The U.S. Army recorded 154 suicides among active-duty soldiers in the first 155 days of 2012, according to Pentagon data. Should that rate continue, Army suicides could surpass the previous record year of 2009.

The self-inflicted deaths come despite years of efforts by high-ranking Army officials to reduce stigma and encourage soldiers to seek mental health care.

The Army has sought in several studies to understand the risk factors for suicide among its ranks. Personal stressors such as relationship, legal, or work problems appear to be major factors, and a decade of war and repeated deployments to Iraq and Afghanistan have also contributed to the pressures that lead up to suicide.

Unit scheduling patterns may play as great a role as individual deployments, said former Army psychiatrist Elspeth Cameron Ritchie, M.D., M.P.H., now chief clinical officer at the District of Columbia Department of Mental Health.

“The stresses placed on entire units to operate in the field or prepare for deployment mean that leaders don’t have the time or energy to look after people,” she told Psychiatric News. “Physical pain and disability are also contributing factors, as are exposure to violence and subsequent fatalism.”

Also, tackling the easy availability of firearms is not simple, said Ritchie. The Army frequently reminds soldiers about the dangers of riding motorcycles or other risky activities, but says little about responsible private gun ownership, she noted.

Generals have pushed for suicide-prevention initiatives, but changing Army culture and policies and eliminating stigma have proven more difficult at the platoon or company level.

Secretary of Defense Leon Panetta, in a May 10 internal memo, said that Army leaders had to take responsibility for suicide prevention. “To that end,” Panetta wrote, “leaders throughout the chain of command must actively promote a constructive command climate that fosters cohesion and encourages individuals to reach out for help when needed.”