2011 seemed promising: For the first time since 2004, the suicide rate among active-duty Army personnel decreased from the previous year. One reason for the decrease seemed obvious: One of the worst stressors of the last decade for military families – the rapidity and frequency of deployments, which compelled some service members to see combat two, three, or even four times – had finally relaxed a bit after the Iraq drawdown. It seemed that the joint Department of Veterans Affairs (VA)/military effort to improve mental health screening and learn about related problems, such as post-traumatic stress and concussions, might have played a role.
The first half of 2012, however, revealed a sad and perplexing statistic: The military suicide rate had surged to a 10-year high, according to the Pentagon. In the first 155 days of 2012, 154 active-duty service members killed themselves – about 50 percent more than the number who had been killed in action in Afghanistan.
The National Action Alliance for Suicide Prevention (Action Alliance) and other leaders from both the public and private sectors released the “2012 National Strategy for Suicide Prevention” on Sept. 10, 2012, at the National Press Club in Washington, D.C. The “National Strategy for Suicide Prevention,” a report of the Surgeon General and the Action Alliance, features community-based approaches to curbing the incidence of suicide, details new ways to identify people at risk for suicide, and outlines national priorities for suicide prevention. VA photos by Robert Turtil.
July was even worse: Twenty-six Army service members killed themselves – the highest monthly total on record for the service – along with eight Marines, six members of the Air Force, and four from the Navy.
Among veterans, the numbers are hardly more encouraging; by the VA’s own estimate, 18 military veterans die by suicide every day. A study published in the Sept. 29, 2011, edition of the American Journal of Public Health indicated that overall, veterans carry a greater suicide risk than other Americans, but that the youngest veterans, those aged 17 to 24, are particularly more likely – four times as likely, in fact – as nonveterans to commit suicide. Though the risk drops off sharply after veterans reach the age of 24, it still remains about one-and-a-half times higher than the general population.
It’s safe to say, then, that the suicide rate among service members and the nation’s youngest veterans – the men and women returning from deployments in Iraq and Afghanistan – is, as of July 2012, dramatically higher than that of other Americans, a fact that prompted Army Vice Chief of Staff Gen. Lloyd James Austin III, in a statement released in August, to call suicide “the toughest enemy I have faced in my 37 years in the Army.”
The fight against such an enemy, Austin acknowledged, will require “sophisticated solutions aimed at helping individuals to build resiliency and strengthen their life coping skills.” It will also require a united front, led jointly by the VA and the Department of Defense (DoD), to both understand the risk factors for suicide and formulate prevention efforts that target these risk factors.
Losing Ground
The first element in the fight against military and veteran suicides – to understand the risk factors associated with veteran and military suicides – has proven a complicated task, given a lack of uniformity in the experiences of service members and veterans. Contemporary news stories about veteran or military suicides – for better or worse, such stories are becoming more difficult to avoid – often include a government, medical, or support-group spokesperson speculating about the reasons behind military and veteran suicide rates. The reasons all sound plausible: The psychological toll of killing in combat. Too few qualified mental health professionals. Family stresses brought on by multiple deployments or the return to civilian life. Financial stresses brought on by a sluggish economy. The loss of a sense of purpose accompanying recent redeployments.
Army STARRS is the largest study of mental health risk and resilience ever carried out among military personnel. Civilian researchers conduct this strictly voluntary study and send soldiers’ confidential responses to the University of Michigan to help the Army identify factors that protect soldiers’ mental health and those that put soldiers’ mental health at risk. U.S. Army photo
The truth is, however, that there aren’t many clinical data to support a consistent theory of “why,” and those that exist are accompanied by a litany of bewildering variables and caveats. One of the most comprehensive longitudinal studies of service member suicides to date, the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), a five-year study launched in 2009 by the Army and the National Institute of Mental Health, released some preliminary findings in the spring of 2011, including the following:
- The suicide rate was highest among service members currently deployed, and dropped after deployment.
- Married service members generally had a lower suicide risk during deployment.
- The suicide rate among women increased with deployment at a much higher rate than among men.
- Over time, the suicide rate increased for soldiers in all settings.
The last finding may be the most salient in considering the surge in suicides in the summer of 2012, more than a decade into the Afghanistan conflict. The number and duration of stressors, many of them perhaps yet to be cataloged, may have reached a tipping point for the 26 soldiers who took their own lives in July; otherwise, the demographics of this (very small and isolated) sample didn’t neatly match up with Army STARRS’s preliminary findings: Of the 26, all were men; two were officers; 13 were married, 10 single, and three divorced. Six of the soldiers had never been deployed; seven had been deployed between one and three times, and one had been deployed six times.
These numbers suggest it’s still very difficult to predict which service members will attempt suicide, which is of course an important first step toward preventing it. The lack of data was one of several obstacles pointed out in a report issued by the Center for a New American Security (CNAS), a Washington think tank, in October 2011, titled, “Losing the Battle: The Challenge of Military Suicide.”