Professional News
Combat Just One Cause of Army Suicide Crisis
Psychiatric News
Volume 44 Number 5 page 4-4

Suicides among members of the U.S. Army increased for the fourth straight year in 2008, nearly doubling since 2004, despite the service's efforts at awareness and prevention. The Army also said that as many as 24 service members may have committed suicide in January, more than the number killed in combat in Iraq and Afghanistan that month.FIG1

At least 128 suicides occurred among active-duty soldiers in 2008, and 15 cases are still under investigation by the Armed Forces medical examiner. In 2004, 67 soldiers committed suicide.

The 2008 deaths represented a suicide rate of 20.2 per 100,000 active-duty personnel, up from 12.7 in 2005. The comparable, demographically adjusted rate for the overall U.S. population was 19.2 per 100,000 in 2005.

Further, 43 members of the Army Reserve or National Guard not on active duty also killed themselves last year.

Comparison with civilian or national rates is difficult, however, because the military background of persons committing suicide in the general population is not always recorded on death certificates.

"We want the families who have lost loved ones to suicide to understand how deeply we feel their loss and that we are committed to doing everything possible to prevent this tragedy in our Army," said Secretary of the Army Pete Geren in a statement.

According to the Army, 30 percent of suicides occurred during deployment to Iraq or Afghanistan, 35 percent happened after deployment, and 35 percent occurred among troops who had never deployed to a war zone.

The Army figures do not include the suicides by soldiers who have left the service. The Department of Veterans Affairs (VA) reported last year that 254 veterans (of all services) under its care who left the military between September 11, 2001, and the end of 2006 committed suicide.

The rise in those numbers partly reflects the increased number of veterans leaving military service since 2001. Not all discharged military personnel choose to obtain medical care from the VA, so the VA count may underestimate the number of suicides among those who served in the two current conflicts.

Suicide remains a challenge for which military leaders must identify effective prevention initiatives, said Adm. Mike Mullen, chair of the Joint Chiefs of Staff.

"We have got to be able to support those individuals in ways that, in some cases, we haven't quite figured out yet," said Mullen in a February speech at Grove City College in Pennsylvania. "Part of [the problem] has got to be the pressure of these constant deployments into combat, where young individuals ... whose lives change forever see things and do things they had never imagined."

The Army has developed or expanded programs in recent years to try to decrease the stigma surrounding mental health issues and encourage soldiers to seek help for themselves or for troubled buddies. The "Battlemind" program, originally designed to prepare soldiers psychologically for the stresses of combat, has now been expanded to include spouses and also cover the homecoming from war.

"Battlemind" is part of a new Comprehensive Soldier Fitness strategy intended to give mental resiliency the same status traditionally accorded to physical health. The Army Chaplains Corps provides training for officers and soldiers in suicide risk recognition and prevention. The service has also begun hiring additional psychiatrists, psychologists, social workers, and other mental health care providers to support its troops.

In January the Army ordered commanders throughout the service to hold two to four hours of suicide prevention training between February 15 and March 15, followed by a "chain-teaching" program to reach all members of the service.

The deaths by suicide of four Army recruiters in the Houston area were attributed to "poor command climate, failing personal relationships, and long stressful workdays...." Those conclusions prompted Geren to order a one-day "standdown" on February 13 for all Army and Army Reserve recruiters during which they could receive training in leadership, suicide-prevention, and coping skills.

To improve the research base about suicide in the armed forces, the Army also signed a memorandum of understanding with the National Institute of Mental Health last October to study ways to reduce suicide.

The proposed research seeks to evaluate risk and protective factors leading to suicide-related events to influence the development of effective strategies to reduce suicide risk and enhance resilience, according to the NIMH request for applications.

"This study will evaluate selected samples of soldiers across all phases of Army service, both cross-sectionally and longitudinally, including entry-level training and service, predeployment training, deployment and noncombat assignments, postdeployment, and postseparation reintegration to civilian life," according to the Army-NIMH memo. ▪

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