A U.S. soldier walks atop his armored vehicle at sunset as he prepares for a nighttime military exercise in the Kuwaiti desert south of the Iraqi border on Sunday, Dec. 22, 2002. (AP Photo/Anja Niedringhaus)

What We Still Don’t Understand about Military Suicides

April 3, 2015
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Military suicides have been climbing since the fighting in Iraq and Afghanistan began. But it’s not because soldiers are going off to war.

Overall, the majority of soldiers who have taken their own lives have had no history of deployment, a finding that was confirmed by the largest study of its kind in the journal JAMA Psychiatry this week.

The Department of Defense (DOD) has spent more than $50 million trying to figure out why. And each service branch has launched programs to prevent more deaths.

Meanwhile, suicide has become the second-leading cause of death among military personnel. Service members take their lives at a rate of 18.7 per 100,000, according to the latest DOD figures, compared to 12.6 deaths per 100,000 in the general U.S. population.

And there are still few explanations for why those who don’t deploy have taken their lives in greater numbers.

That may be because we’re asking the wrong questions, said Craig Bryan, a former Air Force psychologist who now leads the National Center for Veterans Studies and has been researching military suicide for years.

“We need to get out of this mindset of looking at deployment,” he said, since many service members are sent to non-combat bases. “We now have enough evidence that there’s not a useful metric … and we’re not really moving on with understanding why some service members are at an increased risk relative to others.”

Bryan’s research and the JAMA study sketch a more complicated picture of military members who take their own lives. Suicide happens for deeply personal reasons that can affect military personnel and veterans just like the rest of us — not just mental illness, but also relationship, financial and legal woes.

“There is reason to suspect that they might experience these issues at higher rates than the rest of the population,” Bryan said. That’s due in part to the high-stress environment of the military, which has only been exacerbated over the past decade as the U.S. has fought two major wars.

The JAMA study found two subsets of military service members who seem to be especially at risk. It examined the records of 3.9 million service members who served in the military from October 7, 2001, when the Afghanistan war began, through Dec. 31, 2007.

Researchers found a higher risk of suicide among those who either left the military before their four years of service were up, or who received a less-than-honorable discharge.

That raises new questions about how to reach this at-risk population, since they aren’t always eligible for services from the Department of Veterans Affairs and don’t get the support that other veterans might.

The new data leaves another unanswered question: If deployment alone is not a factor, and military members are affected by the same everyday stresses as the rest of the population, why has the suicide rate risen now?

“That is exactly the question everyone is working so hard to understand,” said Mark Reger, the JAMA study’s main author and deputy director of the DOD’s National Center for Telehealth and Technology. “The answers that we have are not satisfying at this point.”

The War Factor                 

One important clue for those who have been to war may center around the question of whether a military member has direct experience with a traumatic event. That’s an issue that Bryan has been examining for some time.

In 2013, military psychologist Peter Linnerouth took his own life after returning from a deployment to Iraq. Linnerouth had worked hard to help other soldiers, and later veterans, who struggled with suicidal thoughts before he died. Bryan said Linnerouth’s death spurred him to take a closer look at the reasons behind suicide for those who had been to war.

“I remember talking with one of his friends, and he said, ‘I know what your studies say, but I’ll never believe that what Peter saw had zero impact — that was the moment that things changed for him.”

Bryan analyzed 22 studies of military suicide in the U.S., Norway and Canada, for a paper to be published later this month. His research suggests it’s not combat alone, but a service member’s experience that makes them more likely to take their own life.

His study found that for those exposed to killing and death, the risk for suicide rises by 43 percent. That includes not just those who witnessed or were involved in a traumatic event, but those who came into contact with those who were wounded or killed, such as medics, chaplains and personnel working in mortuaries. The correlation only emerged in studies that asked specific questions about what people experienced.

“When the researchers get down to asking, ‘Did you kill someone? Have you seen someone get killed? Have you been unable to help someone? — Yes, there’s a relationship,” Bryan said. “We thought, This is what we’ve been missing.”

The findings have implications for the Defense Department, which has struggled to combat the stigma of mental illness in the ranks of the military. Those who ask for help are often seen as weak — which is anathema to the military’s warrior culture. In recent years, the DOD has tried to send a new message, urging people to seek help.

Meanwhile, the deaths continue. This week, the Pentagon confirmed that suicides increased last year among active-duty service members, although the number dropped among reserves. In total, 434 service members, including active duty and reserve, took their own lives.

Need help or know someone who does? Contact the Military Crisis Line via phone, online chat, or text message. Call 1-800-273-8255 and press 1; visit www.militarycrisisline.net; or text 838255. 

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