Army suicides in the month of July were so alarming that the service is holding a worldwide "stand down" or pause in activities -- again -- to try to address the problem.
There were 38 potential or confirmed suicides for the month -- the highest monthly toll since the Army began to release the data on a regular basis in 2009, according to the Army Times.
The suicide prevention stand down will be held on Thursday "to focus on promoting good health, teammate involvement, risk reduction and resilience training," the Army said.
September also is Suicide Prevention Month.
The last time the Army held a suicide prevention stand-down was in 2009."
Suicide is the toughest enemy I have faced in my 37 years in the Army," Gen. Lloyd Austin III, the service's vice chief of staff, said in an Army news release.
The Army must continue to address the stigma associated with asking for help, Austin said.
For 2012 through July, there were 187 potential or confirmed Army suicides among active-duty and reserve ranks.
According to U.S. Army Pacific at Fort Shafter, the command -- which includes Hawaii, Alaska, Japan and, for statistical purposes, South Korea -- has had at least eight possible suicides in 2012.
A three-member Army panel talked about the human toll and strategies Tuesday at Fort Shafter -- and asked for the public's assistance in getting help for any service member who may need it.
Wayne Hankammer, suicide prevention program manager for U.S. Army Pacific, said the Army is "an organization full of warriors," adding, "Well, now we have a new battle. We're fighting something that is within our organization, and it's all around us all the time. So our new heroes are those that come forward with their problems and ask for help."
Hankammer said he expects that "if we can remove the barrier of stigma, that people would get the help that they need."
Command Sgt. Maj. Frank Leota, the top enlisted soldier in the Pacific, revealed that over the past nine months, he's seen behavioral health experts at Tripler Army Medical Center for anger and other issues related to six combat deployments to Iraq and Afghanistan.
"I lost a lot of guys over six deployments. ... And when you do that, you kind of start second-guessing -- did you do everything right?" Leota said.
The losses under his command included combat deaths and suicides, he said.
"I had a command sergeant major who killed himself," Leota said.
Leota said "there's a lot of personal guilt, a lot of second-guessing. There's a lot of anger, so yeah, I was a pissed-off dude."
Leota said he sought help, and he talks about it to encourage other soldiers to seek help.
"Soldiers need to understand that asking for help is taking that moral courage step," he said. "That's what we talk about -- having the courage to go up and (say to) someone, 'I'm having issues,' and that's key."
Leota said "it's not going to go against your career and you are going to be a better soldier for this." Lt. Col. Stephen Morris, the residency training director in the psychiatry department at Tripler, said Army suicides are a "very complex" phenomenon.
"It's at record numbers, but it's very hard to get a handle on that, and I think what you have to do ... is what the Army is doing -- which is, you tackle it from all the points that you can."
That includes "resiliency" training for soldiers and their families, and trying to catch behavioral problems early. It used to be the case that every battalion had a doctor, he said.
"Now, we're moving to a model where every battalion has a battalion behavioral health specialist," Morris said. "We're putting those people as close to the units as we can."
For the past four years, there's been an 18 percent increase in treatment professionals, he said. While soldiers have been on multiple combat deployments over the past decade in two wars, not all Army suicides can be linked to combat, officials said.
More recent data are "showing that we're having an increase in (suicides with) folks that have never deployed, so deployment itself is not the (only) factor," Hankammer said. "It's the impact of whatever life stressors are pushing them to the (point of saying), 'I'm overwhelmed and I can't manage that anymore,' so it can come from any direction. It's not just battle."
Leota asked that the civilian and military community help each other.
"If you think something's going on with one of our soldiers, sailors, airmen or Marines, there's somebody out there that (can help) if you can pick up the phone and say, 'Hey, we think we have an issue,'" Leota said.