TED: 支持美国退伍军人心理健康的可行解决方案

Charles P. Smith! Actionable solutions to support the mental health of US veterans

So on May 6 of 2019,the sun was shining,the sky was blue,clouds were that puffy white.

所以在2019年5月6日，阳光明媚，天空蔚蓝，云是浮肿的白色。

It was a perfect spring day.

那是一个完美的春天。

I was walking back to my office,and my phone rang.

我正走回办公室，我的电话铃响了。

And it was one of my lieutenants.

那是我的副手之一。

I said,"Hey,John.

我说，”嘿，约翰。

How are you?"He said,"Sir,I'm good.

你好吗？他说，〃先生，我很好。

But I've got some bad news."He said our executive officer died that weekend.但我有一些坏消息。他说我们的执行官在那个周末去世了。

We went back and forth,,rWhat do you mean,what are you talking about?”I asked him what happened.

我们来回走，"你什么意思，你在说什么”我问他发生了什么事。

He said,"Sir,he killed himself."I walked around my office for a couple of hours in a complete fog,trying to understand what had happened,why.

他说："先生,他自杀了”我在浓雾中绕着办公室走了几个小时，试图了解发生了什么事，为什么。

I had just communicated with him a few months earlier.

几个月前我刚和他沟通。

And I had no idea that this officer was in trouble.

我不知道这个警官有麻烦了。

And I fault myself as a leader for not having known that.

我责怪自己是一个领导者，因为不知道这一点。

I went on this process of trying to figure out why,what's happening in the veteran community,why are these things going on.

我继续这个过程，试图找出为什么，老兵社区里发生了什么，为什么会发生这些事情。

I read reports from the Department of Veteran Affairs,Department of Defense,I've read national studies on mental health and the issues associated with it.

我读了国防部退伍军人事务部的报告，我读过关于心理健康及其相关问题的全国性研究。

I'm going to share with you some of the things I found out.

我要和你们分享一些我找到的东西。

Department of Veteran Affairs has taken the lead on veteran suicide,and it's actually their number one priority.

退伍军人事务部率先对退伍军人自杀，这实际上是他们的首要任务。

Based on the reports they have and the numbers that I've calculated,between 2001 and 2019,during the time of the Global War on Terror,my approximation is there's 115,000 veterans who have died by their own hands.

根据他们的报告和我计算的数字，2001年至2019年，在全球反恐战争期间，我的近似是有115,000名老兵死于自己的手。

I also looked at the Department of Defense report that lists casualties.

我还査看了国防部列出伤亡情况的报告。

This particular report lists the casualties from October of 2001 specifically to November 18 of last year.

这份特别报告列出了2001年I0月至去年11月18日的伤亡人数。

During that time frame and the Global War on Terror,there have been 5,440 active duty members killed in action.

在那段时间和全球反恐战争中，已有5,440名现役军人在行动中丧生。

So by my numbers,115,000 approximate suicides,5,440 killed in action.

因此，根据我的数字，大约115,000人自杀，5,440人在行动中丧生。

What does that mean to me?

那对我意味着什么？

We have approximately 21 veterans ending their lives by their own hand for every one that is killed by an enemy combatant.

我们有大约21名老兵，他们用自己的手结束了他们的生命，每一个被敌方战斗人员杀死的人。

It's a staggering,staggering number.这是一个惊人的数字。

These national studies that deal with mental health tell us that if you have any type of genetic mental health issue within your family that can be passed on,or if something has happened to you in your childhood that was traumatic,your ability to deal with post-traumatic stress disorder,or PTSD,significantly decreases.

这些涉及心理健康的全国性研究告诉我们，如果你的家庭中有任何遗传性心理健康问题，可以传承，或者如果你童年时发生了创伤性的事情，你处理创伤后应激障碍(PTSD)的能力会显著降低。

They also tell us that if you want to have a full evaluation,determine if somebody has PTSD,you need to have a minimum of one hour interview with a mental health expert that's trained to detect what PTSD is to determine if you suffer from it.

他们还告诉我们，如果你想有一个全面的评估，确定某人是否有创伤后应激障碍，你需要与心理健康专家进行至少一个小时的面谈，该专家经过培训，可以检测什么是PTSD,以确定您是否患有创伤后应激障碍。

Now let me talk about what happens when you enter into the military.现在让我谈谈当你进入military时会发生什么。

When you join the armed forces,you're going to go through a medical exam,you're going to take a physical fitness test,you're going to take a drug test,you're going to take a vocational test so they can figure out what you're good at and hopefully place you in that type of job category.

当你参军时，你要接受体检，你要参加体能测试，你要做药物测试，你要参加职业考试，这样他们就能弄清楚你擅长什么，并希望把你放在那种工作类别里。

But would you believe that with approximately 115,000 suicides over the last 20 years,and the data that we know from the national studies on how to determine if somebody is going to be able to cope with post-traumatic stress disorder,we still don't have a standardized mental health evaluation for our recruits entering into the service.

但是你会相信在过去20年里大约有115,000起自杀事件吗，以及我们从国家研究中了解到的数据，即如何确定某人是否能应对创伤后应激障碍，对于进入该职的新兵，我们仍然没有标准化的心理健康评价。

That's something I think that needs to change.

我认为需要改变的。

Number two,when you leave the service-When I left the service in 2003,1 had to attend some mandatory classes,about two days，worth of classes,and then I was on my way.

第二，当你离开服务时--当我在2003年离开服务时，我不得不上一些必修课，大约两天的课，然后我在路上。

Today,it's a little different.

今天，这有点不同。

Today youll actually get a call if you're on what we call terminal leave or paid time off that you're trying to use up before you actually are fully discharged.

今天，如果您正在休假，或者您试图在完全出院之前使用己用的时间，您实际上会接到一个电话。

I talked to one veteran who got a call.

我和一位接到电话的老兵谈过了。

He was on his way home from work,and the only thing he could think of was,"How quick can I get off this?"And I think the call lasted maybe 10 or 15 minutes.

他正在下班回家的路上，他唯一能想到的就是，"我能多快才能摆脱这个"我想电话大概持续10到15分钟。

But yet the national studies tell us it needs to be an in-person,one-hour interview.

然而，国家研究告诉我们，它需要是一个面对面的，一个小时的釆访。

I think that's something that we can improve upon.

我认为这是我们可以改进的。

There's another thing that the Department of Veteran Affairs talked about in the reports.

退伍军人事务部在报告中谈论了另外一件事。

They said that our service members that are self-medicating tend to be at a significantly higher risk of suicide.

他们说，我们的服务人员，自我治疗往往在自杀的风险高得多。

So those veterans that are self-medicating with alcohol,or drug abuse-and in fact,the Department of Veteran Affairs has classified opioid use disorder,OUD,as one of the epidemics.

所以那些老兵，是自我治疗酒精，或药物滥用-事实上，退伍军人事务部将阿片类药物使用障碍，OUD列为流行病之一。

So as I talked to marines from my unit and tried to learn more about it,I started to find out some really,really alarming things.

因此，当我与我单位的海军陆战队员交谈，并试图更多地了解它，我开始发现一些真正，真的令人震惊的事情。

I had a marine who came back from Iraq and he went to the hospital for a"back pain"and he was prescribed some opioids.

我有一个从伊拉克回来的海军陆战队员，他因为，，背痛“而去医院，他服用了一些阿片类药物。

He also suffered from post-traumatic stress disorder.

他还患有创伤后应激障碍。

He became addicted to these painkillers,because not only did it mask the pain in his back,but it helped him to cope with some of the horrific things that he had to see,experience and do over in the Middle East.

他沉迷于这些止痛药，因为它不仅掩盖了他背部的疼痛，但它帮助他应付一些可怕的事情，他不得不看到，经验和在中东做。

And he eventually overdosed.

他最终服药过量。

Another challenge we have is that when you're on active duty,you are under the Department of Defense.

我们面临的另一个挑战是，当你在现役时，你属于国防部。

And so all of your doctors,all your health care is in that category.

所以，你所有的医生，你所有的医疗保健都属于这一类。

When you leave the service,you are now part of the Department of Veteran Affairs.

当你离开这个部门时，你现在是退伍军人事务部的一员。

So these active duty members that seek help for their mental health issues and are diagnosed with PTSD or other mental health issues,when they leave the service,there's no transition to a doctor that's in the Department of Veteran Affairs or perhaps out in the civilian world because of privacy acts.

因此，这些现役成员，寻求帮助，他们的心理健康问题，并被诊断为创伤后应激障碍或其他心理健康问题，当他们离开服务，没有过渡到医生，在退伍军人事务部，或也许在平民世

界，因为隐私行为。

Now there's some good news in this.

现在有一些好消息。

Just recently,it was legislated that a database will be built that will house both Department of Defense health records and Department of Veteran Affairs health records.

就在最近，据立法规定，将建立一个数据库，将同时容纳国防部的健康记录和退伍军人事务部的健康记录。

But I want to take that thought a step further.

但是我想把这种想法更进一步。

My company was 204 marines and sailors strong.

我公司有204名海军陆战队员和水手。

As I looked at and I talked to my marines from my unit,what we came up with is we are well in excess of a dozen of our members that committed suicide.

当我看着，我从我的部队与我的海军陆战队员交谈，我们想出的是，我们比十几个自杀的成员都多。

When I talk to senior leadership in the battalion,and battalion is about six to seven hundred marines,they estimate that we're in the hundreds who have committed suicide.

当我和营里的高级领导谈话时，和营大约有六七百名海军陆战队员，他们估计我们有数百人自杀。

So let's take this database that we're building,and let's go a little bit further with it.

因此，让我们来拿这个我们正在构建的数据库，让我们更进一步。

What if when a veteran passes away,whether it's natural causes,overdose or suicide,we're able to feed that into the Veteran Affairs who is then able to access Department of Defense records,identify what type of units they were in,what contingencies and operations did they participate in,and let's build the data points to try to figure out are there units that are more susceptible to develop post-traumatic stress disorder so that we can get them the mental health prior to going on deployment,prior to being in theater.

如果老兵去世，无论是自然原因，过量还是自杀，我们能够将这些内容输入退伍军人事务，然后能够访问国防部的记录，确定他们处于何种单位，他们参与的意外事件和操作，让我们建立数据点，试图找出是否有单位更容易发展创伤后应激障碍，以便我们可以让他们在部署之前，在剧院之前心理健康。

If they're in theater,get them the mental health while they're in theater,and get them mental health counseling and help before they even come home out of theater.

如果他们在剧院，让他们在剧院里时心理健康，让他们在走出剧院回家之前为他们提供心理健康咨询和帮助。

(Applause)And by the way,if we can build those sets of data points to be able to do that,we don't just apply them to the military,we can also use that for the general population.

(掌声)顺便说一下，如果我们能建立这些数据集，以便能够做到这一点，我们不只是将它们应用于military，我们也可以用它为一般人口。

If we put our minds together and our resources together,and we openly talk about this,and try to find solutions for this epidemic that's going on in America,hopefully we can save a life.

如果我们把我们的思想和资源放在一起，我们公开谈论这个问题，并试图找到解决在美国发生的流行病的办法，希望我们能拯救生命。

Those are my thoughts,my ideas,I hope that this talk is not the end of this discussion but rather the beginning of it.

这些是我的思想，我的想法，我希望这次讨论不是这次讨论的结束，而是讨论的开始。

And I want to thank you for your time today.

我要感谢你今天的时间。