Soldiers and Suicide: A familiar tale
As a Marine, there is a special place in my heart for all things military. While most protesters are busy arguing about the people who are dying overseas, there is an even more disheartening statistic — the suicide statistics of service members here at home. Suicide is an ugly word, so it’s no surprise that there is not a large movement fighting for better care and a new study done on soldiers doesn’t help.
U.S. Army soldiers hospitalized with a psychiatric disorder have a significantly elevated suicide risk in the year following discharge from the hospital, according to research from the Army Study to Assess Risk and Resilience in Service members. The yearly suicide rate for this group, 263.9 per 100,000 soldiers, was far higher than the rate of 18.5 suicides per 100,000 in the Regular Army for the same study period, the study found.
The researchers looked at data from the 12 months following a hospital discharge for more than 40,000 anonymous, Regular Army soldiers (full-time soldiers which did not include Army National Guard and Army Reserve) who served on active duty from 2004 through 2009.
The Army’s suicide rate began increasing in 2004, exceeded the rate among a similar group of U.S. civilians in 2009, and has remained high through 2014. This study of administrative data shows that 40,820 soldiers (0.8 percent of all Regular Army soldiers) were hospitalized with a psychiatric disorder in 2004-2009, the period covered by this research. Suicides occurring in this group during the year after a hospital discharge accounted for 12 percent of all Regular Army suicides during this period.
Researchers also found that it was possible to identify smaller, higher-risk groups within this at-risk population. Analyzing soldiers’ characteristics and experiences, researchers identified the 5 percent of soldiers with the highest predicted risk of suicide after leaving the hospital. This top 5 percent accounted for 52.9 percent of the post-hospital suicides. Soldiers in the top 5 percent also accounted for a greater proportion of accident deaths, suicide attempts, and re-hospitalizations.
The researchers report that, for this group of hospitalized soldiers, some of the strongest predictors of suicide include being male, having enlisted at an older age, having a history of criminal offenses during Army service, having had prior suicidal thoughts or actions, as well as disorders diagnosed during hospitalization and aspects of prior psychiatric treatment. However, researchers found that many factors contributed toward predicting suicide risk in this group, individually and in combination. This fact underscores the complexity of assessing suicide risk and the added value of developing new approaches to better predict very challenging events.
“This is the first publication from Army STARRS that reports on the ability to use Army/Department of Defense data to identify specific subgroups within the Army that have very significantly elevated suicide risk,” said NIMH Director Thomas R. Insel, M.D.
“However, there are sensitivities to using data to identify high-risk subgroups. It’s important to remember that although a particular population may be at elevated risk, suicide remains a rare event.”
The team concluded that the high concentration of suicide risk among this study group, and particularly in the smaller highest-risk groups, might justify targeting expanded post-hospital interventions for such people. Researchers continue to develop and refine computer models to help the Army predict suicide risk among soldiers and prevent self-harm.
Here in the US we have the luxury of having an all volunteer military, so to me when a servicemember dies overseas that comes with the job. Unfortunately, the truly preventable deaths — the ones here at home — are being largely ignored. Just something to think about if you happen to be an anti-war protester — a more realistic fight would be for better care for the vets doing the fighting.
Kessler RC, Warner CH, Ivany C, Petukhova MV, Rose S, Bromet EJ, Brown M 3rd, Cai T, Colpe LJ, Cox KL, Fullerton CS, Gilman SE, Gruber MJ, Heeringa SG, Lewandowski-Romps L, Li J, Millikan-Bell AM, Naifeh JA, Nock MK, Rosellini AJ, Sampson NA, Schoenbaum M, Stein MB, Wessely S, Zaslavsky AM, Ursano RJ, & for the Army STARRS Collaborators (2014). Predicting Suicides After Psychiatric Hospitalization in US Army Soldiers: The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA psychiatry PMID: 25390793