About 18 U.S. veterans kill themselves each day. Why? Clearly the trauma of warfare and PTSD plays a significant role. But why are these suicide rates higher now than in the past?

What we do know is that something has clearly changed. “Up until the last 10 years, being in the military, including serving in combat, seemed to be a protective factor against suicide,” says Peter Gutierrez of the Denver VA, codirector of the Military Suicide Research Consortium. “[But now] in certain cohorts of active-duty personnel, the suicide rates are actually higher than in their civilian counterparts.”

Could this be because our society values our troops’ service less than it did in the past, so that the heavy physical and psychological price our soldiers and vetarans are required to pay no longer seems worth it to many? “Now we pretend the vets don’t even exist.” says Dr. David Spiegel of the Stanford Center on Stress and Health.

At least the VA has finally begun to screen for posttraumatic stress disorder and suicidal tendencies, even if a guy walks into the ER with nothing more than a broken thumb. Caregivers from social workers to physicians are supposed to be asking the right questions and listening for the answers that indicate significant psychological problems. If a veteran is drinking excessively or using drugs, not sleeping, out of a job, and isolating himself, those are pretty good indicators that he’s in trouble. Matt Kuntz, a mental-health advocate in Helena, considers the shame attached to mental illness for soldiers and veterans the major hurdle to individuals seeking care. As Kuntz, a West Point graduate, puts it, “In the infantry there’s a stigma against blisters. You think a combat vet is going to reach out for help? The soldiers need to be aggressively screened. Repeatedly.”

[Based on “We Pretend the Vets Don’t Even Exist”, Anthony Swofford, Newsweek, May 28, 2012]