DAVIES: Well you know, as I read in many points in the book you
describing military reluctance to act directly against, you know,
narcotics traffickers, I had to wonder if part of that is the fact that
over the years, there have been warlords and others who are allies of
the United States who are themselves involved in the drug trade, and
that in some respects, you know, we were compromised in going after
these targets.

Ms. PETERS: That’s certainly true. The U.S. military, the CIA and other
international organizations have, at times, aligned themselves with
warlords, regional commanders, who have definite links to the drug trade
and other criminal activity.

I think another issue that has been a problem here is that there has
been this mindset within the U.S. military in particular, and I do see
this changing, but there has been this mindset that the insurgency is a
military matter, and drug smuggling is a problem for law enforcement.

There’s continually this opinion within our government that the DEA and
other counter-narcotics law-enforcement officials are the ones who need
to deal with the drug problem. However, the military is fighting the
Taliban and al-Qaida. I contend that this separation leads us to
failure. If they’re working together, our operations have to be working
together. And I also believe that we have to start looking at fighting
this insurgency more the way a law-enforcement team would fight a
criminal gang.

We need to figure out how to cut these people off from their profits,

that’s a central tenant of any successful counter-insurgency strategy.
Just recently, just last month, the DEA announced that it will now be
sending 80 agents to Afghanistan, and I think that’s a good start. But
what I see a need for is to actually embed law-enforcement officials who
can collect intelligence, collect evidence in each of the military units
that are operating in these areas where the drug trade is taking place.
And the Pentagon does appear to realize now that they’re going to have
to cut off the enemy from this important source of funding.

DAVIES: Gretchen Peters’ book is called “Seeds of Terror.” She’ll be
back in the second half of the show. I’m Dave Davies, and this is FRESH
AIR.

(Soundbite of music)

DAVIES: This is FRESH AIR. I’m Dave Davies, filling in for Terry Gross.
We’re speaking with Gretchen Peters. She’s covered Pakistan and
Afghanistan for more than a decade and has written a new book about the
growing ties between the Taliban and al-Qaida, and the heroin trade. She
writes that the drug trade is now the prime funding source for the
Taliban and should be getting more attention from U.S. policymakers. Her
book is called “Seeds of Terror.”

You know there’s a notion here in the United States that for all of the
enormous effort put into the war on drugs that it’s a terrible failure,
that for all the surveillance and interdiction and arrests, we have
prisons full of people, but the street drug trade continues to flourish
because the demand is what really matters. And I'm wondering - I don’t
know if you agree with that - but what are the implications of that
notion for dealing with this in Afghanistan where we don’t have nearly
the law enforcement infrastructure, and a corrupt government that really
is abetting the narcotics trade?

Ms. PETERS: It’s going to be unbelievably complex to try and clean up
Afghanistan at this point. And I think it can happen but it’s going to
take a huge amount of effort, a lot of money, a fair amount of time. One
of the reasons that the United States has always resisted getting
involved in fighting drugs in Afghanistan is because very little of the
crop of drugs produced there, either the hashish, or the opium actually
ends up in the United States. Our counter-narcotics programs have
traditionally focused on stopping drugs from coming to the United
States, from stopping our citizens from using them basically. So...

DAVIES: But where is the heroin that’s used in America come from if not
from the opium in Afghanistan?

Ms. PETERS: The heroin used in the United States generally comes from
Latin America. So there were points in recent history, as recently as
the 1980s when about 40 percent of the heroin sold in U.S. streets came
from Pakistan and Afghanistan. That’s no longer true. However, I have
heard reports that the amount of Afghan heroin being sold in the United
States is on the increase. But it’s very, very incremental. To me,
what’s the bigger issue is that insurgent groups who are fighting
against U.S. troops in Afghanistan are using money that they get from
the drugs trade to attack our soldiers. Every time a U.S. soldier dies
in an IED attack in Afghanistan there's an extremely good chance that
opium money paid for that IED.

What worries me more is that al-Qaida also appears to be profiting from
the drugs trade, which means the next time, God-forbid, they launch an
attack on the United States there's a very good chance the drug money
will pay for that attack.

DAVIES: It certainly underlines the importance of dealing seriously with
the problem. And in, I guess, the last chapter to your book, you offer,
I guess, it’s about a nine point plan that involves you know serious
interdiction efforts and going after the top criminals, but also things
like providing real alternatives for Afghani farmers, for financial
monitoring and enforcement on the Hawala system of transferring money,
dealing with corruption in the government.

I mean it’s ambitious and I guess pretty expensive. And, you know we
just saw leaders from Afghanistan and Pakistan meet with President Obama
and it was interesting, having just read your book, I looked at the
press reports of, following those meetings and the word opium appeared
about two-thirds of the way down. Are policymakers getting it do you
think?

Ms. PETERS: Well I think officials in Washington recognize how serious
the problem is. The challenge that the Obama administration faces is how
are they going to finance the efforts it’s going to take to turn this
situation around? Afghanistan has already gone way up in cost every
month and we’re about to send another 17,000 troops out there. This is
becoming a very, very expensive operation. And yet, everybody in
Washington seems to be allergic to the idea of nation-building.

The way I look at it: yes, nation-building is going to be expensive. A
lot of the policies that I recommend they take up will be expensive. It
will be very expensive, for example, to try and move poppy farmers on to
alternative crops. Subsidizing the legal crops will be expensive. It’s
already very, very costly - the police reform program that is being
undertaken right now, however, the costs that we incur as a nation by
continuing to fight the Taliban and al-Qaida in that region are far, far
higher.

I just think that down the line the better investment is not to keep
trying to kill Taliban and al-Qaida in the mountains of Afghanistan and
Pakistan, it’s to make them irrelevant to actually create a region that
is stable, that has good governance, that has rule of law. That to me
seems like a better investment. And, in addition, it’s just the morally
right thing to do. These are countries we have, we call our allies, that
we are ostensibly trying to help and yet, whenever I hear officials talk
about what they plan to do in those regions, they seem to be trying to
reduce our expectations that anything good will come out of it. They
seem to be trying to get by, by doing as little as possible.

I think it’s going to be less expensive in the long run to try and
really turn these countries into stable places to live.

DAVIES: Well Gretchen Peters, thanks so much for speaking with us.

Ms. PETERS: No problem.

DAVIES: Gretchen Peters’ book is called “Seeds of Terror: How Heroin Is
Bankrolling the Taliban and al Qaeda.”

Coming up, we speak with a general who’s working to reverse the growth
in suicides in the Army.

DAVIES: This is FRESH AIR.
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Reducing Suicide Rates In The Military

DAVE DAVIES, host:

At least 140 American soldiers committed suicide last year giving the
Army its highest suicide rate in decades. One military leader who’s
taken a lead in addressing the issue is our next guest, General Mark
Graham, Commander of Fort Carson, Colorado. Graham’s experience with the
issue is personal. In June, 2003, his son Kevin, a promising ROTC cadet
at the University of Kentucky, took his own life after battling
depression. Graham’s older son, Jeff, was killed in action in Iraq eight
months later. General Graham has worked as a commander and advocate to
heighten the military’s awareness of stress and mental illness among its
soldiers and to improve their treatment.

Well General Graham, welcome to FRESH AIR. Before military suicide
affected you personally, was this a problem that you were aware of as a
soldier or a commander?

General MARK GRAHAM (Commander, Fort Carson, US Army): Well I was,
certainly not to the extent I am now. You know for years, since I've
been in the Army we’ve done suicide prevention classes. But I have to
tell you, before, you know, years ago, suicide prevention classes where
one of many required classes that you gave and we put the soldiers in
the classroom and we gave them a pretty standard briefing. It was a 30-
minute thing on suicide. And I mean frankly, it was okay, it wasn't very
dynamic and it wasn't - some units I’m sure did a lot better than
others. But it was one of those okay, here we go again. Another class
that’s mandatory required to do.

You know, I mean I guess the phrase to me today is that oh, we get it,
and we’re doing a lot more about it. And we recognize that investigating
a suicide after it’s over is important to do to see what you can learn
from it. But what we really want to do is to get left of this and to
prevent suicides.

DAVIES: When you say get left of it, you mean get out in front of it,
right?

Gen. GRAHAM: Yes.

DAVIES: Yes.

Gen. GRAHAM: Get left of it. You often hear us say...

DAVIES: Right.

Gen. GRAHAM: ...you know get left of the boom. We want to get left of
the event and right, exactly right, get out in front of it so we can
prevent these. Because oftentimes, when you go back and look at suicide,
as is with my wife and I with our son, Kevin, when you go back and look
it, you see the warning signs that were there and you just don’t
understand - why didn’t see this coming? Why, you know, why didn’t we
know this?

DAVIES: Let’s talk about your son, Kevin. In 2003 he was a 21-year-old
ROTC cadet at the University of Kentucky - wanted to be an Army doctor,
right?

Gen. GRAHAM: Yes.

DAVIES: Soldier of great promise, selected for airborne training - at
the time of his suicide I believe you were stationed in Korea.

Gen. GRAHAM: Correct.

DAVIES: Looking back on it, what understanding do you feel you have
about what Kevin was going through that might have led to this?

Gen. GRAHAM: I don’t think I can even imagine what he was going through.
The pain he was going through and his feelings, and his sometimes
hopelessness, I don’t think I can ever - I don’t think I can even think
of fathom what he was going through. I can tell you, I spoke - it took
me a long time before I could ever speak about suicide - but I did speak
one day, probably a year, it was probably a year, a year and a half
after Kevin died. I spoke to a group on a Saturday morning and afterward
I had a man come up to me. And this man came up to me and said, you
know, thank you for speaking out, thank you for saying something about
suicide.

And, of course, I was very emotional. It was pretty hard and it was the
first time I had spoken. And he looked at me and he said, he goes, you
know General, I've tried to take my life three times. He said but let me
tell you because, he goes, I do understand what your son was going
through and let me explain to you. It’s like being in a dark tunnel and
you keep looking to the end of the tunnel to see any light and there is
no light. And he said it’s the most excruciating, worst pain you could
ever imagine, and all you’re thinking about is getting out of the pain
right now. And he goes, that’s what you go through when you go through
this, with depression. And he said I just want to let you know that so
you’re aware of what - a little bit of what your son was going through.

And I’ll tell you, that man helped me right then in a way that it’s been
very comforting to me to at least understand it a little better. You
know I oftentimes tell people you know our sons both died fighting
different battles and I clearly believe Kevin died fighting a battle
with depression and lost the fight.

DAVIES: You know I have to say, I mean I can only imagine how difficult
it was - must be for you to talk about this. Few things are more
heartbreaking than the suicide of a young person, and particularly one’s
own child. But I know that you have a deep commitment to trying to deal
with these issues in the military. And as we look at that, I know that
Kevin, you were aware of his depression and he had been receiving
treatment from it. Now I read that he had stopped taking the medication.
In looking back at that, I wonder if you think the way that the Army
dealt with people who are taking, you know, medications for mental and
emotional issues made it more likely that he would’ve have abruptly
stopped taking it and whether that might have contributed to the
outcome.

Gen. GRAHAM: Well I think that’s part of the stigma. Whether it was the
Army or just society in general, it was part of the stigma to be on
medication, to be on medication for depression. And also, I know there
were side-effects that Kevin probably didn’t like as well. But I
remember one time he even told his mom, he said, mom I don’t want to
have to take a pill to be happy the rest of my life. So those should've
been key warning signs for us to know - this is going down a slippery
slope here in a road that's not good. But we, you know, we heard it, we
listened to him, we, you know, he was getting counseling, he was on
medication.

But he did come off the meds we understand. And that’s one thing I try
to tell people about depression medicine is sometimes it takes a while
for it to start taking effect, and it starts to work, and then they
think well, I'm better now and they stop taking it. And you just, you
can’t do that. You need to go back to your doctor before you change
anything with your medications, whether you come off it or stop and
taper off it or whatever. You got to see a doctor first because it’s
very dangerous to do that. So I think, I mean I think it was just part
of the stigma with Kevin - is you know, not wanting someone to know he
was on them.

DAVIES: It was less than a year after Kevin’s death that your older son,
Jeff was killed while on patrol in Iraq. And, of course, people treat
servicemen and women who are killed in action as heroes. And I'm
wondering if you were struck by any differences in the way people dealt
with you about the differences in the death of your two sons.

Gen. GRAHAM: Absolutely. There’s no comparison. But you know it’s, and
I’ll quote my wife here. When my wife says sometimes, you know, we felt
we were the worst parents in the world when we lost Kevin. And then the
same parents treating our kids, you know, raising our kids the best we
can the same way, eight months later we lose Jeffrey in Iraq and people
said he was a hero, that he helped save lives of his platoon. They were
both heroes to us. They were both great young men. And you’re right.
When we lost Kevin you don’t - you didn’t see anything like you do when
we lost Jeffrey.

DAVIES: So let’s talk about some of the ways the Army needs to change.
The military functions on discipline and, you know, in battlefield
situations there has to be no question about people obeying commanders
and following orders. But that tends to create you know a macho ethic
and one which sort of says you got to suck it up, you got to, you know,
you got to be tough. What are some of the specific ways, what are some
of the ways you think the military culture needs to change and how do
you make that happen?

Major General Graham: Well I think we’re doing it now. I mean I think
we’re making that happen. And senior leaders in the military are clearly
doing that. One is just by their speaking out and letting people know.
But the Army has some programs that the Army is using to help others. A
huge piece of the stigma is getting leaders, from the senior leaders all
the way down to the youngest soldiers, to know more about it, to
understand depression, to understand suicide prevention, to help their
buddies. For example, if a soldier breaks a leg or gets injured or gets
shot in combat, soldiers know what to do. They call for the medic to get
even additional support and then they get that soldier to care. Well, we
need to continue to help our soldiers understand the risk signs and the
warning signs of depression or of potential suicides, so that we can get
that soldier to care before they get hurt.

You know, you wear body armor to protect you before you get shot, but
once you get shot or once you get injured or something with shrapnel or
anything else, you get them to care. So, we need to arm our soldiers
with information so that they are aware. If you see your buddy doing
these things or you hear your buddy saying these sort of things, those
are warning signs that your buddy is reaching out, or your buddy is
telling you know that he’s going through something, you need to get him
to care.

DAVIES: You know, one way to change behavior in any organization is to
change how that organization, you know, rewards and punishes behavior.
And I’m wondering if there’s been any effort to either commend or
promote commanders who are particularly sensitive and help soldiers who
are in mental or emotional trouble, or cases where people have been
demoted or transferred or reprimanded or in some way held accountable
for not giving soldiers help that they need.

Gen. GRAHAM: Well, I mean, I think this is part of the overall big
picture for the - at least for the Army and how we do business. And it
needs to be something that, you know, commanders do think about and I
think they do. I mean, I think the awareness is more now than it’s ever
been in our army and I think commanders are seeing that, that sometimes
- and what we’re trying to do now is help our junior commanders
understand and see - and I mean, for me it’s to see better. If you have
a soldier that is coming to you for an alcohol issue, they got in
trouble for a DUI or a drug offense. You know, get - you know, I know
you’re going to do good order and discipline, you have got to do
something. You can’t condone that. But step back from it, make sure you
get him into substance abuse program, but also step back and look at it
and say, is there more to this.

DAVIES: The issue of military suicides has gotten a lot of media
attention over the last year or two. But when you began raising this
issue a few years back, it was probably less widely talked about. And I
wonder if as you began talking about this within the military, if other
commanders ever might have felt other commanders ever looked at you as
someone who, you know, under the weight of personal tragedy had lost
prospective or gone soft or had undervalued the importance of military
discipline. Did you ever get that sense from folks as you tried to raise
this issue?

Gen. GRAHAM: No. Actually when we lost Kevin, our military family is -
you know, the Army seems like a huge organization, but I can tell you
the Army gets pretty small pretty fast. When we lost Kevin, the Army was
there for us every step of the way. It was pretty tremendous. Our own
family, I think, was even taken aback a little bit about how great the
Army was to us and how supportive they were to us when we lost Kevin to
suicide. The ROTC Detachment at the University of Kentucky, the active
army, everyone was wonderful. And the Army even told my son Jeff - a
Major General Terry Tucker was the commanding general at Fort Knox,
Kentucky at that time - and he even told my son Jeff, you know, who was
scheduled to go Fort Riley to deploy with the unit from the 1st Infantry
Division, General Tucker told my son, you know, you don’t have to go to
that assignment. We’ll keep you here at Fort Knox and we’ll give you a
different job. But you’ve been through a tragedy in your family and if
you want to stay here, we will keep you here and you won’t have to
deploy here.

And my son told them, thank you very much but he said I need to go be
with my men. So, as a dad, that was hard. As a soldier, I understood why
my son made that decision but as a father that was a hard one for me.
Because as a dad, I was, you know - I think of, you know, maybe if Jeff
would’ve stayed and, you know, and wouldn’t have deployed what would’ve
happened. But I mean there is a - I do believe there is a plan out
there. I don’t get to vote on it, but I do believe there is one.

DAVIES: We’re speaking with General Mark Graham. We’ll talk more after a
break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you’re just joining us, our guest is General Mark Graham.
He’s the commander of Fort Carson in Colorado and has been active in
getting the military to devote more attention to the issue of military
suicides. General Graham, you know, there’s a lot of attention paid to
the suicide rate in the military in 2008. To what extent do you think
the increase in suicides that we’ve seen are related to the repeated
deployments to Iraq and Afghanistan?

Gen. GRAHAM: Well, I think it clearly - I mean, I think it’s clearly
hard on soldiers and their families. So, I don’t – I mean, I don’t think
there is any question about it. I think that’s pretty well understood
that this is hard - these are hard times for our nation and for our
army. And our - you know, the leaders of our army have said our army is
stressed and it is and the families are too. And those - you know, some
– and that’s why it’s so - even more important now we’re aware of the
warning signs.

To - when you see that - and I call it a crescendo - when you see that
crescendo coming of risk factors and warning signs, we need to get in
early and intervene early to assess the soldier and his family.

DAVIES: You took command of Fort Carson, I believe, in September of
2007. Is that right?

Gen. GRAHAM: Yes.

DAVIES: Yeah. Now there had been a fair amount of some criticism and
controversies surrounding the treatment of some servicemen at Fort
Carson. There was a piece in Salon, the online magazine, about a soldier
who had tape recorded a session with a psychiatrist and he had tape
recorded it because he had a short-term memory loss. And according to
the story, the psychiatrist confessed to him that he had been getting
pressure to downgrade diagnosis, so that people - soldiers were not
diagnosed with post-traumatic stress disorder, which would suggest that,
you know, there was a way - in a way mental health issues weren’t being
taken as seriously as they should have been perhaps to save money in
treatments and benefits. What do you make of that case?

Gen. GRAHAM: Well, I’ll tell you. The – when I found out about that -
and it was a summer of 08 that I found out but I think, it was on the
2nd of July actually - and when I found out about it, we were – I
reported that up - quickly up the chain of command, through the medical
chain as well as the normal chain of command, to make leaders at higher
levels aware. And the concern was if one provider would have said, you
know, something like this provider said would’ve been one thing, but
when the provider said that they all were feeling this pressure, that to
me was a red flag and a concern.

So we raised the issue up the Army medical command immediately, set a -
decided to do a 15-6 investigation on this. And they sent someone from
the Department of the Army level. So, it was not even in – not a Fort
Carson person, but not even from the medical region, it was a person out
of Washington that came down here. So they were very removed from the
situation. And he came down and did the investigation and interviews and
talked to determine what - is there something here.

I mean, what’s going on here and they did that. They came out and looked
at this and made some determinations. I have not seen that report. But I
know others have. And they made a determination that they didn’t – they
did not see any evil or wrong doing there on the part of that. There
were some challenges and part of it was the documentation to determine
PTSD. But the Army made a change in December of ‘08. They changed the
criteria for determining PTSD and the diagnosis of PTSD.

DAVIES: Right.

Gen. GRAHAM: And I can’t tell you the results of that. But intuitively I
think what you’ll see is, is that will solve some of those challenges.
Now, that doesn’t mean it’s all going to get corrected and - to the
satisfaction of some. But I think it will be easier now to show - for
them to show PTSD because of their requirement. There’s a requirement
that was in there before, that’s now been taken out.

DAVIES: Yeah. I mean just to finish the record on this, I mean Salon
said in their follow-up interviews, it appears that the army
investigation actually did not include an interview of the psychiatrist
who was tape recorded saying that he had been pressured to change the
diagnosis or the person who had headed the Department of Behavioral
Health there. Do you feel like you have - that you have to battle with
people in the Army command structure to get these issues taken
seriously?

Gen. GRAHAM: No, I don’t. I mean actually I don’t think I have to battle
with them. I think we work through these together. And part of my job as
the senior commander here is to raise these level issues to the senior
levels, so that they can look at these as in this investigation did, so
they can look at these independently.

DAVIES: You’ve said that there were encouraging signs in the way the
Army is dealing with issues of stress and mental illness and suicide
prevention. Are there ways to - are there things you see that tell you
the military still has some work to do on this area?

Gen. GRAHAM: Well, we’re still having suicides. You know, will we ever
stop all suicides? You know, I’m an optimist, but frankly I don’t think
we will. We - you know, one is too many. So, I think that is a sign
that, you know, we’re still losing soldiers. And losing one soldier to
suicide is too many. Sergeant Major of the Army Preston army has said
that himself. He said, you know, one - losing one soldier to suicide is
one too many. So, I mean, to me that’s the indicator, is how we help
these soldiers and families and keep helping them to prevent suicides
but also to get them help from behavioral health issues.

DAVIES: Well, General Graham I want to tell that we certainly honor the
sacrifice of your two sons and wish you and your family the best. And
thanks so much for speaking with us.

Gen. GRAHAM: Well, you’re welcome. And if I could before you sign off,
you know, the gravesite of my son, Jeff and Kevin, after we buried our
son Jeff, who was killed in Iraq, my wife and I went back to the
gravesite the next morning and at the gravesite, someone had left a
banner with a magic marker written on a banner, hung next to the
gravesite of our boys and on that banner it said, land of the free
because of the brave.

And I certainly believe that. And to this day, we don’t know who put the
banner there, but in everything I do and everything I say and write, I
put on there now, land of the free because of the brave. And I’ll use it
the rest of my life because I think this is the land of the free because
of the brave. And, you know, I think both my boys were brave men.

DAVIES: Major General Mark Graham is a 32-year-old veteran of the army
and commander of Fort Carson, Colorado.

(Soundbite of music)

DAVIES: You can download podcasts of our show at freshair.npr.org. For
Terry Gross, I’m Dave Davies.
..COST:
$00.00
..INDX:
104008228
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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