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During the past year, the installation's medical and substance abuse experts have seen an increase in stress among Soldiers and Department of the Army civilians that has resulted in concerns about suicide, workplace burnout and hostility.

"The operations tempo [of the military], global wars, fighting two wars, are causing a lot of stress," said Kenneth Jones, Army Substance Abuse Program manager.

"We're obviously concerned about the Soldiers, the increase in suicide activity - gestures, attempts - and thoughts of suicide," he said. "We're starting to see cases of Department of the Army civilians under serious stress - expressing self-harm and thoughts of harm."

Jones said the operations tempo of the wars in Iraq and Afghanistan and repeated deployments have taken a toll on the Army in general.

Although Fort Meade does not deploy large numbers of Soldiers such as Fort Bragg, N.C., or Fort Campbell, Ky., those individual service members who do deploy do not have the same support that comes from the camaraderie of deploying with a large unit, Jones said.

In addition, Fort Meade also deploys an increasing number of government civilians who deploy as individuals and do not benefit from unit camaraderie.

Dr. Mark Fisher, chief of behavior pediatrics at Kimbrough Ambulatory Care Center and a Medical Department Activity subject matter expert on suicide, said Soldiers are experiencing stress from working long hours with decreased resources, deployments and family issues.

"Stress comes in the form of relationship problems at work and home, loss of sleep, anxiety, depressed moods, irritability and sometimes decreased productivity," Fisher said. "With stressors and other risk factors piling up, along with a decreased sense of hope and not seeing a way out of their problems, service members start to think about not wanting to live or of killing themselves."

Victor Arthur, Risk Reduction Program coordinator for ASAP, routinely surveys units on post using the Army's anonymous Unit Risk Inventory to determine how susceptible Soldiers are to risk factors relating to alcohol and drugs, and other stressors.

Arthur surveys Soldiers who are within 30 days of deployment and those who have returned from deployment.

Within the past four months, 10 Soldiers have answered positively that they have had suicidal thoughts, Arthur said. Three Soldiers responded that they have made a plan to commit suicide.

In response to the inventory, Arthur spoke with their unit commanders to inform them of the potential for suicide. A chaplain was assigned to the units to discuss stress and suicide.

In addition, Arthur said Soldiers also have expressed a lack of trust in their chain of command.

DA civilians also are feeling the strain of increased pressures in the workplace, mostly due to budget cutbacks.

Last July, the Installation Management Command directed Fort Meade and other Army installations to reduce its civilian appropriated funded authorizations for fiscal year 2013 to 15 percent below its June 2011 onboard civilian strength.

Other IMCOM directives also have mandated a reduction in the civilian workforce, according to the installation's Resource Management Office.

The cuts mean remaining employees are required to take on additional responsibilities.

"They're under a lot of stress, having to do the job of two or three people," said Marcia Lang, clinical supervisor for ASAP and acting manager of the Employee Assistance Program.

The EAP provides confidential services for service members, government employees, their dependents and retirees, including short-term therapy and referrals to civilian mental health professionals for psychiatric as well as abuse-related challenges. The program also helps civilians identify and resolve personal problems that affect their job performance and well-being.

Lang said the stress has made civilian employees more susceptible to physical aches and pains and colds due to a weakened immune system.

Clients also complain that the pressures of their job "consumes life outside of work," Lang said, and that people find it hard to relax and spend quality time with family and friends.

In the past year, about 25 percent of the civilians Lang has served have been so depressed that they have contemplated suicide.

"Luckily, I have not had anyone so depressed that they acted on it, or had a plan or a means of hurting themselves," she said.

About 10 percent of civilian clients have been so stressed and angry that they have been referred to EAP for physical altercations in the workplace and for damage to a co-worker's property.

"The fact that this is happening is a concern," Lang said.

In each of these cases, Lang has worked with managers and clients to resolve conflicts. She also has helped clients develop ways to manage their stress and has referred them to civilian mental health professionals for treatment.

Lang said she routinely follows up with clients to see how they are progressing.

Dr. Beverly Maliner, chief of Preventive Medicine Services at Kimbrough, said the clinic's Occupational Health team has evaluated an increasing number of civilian employees complaining of illnesses and distress related to the workplace and workplace relationships.

"They are pretty distressed. ... Employees are unhappy with the pace of workplace change," Maliner said.

A staff of three full-time Occupational Health nurses assess the mental and physical health of civilian employees to determine their fitness for the workplace.

Maliner said many managers are requesting that the staff complete medical evaluations for employees who have behavioral issues and stress-related aliments.

Work-related stress has made some employees less available for full performance of duty and has increased absenteeism, Maliner said.

The installation's Community Health Promotion Council, which is chaired by Garrison Commander Col. Edward C. Rothstein, is working to integrate community services and resources, identify gaps and overlap of programs and services and assess community health to enhance the well-being of service members, their dependents and civilian employees.

The council is comprised of four working groups - the Installation Prevention Team, Physical Resiliency, Family Resiliency and Spiritual Resiliency.

Lt. Cmdr. Marivic Fields, director of Behavior Health Patient Management and a licensed social worker at Kimbrough, is the council's interim health promotion officer. She said suicide prevention is one of the main tasks of the council.

ASAP, under the leadership of Jones, who also is a council member, funds Applied Suicide Intervention Skills Training, a 15-hour suicide prevention workshop. The course is considered to be suicide first aid. It is open to active-duty service members, Reservists, National Guardsmen, DoD civilians and military contractors. ASIST is offered on post every month.

The installation is also working to create a Resiliency Center/Campus at Fort Meade, which will focus on the Army's five pillars of resiliency: spiritual, social, family, physical and emotional.

In the meantime, the experts said service members, civilians and family members must seek help if they cannot cope with the demands of military life and are thinking of hurting themselves.

"If anyone is even thinking about not wanting to live or of killing oneself, regardless if there are no plans or intent to act, walk in directly and immediately to behavioral health. After hours, go the closest emergency room or call 911," Fisher said. "Do this also if someone you know is in this spot, and don't leave them alone until help is received."

For more information, call ASAP at 301-677-7121.

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