“In our [2017 Policy Studies Journal] paper, we mostly looked at overall gun control policies and access to mental health rather than specific policies,” Smith said, explaining that most states which implement gun control laws do so more with more than one, making it difficult to assess which laws have caused what specific effect. Despite this challenge, Smith and his team still found a definite pattern in terms of how gun control laws impacted suicide rates.

“What we do find in our research is that states with more gun control laws have fewer gun deaths (including those who die by suicide from guns) and for non-suicides (homicides and accidental discharge together), a combination of more access to mental health services and an overall stricter climate for gun control laws correlates with a particularly lower rate of gun deaths,” Smith said. Specifically, the team found that more access to mental health care did not correlate with lower rates of suicide by gun; stricter gun control laws, however, had that desired impact.

“This relationship is perhaps due to the fact that many mental health treatments take time to have an effect, while the effect of removing a gun (or preventing one from having it in the first place) is immediate,” Smith said, adding that more access to mental health care is still good for other reasons. “It is also very difficult under existing law to remove a gun due to mental illness, but having stricter gun control laws generally can either prevent (assault weapons ban) or delay (through background checks) when one has access to a gun.”

In the United States, where just 0.2 percent of the population serves in the armed forces—compared to six percent during World War II—the threads that bind veterans and civilians together have weakened, as their lives rarely intertwine.

A new initiative spearheaded by the Veteran’s Administration (VA) aims to bridge the divide through a training program that pairs business leaders and veterans together for a full day of lectures, workshops, role-playing, and performances.

On Wednesday, Dec. 12, about 70 people attended the workshop, “Veteran Cultural Competence Training Program” at Fordham’s Rose Hill campus.

An Immersive Experience

Joseph Geraci, Ph.D., a retired lieutenant colonel in the Army and founder and director of military relations for the Resilience Center for Veterans & Families at Columbia University, said the trainings, which have been taking place under the auspices of the James J. Peters Veteran Affairs Medical Center, where he is on staff, are based around a simple premise: If an employer can put themselves in the shoes of a veteran, they can help them make the leap to civilian life.

“As a veteran, I’m expected to just merge into civilian society, acclimate to everyone else, and to some extent disavow my identity as a warrior and as a military service member,” said Geraci, who based the training on findings he published in his doctoral dissertation, Trained, Peer Mentorship and Veteran Support Organization Membership to Assist Transitioning Veterans: A Multi-arm, Parallel Randomized Controlled Trial (A Preliminary Investigation).

“That can be really frustrating and hard and further the divide, because there are not a lot of people who can relate to me. At the VA where I work, for example, there’s not one clinical psychologist who’s a veteran. Even in organizations where people are dedicated and are hired to assist me, they really don’t understand me on a very deep, personal level.”

That isolation manifests itself in the workplace, as the average veteran today will change jobs three times in the first two years after they’ve re-entered the civilian world.

A Challenge for Students

The training on Dec. 12 was the sixth of its kind and the first that Fordham supported. It drew attendees from firms and institutions such as Bloomberg LP; Mount Sinai Health System; entertainment firm Avant Gardner, LLP; and the David Lynch Foundation, which promotes transcendental meditation. Last year, students in a consulting class taught by Michelle Weber, Ph.D., a clinical assistant professor at the Gabelli School of Business, helped Geraci launch his first training outside of New York, in Charlotte, North Carolina. This fall, Weber gave students in a similar class, called Applied Social Innovation, the option of working on one of three projects. One of them was organizing the Dec. 12 event at Rose Hill.

“This country has a really big suicide problem with veterans, and it hasn’t been totally proven yet, but what I contend is that it is tied to work. What we know about work is veterans don’t have a hard time getting jobs, but they have a hard time sticking to it, whether they get fired or quit,” she said.

“There’s something going on in this country with the assimilation part. I’ve seen it in my classrooms. It’s sad. It could be so much better than it is.”

The Dec. 12 event became, in essence, a final exam for the team of students tasked with coordinating the logistics, from reaching out to participants and working with caterers, to securing space in Faber and Campbell Halls. Julia Townsend, a junior at the Gabelli School majoring in business administration, was one of them. A native of Washington, D.C., whose family has served in various capacities in the military, she felt drawn to Geraci’s cause the moment he presented to the class.

“When Joe spoke, he was really personable, and he talked about suicide from a very personal perspective about his friends passing away and him having PTSD. I felt like helping him be successful could in some small way help other people,” she said.

Workshops, Role Playing, and Performance

The day started with sessions such as “Knowledge and Understanding of Military Worldview, Veteran Risk/Protective Factors, and Effective Skills,” and “Military Culture, and Awareness of Our Own Personal Beliefs/Attitudes.” The afternoon kicked off with “Operation Restore Hope,” a mock training exercise where participants were tasked as a team with rescuing a hostage from a room of hostile forces. It ended with a dramatic reading, by professional actors, of scenes from Sophocles fifth-century play Ajax, which chronicles the fate of the Greek warrior Ajax the Greater after the events of The Iliad and the Trojan War.

Daniel Gomez, GABELLI ’18, an Army veteran and founder of First Person Xperience L.L.C., helped facilitate some of the sessions. He was most impressed with Operation Restore Hope. As part of the post-mission debriefing, participants were asked what they were thinking about as they attempted the rescue. Answers ranged from “the person to the left of me,” “the person to the right of me,” “the mission”, and “don’t get shot.”

When they were asked what they were not thinking about, Gomez said a look of confusion would cross their faces.

“I told them, ‘You weren’t thinking about your family, your Christmas party, or what kind of car you were going to buy.’ The only thing you could think about at these seconds while you were entering the room was the mission. Pretty intense,” he said.

“So now, go back to your normal life, pushing paper or working with a broken copy machine, and now it just seems completely different. That’s not a bad thing, but it’s something we all need to understand. Even this simple thing really helped them get a quick understanding of the types of things we go through. It was like their ‘aha’ moment.”

You Never Know How Deep It Is

Miguel Melbourne, GABELLI ‘13, an associate at JustWorks, a human resources partner for small businesses, echoed Gomez’s take on the mock training exercise and said the day went by faster than he expected.

“From start to finish, it took you to so many places. You cried, you laughed, you sat down, you got up and did exercises, there was a play at the end. It was beyond anything I’ve ever experienced,” he said.

He was especially moved by a session in which Geraci took off his suit jacket, donned his military uniform, sat in a chair perched atop a roundtable, and told the story of his own service, including details about three friends who were killed in battle.

“There might not have been one dry eye in the room,” Melbourne said.

Because his younger brother is in the Army and his company’s CEO is a veteran, Melbourne said he felt confident going into the training that he could relate to veterans. That session made him realize he still had much to learn.

“When we had that session, man, it was rough. It made me really realize, sometimes you just never know what vets have experienced, you just never know how deep it is,” he said.

“There’s no way to be prepared for it, but just having that awareness that these conversations may not be as easy as I thought, was probably one of the most valuable and touching parts for me.”

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“Suicide is the second leading cause of death among college-age students,” said Jeffrey Ng, Psy.D., director of Fordham’s counseling and psychological services. “This period of life presents a unique set of stressors, including increased academic demands, financial pressures, identity struggles, increased autonomy, and so on.

“In addition, various mental health problems might be more likely to emerge during this age period, such as certain psychoses, bipolar disorder, and depression.”

The grant, Ng said, will allow Fordham to strengthen its existing infrastructure by engaging the entire campus community in mental health and suicide prevention efforts. In particular, increased awareness will help reach students who have historically underused mental health services or who the National Action Alliance for Suicide Prevention have identified as high-risk, including veteran, LGBT, international, and particular ethnic and racial minority students.

“The grant funding will allow us to augment what we’re already doing to support our students,” Ng said. “We’re working to communicate to our entire community of faculty, staff, administrators, coaches and others that suicide prevention and mental health promotion is everyone’s responsibility—we all have a role to play in the wellness of our student body.”

The grant has four overall objectives:

• Enhance students’ coping and resiliency skills by delivering stress reduction seminars and disseminating the Stressbusters mobile application.
• Increase identification, support, and referral of students in distress or at an increased risk of suicide by providing “gatekeeper” trainings and developing suicide prevention peer education programs;
• Increase help-seeking behaviors among students by enhancing partnerships with on- and off-campus constituencies and developing peer-driven public awareness campaigns to reduce stigma, shame, and misinformation about mental health;
• Improve student access to mental health services by increasing visibility of on- and off-campus mental health services and resources.

Engaging the community—especially students—will be among the most important elements of Fordham’s suicide prevention efforts, Ng said. Students can help with normalizing and de-stigmatizing the use of mental health services, which some students may hesitate to use due to fear or shame.

“The most effective way to decrease stigma is through peer-driven advocacy and promotion,” he said. “Messages and information about mental health and wellness are most powerful and effective when they come from our peers.”

But unfortunately, such attitudes, as well as many other expectations that men feel they must live up to, can drive some to desperation.

Those are the attitudes that Daniel Coleman, Ph.D., is working to change. Coleman, an associate professor at the Graduate School of Social Service (GSS) with more than a decade of experience as a mental health counselor, has recently turned his focus to the area of suicide prevention.

Within that area, one group in particular seems to be crying out for help.

“It’s not a very widely known fact that 80 percent of suicide deaths in the United States are men,” Coleman said. “So the cutting edge in suicide research now is to understand why there is this gender discrepancy.”

Coleman’s foray into suicide research began at Portland State University in Oregon, where he taught for nine years before coming to Fordham last fall. There, he was the lead evaluator on Oregon’s Garrett Lee Smith Memorial Act Grant for youth suicide prevention. The $1.4 million Substance Abuse and Mental Health Services Administration (SAMHSA) grant provided suicide prevention services and allowed Coleman and his team to evaluate the program’s effectiveness.

During this time, Coleman began to explore the link between suicide and gender roles. It was already known among researchers that men tend to use more violent and thus more deadly means of suicide, such as guns or hanging. But the “why” behind this fact remained unclear. With two colleagues at Portland State, Coleman developed a theoretical model of traditional masculinity and suicide risk that was published in the International Journal of Men’s Health.
The model hypothesizes that men who adhere to more traditional masculine ideals are at a higher risk of suicide and other mental health problems.

“Traditional masculinity includes attitudes such as the beliefs that men should be leaders, should be in control of situations, should restrict their emotions and remain calm under stressful situations, shouldn’t cry or show emotions other than anger. In a way, it’s an extreme set of factors,” Coleman said.

“So when in situations of stress—for instance, employment loss or relationship problems—those men have less flexibility in terms of coping styles. Suicide can seem like a way of escaping a conflict about feeling like they are not meeting masculine ideals.”

He tested this hypothesis by conducting a secondary analysis of data archived at the University of Michigan’s International Consortium for Social and Political Research. The analysis screened data on young adults for variables relating to suicide and masculinity and found that a link indeed exists between the two.

Now, thanks to a $40,000 grant from the Lois and Samuel Silberman Fund, Coleman is applying the question of masculinity and suicide to another population, adults age 60 and older. For this group, he said, suicide statistics are even more striking: the gender ratio for suicide overall is approximately four male suicides for every one female suicide, but among older adults, this ratio is nine to one.

In addition to looking at age, Coleman will measure how gender role patterns vary across cultures, as this may have an effect on suicide rates (for instance, white men over the age of 70 have one of the highest suicide rates of any age by ethnicity grouping). A next step in this research is to analyze data from the National Violent Death Reporting System to test whether suicide decedents were of a higher traditional masculinity.

“Gender role is a highly culturally influenced factor,” he said. “There’s no data yet as to how traditional masculinity may differ across ethnicities, but I think that’s a very important area to investigate.”

After identifying the factors that place men at a higher risk of suicide, the challenge becomes intervention and prevention.

“Men are well-documented to not want to seek help for mental health problems. And that’s a dilemma in trying to address this problem—how do you make asking for help acceptable?” Coleman said.

Movements are underway to reach out to men who are reluctant about seeking professional help, Coleman said. The U.S. military, for instance, has increased awareness campaigns surrounding mental health issues and the importance of asking for help.

Working toward the same goal, several Colorado organizations joined to launch the website Man Therapy, which features fictional therapist Dr. Mahogany. Seated in a leather armchair in an office bedecked with hunting and sports paraphernalia, Mahogany uses humor to discuss issues such as depression and suicide, and how these affect men.

Though the jury is still out as to whether these targeted efforts can reduce male suicides, it’s important to start somewhere, Coleman said. His hope is that his research will help refine these efforts.

“So far, we don’t really know if any of these campaigns work,” he said. “But that’s how it is in public health. You can’t wait to have a proven intervention. You just have to try things out and evaluate as you go along.”

At the top of a long list of gender stereotypes is a central tenet: Real men don’t cry.

But unfortunately, such attitudes, as well as many other expectations that men feel they must live up to, can drive some to desperation.

Those are the attitudes that Daniel Coleman, Ph.D., is working to change. Coleman, an associate professor at the Graduate School of Social Service (GSS) with more than a decade of experience as a mental health counselor, has recently turned his focus to the area of suicide prevention.
Within that area, one group in particular seems to be crying out for help.

“It’s not a very widely known fact that 80 percent of suicide deaths in the United States are men,” Coleman said. “So the cutting edge in suicide research now is to understand why there is this gender discrepancy.”
Coleman’s foray into suicide research began at Portland State University in Oregon, where he taught for nine years before coming to Fordham last fall. There, he was the lead evaluator on Oregon’s Garrett Lee Smith Memorial Act Grant for youth suicide prevention. The $1.4 million Substance Abuse and Mental Health Services Administration (SAMHSA) grant provided suicide prevention services and allowed Coleman and his team to evaluate the program’s effectiveness.

During this time, Coleman began to explore the link between suicide and gender roles. It was already known among researchers that men tend to use more violent and thus more deadly means of suicide, such as guns or hanging. But the “why” behind this fact remained unclear. With two colleagues at Portland State, Coleman developed a theoretical model of traditional masculinity and suicide risk that was published in the International Journal of Men’s Health.
The model hypothesizes that men who adhere to more traditional masculine ideals are at a higher risk of suicide and other mental health problems.

“Traditional masculinity includes attitudes such as the beliefs that men should be leaders, should be in control of situations, should restrict their emotions and remain calm under stressful situations, shouldn’t cry or show emotions other than anger. In a way, it’s an extreme set of factors,” Coleman said.

“So when in situations of stress—for instance, employment loss or relationship problems—those men have less flexibility in terms of coping styles. Suicide can seem like a way of escaping a conflict about feeling like they are not meeting masculine ideals.”

He tested this hypothesis by conducting a secondary analysis of data archived at the University of Michigan’s International Consortium for Social and Political Research. The analysis screened data on young adults for variables relating to suicide and masculinity and found that a link indeed exists between the two.

Now, thanks to a $40,000 grant from the Lois and Samuel Silberman Fund, Coleman is applying the question of masculinity and suicide to another population, adults age 60 and older. For this group, he said, suicide statistics are even more striking: the gender ratio for suicide overall is approximately four male suicides for every one female suicide, but among older adults, this ratio is nine to one.

In addition to looking at age, Coleman will measure how gender role patterns vary across cultures, as this may have an effect on suicide rates (for instance, white men over the age of 70 have one of the highest suicide rates of any age by ethnicity grouping). A next step in this research is to analyze data from the National Violent Death Reporting System to test whether suicide decedents were of a higher traditional masculinity.

“Gender role is a highly culturally influenced factor,” he said. “There’s no data yet as to how traditional masculinity may differ across ethnicities, but I think that’s a very important area to investigate.”

After identifying the factors that place men at a higher risk of suicide, the challenge becomes intervention and prevention.

“Men are well-documented to not want to seek help for mental health problems. And that’s a dilemma in trying to address this problem—how do you make asking for help acceptable?” Coleman said.

Movements are underway to reach out to men who are reluctant about seeking professional help, Coleman said. The U.S. military, for instance, has increased awareness campaigns surrounding mental health issues and the importance of asking for help.

Working toward the same goal, several Colorado organizations joined to launch the website Man Therapy, which features fictional therapist Dr. Mahogany. Seated in a leather armchair in an office bedecked with hunting and sports paraphernalia, Mahogany uses humor to discuss issues such as depression and suicide, and how these affect men.

Though the jury is still out as to whether these targeted efforts can reduce male suicides, it’s important to start somewhere, Coleman said. His hope is that his research will help refine these efforts.

“So far, we don’t really know if any of these campaigns work,” he said. “But that’s how it is in public health. You can’t wait to have a proven intervention. You just have to try things out and evaluate as you go along.”