May 28, 2009 -- Gen. Mark Graham, the commanding general at Ft. Carson in Colorado, lost both of his sons in the same war -- but to two separate battles. The devastating losses of his sons to suicide and a roadside bomb just months apart have been his impetus to lead the military's battle against suicide.
Graham never imagined he would be one of the most learned experts on suicide, turning his pain into knowledge.
"I'd trade every bit of it in a second to get my boys back," Graham said.
Taking the attitude that one suicide is too many, Graham is trying to dramatically reduce the suicide rate in the military, which has nearly doubled since 2005.
"I think the whole Army leadership is shocked by it and realizes we've got to do more," Graham said.
Graham has turned Ft. Carson into a testing ground to find new methods to combat stress and prevent suicide.
One of the methods being implemented is mental toughness training.
"We climb ropes, we do pull-ups, we do all of these things when we strengthen our muscles," Graham said, "and we're trying to do the same thing with our mind."
The military has found that soldiers with mental health issues are vulnerable to suicide when they come down from the adrenaline rush of battle. So, in the weeks before the young soldiers at Ft. Carson deploy to Afghanistan, they will be trained on what to do when adrenaline and stress from the war zone spike in their bodies.
"We put them in situations where they do lots of things that increase their heart rate and then there might be a loud noise," Graham said. "And then we talk about how they feel and how they bring their heart rate down, how they bring their stress down, and being able to handle some of those situations."
Soldiers are almost always under stress in the wars in Iraq and Afghanistan, where roadside bombs can kill at any time. After a soldier experiences a stressful situation, he or she receives additional training on how to recognize and ease stresses in the body.
The soldiers' instructors are military members who have experienced combat firsthand. One is a former Marine who spent time in Fallujah, and another a former senior non-commissioned officer in the Ranger Regiment 275.
One soldier found it relaxing to hear from the special forces and rangers in his training class.
"That made everybody a lot more in tune to listening instead of just a civilian doctor comes in and talks to you," E-5 Army Sgt. Chuck Dostal told ABC News.
Interactive Military Programs for Suicide Prevention
Most of the Army voices similar approval for the mental toughness training. In recent years, the Army has moved away from lecture-based, PowerPoint presentations and instead taken a hands-on, interactive approach.
In some training, soldiers perform breathing exercises and engage in discussion groups while sitting on mats. While some of the exercises can be challenging, the moment is light and fun.
One exercise the soldiers at Ft. Carson learn is the bird -- a belly down, flying motion exercise. Soldiers broke out into laughter and wide smiles as they lifted their arms up and down again and again. The results were immediate, as one soldier announced upon standing, "I feel lighter."
Another Army-wide program recently rolled out is Warrior Venture Quest. Started in September 2008, the program gives soldiers the opportunity to participate in high-adventure events, such as white water rafting or mountain climbing. Counselors accompany the soldiers and coach them on how to bring themselves back down once their adrenaline reaches levels similar to those in the combat theater. It's a program that soldiers can use once they've returned from war.
"If they are on their own, their apartment or where they live off-post, and they feel that anxiety coming, they'll have a skill to help them come back down off that adrenaline rush," Graham said.
Programs are also in place to increase awareness of depression and suicide prevention. One of these programs "Ask, Care, Escort" (A.C.E) encourages soldiers to listen and ask other soldiers about their mental state. If a soldier informs another of thoughts about taking their life by suicide or hurting someone else, that soldier should be escorted to the hospital to seek help. The Army is seeing that happen repeatedly.
Another program recently launched at Ft. Carson is the mobile behavioral health team comprised of 14 behavioral health providers and staff members.
"We actually now have soldiers trained in every company in the brigade as behavioral health advocates, someone whose job it is to kind of have a finger on the pulse of the unit and see who might be at risk, who might need to talk to someone like myself," Cpt. Katie Kopp told ABC News.
As an Army psychologist, Kopp determines system-wide how the Army can decrease risk factors and increase protective factors. The Army is training soldiers to gain these skills as well.
These programs illustrate the Army's push for soldiers to seek help for mental health problems, an attitude that differs considerably from ones held just two years ago.
"As soldiers, it's in our creed -- we're physically and mentally tough," Kopp said. "So, particularly among the war-fighting soldiers, their job is to be strong. And so sometimes, it can be difficult for some people to come in and talk to someone like myself."
The Army has increased its efforts to remove the stigma attached to mental health problems in its ranks. Graham thinks the stigma has spread nationwide and believes its erasure can be accomplished, in part, "by being very open and talking about it more and more and letting soldiers know it's a sign of strength, not weakness, to come forward and ask for help."
As new soldiers come into a more accepting culture of mental health treatment, they are beginning to feel more comfortable seeking out help, Kopp believes.
Getting Help and Saving Lives
The Army is serious about its mission to save lives and is constantly testing new programs or making changes to pre-existing ones.
Recently, the Army held a stand-down for suicide prevention, the first of its kind, in which Army members were required to spend a minimum of four hours in a suicide prevention program.
Also, soldiers are shown various interactive videos, such as "Beyond the Front" and "Shoulder to Shoulder," that highlight Army soldiers who are depressed or suicidal. The Army is seeing the impact of these videos firsthand.
"Several soldiers came forward and said, 'I feel like that NCO in the movie,' or they said, 'I've had those feelings before,'" said Graham, who is convinced the videos are helping a lot of soldiers. "And then, we escort them and get them help right then. We don't wait."
While the Army cannot determine the exact amount of lives that have been saved because of the programs, the impact is evident.
"I have had soldiers who've said that they'd been thinking about it and had, at times, started to make plans," Kopp said. "And so we feel very fortunate when we catch someone like that."
In many ways, Graham's personal tragedy has permeated the culture of Ft. Carson.
"When you've got the commanding general of your military installation saying mental health is important, suicide is something to be aware of and to try to prevent -- I don't see how that couldn't have an impact on the soldiers," Kopp said.
Kevin Graham, the youngest son of Gen. Graham, committed suicide at the age of 21. He was the top ROTC cadet at the University of Kentucky, was fluent in German, and had dreams of being a doctor in the Army.
On the evening of his death, his sister Melanie went looking for him when he didn't show up for a game of golf with his brother Jeffrey. She found his body in the apartment they shared. He had hanged himself.
While Graham did not suspect his youngest son was battling with depression and never fathomed he would take his own life, retrospectively he can pinpoint some of the indicators in his behavior. One of the signs was that Kevin Graham's once-stellar grades had begun to slip.
"He told his mom one time, 'Mom, I can't think anymore,'" Gen. Graham recalled.
Kevin Graham also was working out excessively.
"We learned later that that's because his serotonin level was low," Gen. Graham said. "So he was working out twice a day to keep his serotonin level up because that made him feel better."
For Graham, the programs at Ft. Carson offer him an opportunity to educate soldiers about the same depression his son suffered from.
He lamented that his wife, "Carol, and I beat ourselves up all the time and we'll always do that. We didn't realize you could die from depression. It isn't just a sad feeling. It's something that can lead to death."
Kevin Graham had to learn about depression on his own and fought off feelings that he did not understand.
"Kevin didn't realize he was depressed," Graham said. "He read on his own and kept learning. And pretty soon that's when he realized and called his mom Carol in Korea and said, 'Hey mom, I know what's wrong with me. I've got depression.'"
Kevin Graham sought medical help but came off his medication before his death, Gen. Graham said.
Turning Pain Into Knowledge
Graham hopes that the program he is involved with will raise awareness and allow others to identify those suffering with depression -- and encourage or lead them to help.
The program also helps Graham reach out to parents who may feel an initial surge of disbelief upon first hearing their child is depressed.
"I know it seems hard that, you know -- yes, your child. But they didn't ask for this. They didn't want it, but now they have it," Graham said.
Soon after Kevin Graham's death, Gen. Graham watched his 23-year-old son, Jeffery, deploy to Iraq. Three months later, he bid a final goodbye to his eldest son who was killed while on foot patrol in Iraq.
The general remembers his sons with the photographs that fill his office space. He carries his sons with him every day. The boys' personal items are now his keepsakes -- Kevin's license that Jeffrey Graham was carrying when he died, Jeffrey Graham's dog tag, a bracelet inscribed with both boys' names that only comes off at airport security, and Kevin Graham's 1989 Honda Accord, which is still parked in the general's garage.
The general has found some comfort in helping others live by teaching what he has learned from his loss.
"I miss them all the time. But, I mean, it helps me. They made a big contribution during their short time on the Earth," Graham said. "I'd give it all back to get them back, though. You know, just for a moment I would, if I could, just hug them one more time."
Today, Graham's sons are together again, two names inscribed on one gravestone, inseparable as they once were.
A banner left at the boys' gravesite still resonates with Gen. Graham: "The land of the free because of the brave."
Graham said he'll use the phrase for the rest of his life -- because both of his sons were heroes who died fighting different battles.