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CharlesPSmith_2020S-_关爱美国退伍军人心理健康的可行方案_-
So on May 6 of 2019, the sun was shining, the sky was blue, clouds were that puffy white. 2019 年的 5 月 6 日, 阳光灿烂,天空蔚蓝, 云蓬松而洁白。
It was a perfect spring day. 这是春天里一个完美的日子。
I was walking back to my office, and my phone rang. 我正在往办公室走, 突然手机响了,
And it was one of my lieutenants . 是我的一个中尉打来的。
I said, "Hey, John. 我说:“你好,约翰。[00:31]
puffy:adj.一阵阵吹的;胀大的;喘气的; lieutenants:n.中尉;副官;助理人员;
How are you?" 最近还好吗？”
He said, "Sir, I'm good. 他说:“长官,我很好。
But I've got some bad news." 但是我有一个坏消息。”
He said our executive officer died that weekend. 他说我们的执行长官 在那个周末去世了。
We went back and forth , "What do you mean, what are you talking about?" 我们继续交谈着, “这是什么意思？你在说什么？”
I asked him what happened. 我问他发生了什么。
He said, "Sir, he killed himself." 他说: “长官,他自杀了。”
I walked around my office for a couple of hours in a complete fog, trying to understand what had happened, why. 我茫然地在办公室里 徘徊了几个小时, 尝试去理解究竟发生了什么, 以及背后的原因。[00:55]
executive:n.管理人员; adj.经营管理的; back and forth:前后移动的,来回的,反复的;
I had just communicated with him a few months earlier. 我在几个月前刚和他交流过。
And I had no idea that this officer was in trouble. 我完全没有想到这位军官 正陷入麻烦之中,
And I fault myself as a leader for not having known that. 也并不知道这件事 是我作为一个领导的失职。
I went on this process of trying to figure out why, what's happening in the veteran community , why are these things going on. 于是,我开始尝试弄清楚 退伍士兵群体中正在发生什么, 事情为什么会这样。
I read reports from the Department of Veteran Affairs, 我阅读了来自 退伍军人事务部
Department of Defense, 和国防部的报告,
I've read national studies on mental health and the issues associated with it. 我读了关于心理健康 和相关问题的国家研究。
I'm going to share with you some of the things I found out. 我将和你们分享一些我的发现。[01:30]
process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的; veteran:n.老兵; adj.(尤指军事方面)老练的; community:n.社区;[生态]群落;共同体;团体; mental:adj.精神的;脑力的;疯的;n.精神病患者; issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) associated:adj.有关联的; v.联想; (associate的过去分词和过去式)
Department of Veteran Affairs has taken the lead on veteran suicide , and it's actually their number one priority . 退伍军人事务部负责 带头调查退伍军人自杀事件, 这其实也是他们工作的重中之重。
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的计算, 在 2001 年到 2019 年 全球反恐战争期间, 据我估计, 大约有11 万 5 千名退役老兵 死于自杀。
suicide:n.自杀;自杀行为;自杀者;adj.自杀的;v.自杀;vi.自杀; priority:n.优先;优先权;[数]优先次序;优先考虑的事; Global:adj.全球的;总体的;球形的; approximation:n.[数]近似法;接近;[数]近似值; veterans:n.老兵;退伍军人(veteran的复数形式);
I also looked at the Department of Defense report that lists casualties . 我同时也阅读了记录伤亡者的 国防部报告。
This particular report lists the casualties from October of 2001 specifically to November 18 of last year. 这个报告 列出了从 2001 年 10 月 到去年 11 月 18 号的 所有伤亡军人的信息。
During that time frame and the Global War on Terror, there have been 5,440 active duty members killed in action. 在那段时期的全球反恐战争中, 有 5440 名现役军人 在行动中阵亡。
casualties:n.伤亡;人员伤亡(casualty的复数); specifically:adv.特别地;明确地; time frame:n.期间时限;
So by my numbers, 115,000 approximate suicides , 5,440 killed in action. 所以根据我的统计, 有大约 11 万 5 千人自杀, 5440 人在行动中阵亡。
What does that mean to me? 这对于我来说 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 . 每当一位军人 在敌人手中牺牲, 就有 21 位退伍军人 结束了自己的生命。
It's a staggering , staggering number. 这是个非常惊人的数字。
approximate:v.近似;使…接近;粗略估计;接近于;adj.[数]近似的;大概的; suicides:n.自杀;自毁;自杀者;(suicide的复数) approximately:adv.大约,近似地;近于; combatant:n.战士;争斗者;adj.战斗的;好斗的; staggering:adj.惊人的; v.蹒跚; (stagger的现在分词)
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, 这些关于心理健康的 国防报告告诉我们, 如果你的家族存在 有可能导致精神健康问题的 遗传基因,
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 . 或者你在童年经历过创伤, 你处理创伤后应激障碍（PTSD）的能力 会明显下降。
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. 他们也告诉我们, 如果你想要 一个全面的评估, 判断某人是否患有 PTSD, 你需要和一位心理健康专家 进行至少一个小时的面谈。 他们受过相关的训练, 可以判断你是否患有 PTSD。
genetic:adj.基因的;遗传学的; childhood:n.童年;幼年;孩童时期 post-traumatic stress disorder:n.创伤后精神紧张性障碍; PTSD:abbr.创伤后精神紧张性精神障碍(post-traumaticstressdisorder); significantly:adv.意味深长地;值得注目地; decreases:减少(decrease的复数); evaluation:n.评价;[审计]评估;估价;求值; determine:v.决定;确定;测定;查明;形成;影响;裁决;安排; minimum:n.最低限度;最小值;最少量;极小量;adj.最低的;最小的;最低限度的; interview:n.接见,采访;面试,面谈;v.采访;接见;对…进行面谈; detect:vt.察觉;发现;探测;
Now let me talk about what happens when you enter into the military . 现在我来讲讲, 当你进入军队后会发生什么。
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 . 当你入伍之后, 你需要通过一个健康检查, 你需要参加一个体能测试, 你需要参加一个药物检测, 你需要参加一个特长考试, 这样他们才能弄清 你善于干什么, 然后有可能将你放在 合适你的工作岗位上。
enter into:进入;讨论;成为…的一部分;研讨;分享;体谅; military:adj.军事的;军人的;适于战争的;n.军队;军人; armed forces:n.武装力量; physical:adj.[物]物理的;身体的;物质的;符合自然法则的;n.体格检查; fitness:n.健康;适当;适合性; vocational:adj.职业的,行业的; category:n.种类,分类;[数]范畴;
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, 但是你能相信吗？ 得知过去二十年间 有超过 11 万 5 千起自杀, 以及根据国防报告的数据, 我们也知道了如何判断某人 是否有能力克服 PTSD,
we still don't have a standardized mental health evaluation for our recruits entering into the service. 我们却依旧没有一个 用于服务新兵的 心理健康评判标准。
That's something I think that needs to change. 这是我觉得 需要改变的地方。
Number two, when you leave the service -- 第二点, 当你退伍的时候——
cope:v.处理;n.大圆衣; standardized:adj.标准的; v.使合乎标准; recruits:n.新兵; v.征募;
When I left the service in 2003, 我在 2003 年退伍的时候,
I had to attend some mandatory classes, about two days' worth of classes, and then I was on my way. 需要参加一些为期两天的 强制性的课程, 然后我才可以正式退伍。
Today, it's a little different. 现在,这一流程有了一些变化。
Today you'll 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 . 现在,如果你在享受退伍前的 终端休假, 或者剩余的带薪休假, 你会接到一个电话。
mandatory:adj.强制的;托管的;命令的;n.受托者(等于mandatary); terminal:n.终端;航站楼;终端机;航空终点站;adj.晚期的;不治的;致命的;患绝症的; discharged:v.准许(某人)离开;解雇;释放;排出;(discharge的过去分词和过去式)
I talked to one veteran who got a call. 我曾和一个接到过这个电话的 退伍士兵聊过。
He was on his way home from work, and the only thing he could think of was, "How quick can I get off this?" 他当时正在下班回家的路上, 他唯一可以想到的东西 就是,“我如何才能尽快摆脱这件事？”
And I think the call lasted maybe 10 or 15 minutes. 我记得这个电话持续了 大概 10 到 15 分钟。
But yet the national studies tell us it needs to be an in-person , one-hour interview. 但是国防报告告诉我们, 这应该是一个一对一, 持续一个小时的面谈。
I think that's something that we can improve upon. 我认为这也是我们可以改进的地方。
There's another thing that the Department of Veteran Affairs talked about in the reports. 退伍军人事务部还在报告中 提到了一件事。
They said that our service members that are self-medicating tend to be at a significantly higher risk of suicide. 他们说选择自我治疗的军人们 有更显着的自杀风险。
in-person:亲自;外貌上; improve:v.改进;改善;
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 . 也就是那些选择用酒精 或者滥用药物 来进行自我治疗的—— 事实上,退伍军人事务部已经将 阿片类药物使用障碍 （OUD） 定义为一类流行疾病。
So as I talked to marines from my unit and tried to learn more about it, 所以当我与我所在的 海军陆战队的士兵聊天, 想要获取更多信息时,
I started to find out some really, really alarming things. 我发现了很多绝对需要 引起重视的事情。
I had a marine who came back from Iraq and he went to the hospital for a "back pain" 我有一个从伊拉克回来的士兵, 他曾经去医院治疗背痛,
alcohol:n.酒精;乙醇;含酒精饮料; abuse:n.滥用;虐待;辱骂;弊端;恶习,陋习;v.滥用;虐待;辱骂; classified:adj.机密的; v.将…分类; (classify的过去分词和过去式) opioid:n.[生化]阿片样物质;类鸦片; epidemics:n.流行病;蔓延(epidemic的复数);时疫; marines:n.海军陆战队士兵;(marine的复数)
and he was prescribed some opioids . 然后他使用了一些阿片类药物。
He also suffered from post-traumatic stress disorder. 他也同样患有 PTSD。
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 . 他变得对这些止痛药上瘾, 不仅仅因为 它们可以消除他背部的疼痛, 也因为它们可以帮助他应对 一些他在中东看到、 体验到和做过的 非常糟糕的事情。
prescribed:v.给…开(药); (prescribe的过去式和过去分词) opioids:n.阿片类药物;类阿片;鸦片类药剂(opioid的复数形式); addicted:adj.上瘾的;上瘾;成瘾;有瘾;入迷; painkillers:n.止痛药(painkiller的复数形式); horrific:adj.可怕的;令人毛骨悚然的; Middle East:n.中东(包括亚洲西南部和非洲东北部);
And he eventually overdosed . 结果导致了他用药过量。
Another challenge we have is that when you're on active duty, you are under the Department of Defense. 我们要面对的另一个挑战是, 当你还是现役军人的时候, 你隶属于国防部。
And so all of your doctors, all your health care is in that category. 所以你能接触到的 所有医生和医疗设施, 都属于那个种类。
eventually:adv.最后,终于; overdosed:v.一次用药过量;(overdose的过去分词和过去式) health care:n.卫生保健;
When you leave the service, you are now part of the Department of Veteran Affairs. 在你退伍之后, 你隶属于退伍军人事务部。
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. 所以这些需要心理健康疏导, 并被诊断患有 PTSD 或其他心理健康疾病的 现役军人, 当他们退伍的时候, 因为需要遵守隐私法, 所以他们无法平稳过渡, 以顺利接受 退伍军人事务部 或者外界的医疗服务。
Now there's some good news in this. 现在我们有了一些好消息。
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,有新的立法提出, 将建立一个数据库来容纳 国防部和退伍军人事务部的 健康档案。
seek:v.寻求;寻找;谋求; diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) transition:n.过渡;转变;变革;变迁;v.经历转变过程;过渡; civilian:adj.民用的;百姓的,平民的;n.平民,百姓; privacy:n.隐私;秘密;隐居;隐居处; recently:adv.最近;新近; legislated:vt.用立法规定;通过立法;vi.立法;制定法律;
But I want to take that thought a step further. 但是我希望能更进一步。
My company was 204 marines and sailors strong. 我的公司由 204 名 海军陆战队队员和水手组成。
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. 当我们在一起聊天时, 我们意识到, 也曾有十几位我们的同伴 选择了结束自己的生命。
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. 当我和这个营的领导 聊到这个话题—— 一个营大约有 600 到 700 名海军成员—— 他们估计,我们有 数百个成员死于自杀。
excess:n.超过,超额;过度,过量;无节制;adj.额外的,过量的;附加的; committed:adj.坚信的; v.做出错事; (commit的过去分词和过去式) senior:adj.大;级别(或地位)高的;成人的;高级水平的;n.上级;上司;较…年长的人; battalion:n.营,军营;军队,部队;
So let's take this database that we're building, and let's go a little bit further with it. 那么,我们不妨赋予这套 即将建立起来的数据库更多功能, 让它能关注更多的东西。
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, 如果我们有一位退伍军人去世了, 不管是因为自然原因, 用药过量或者自杀, 我们都可以将这一事实反馈到 退伍军人事务部, 再由他们通过查询国防部的数据, 分辨出这个老兵来自于哪个部门,
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. 他们参与过什么紧急行动和任务。 我们也可以建立数据点, 想办法弄清楚 有没有更容易发展出 PTSD 的部门, 这样我们就能让他们在被部署之前, 在进入战区之前 得到心理健康方面的帮助。
What if:如果…怎么办? identify:v.识别:鉴定:确认:发现: contingencies:n.临时费;不可预见费;意外事件(contingency的复数); participate:v.参加;参与; susceptible:adj.易受影响的;易感动的;容许…的;n.易得病的人; deployment:n.调度,部署;
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. 如果他们身处战区, 可以就地给他们提供医疗服务, 在他们离开战区回家之前, 给予他们应得的心理疏导和帮助。
(Applause) （掌声）
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. 另外, 如果我们能够成功设立这些数据点, 我们不会只把他们运用在军事领域, 也可以用在广大公众身上。
counseling:n.咨询服务;v.建议;劝告;商讨;(counsel的现在分词形式) by the way:顺便说一下; apply:v.申请;涂,敷;应用;适用;请求;
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. 如果我们团结一心, 调动所有可用的资源, 开诚布公的谈论这件事, 并且尝试为当前 在美国肆虐的这一流行病 找到解决方案, 我们也许就可以拯救一条生命。
Those are my thoughts, my ideas, 这些是我个人的一些想法,
I hope that this talk is not the end of this discussion but rather the beginning of it. 我希望这个演讲并不是 相关讨论的尾声, 而是这个话题的起点。
And I want to thank you for your time today. 非常感谢大家的聆听。
resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
(Applause) （掌声）