Defense Media Network

Military Suicide Prevention

More service members are dying by their own hands than in the battlespace – and the government and the military are trying desperately to help.


The CNAS report acknowledged the efforts made by the VA and DoD to improve suicide prevention, but listed several other remaining obstacles, including the difficulty of providing consistent mental health services to personnel who are frequently transferred; the encouragement of soldiers to provide untruthful answers in post-deployment mental health screenings – and a related cultural stigma against mental health care across the armed forces; and a fragmented approach to suicide prevention among the organizations charged with it, including the DoD, VA, Congress, and the Department of Health and Human Services (HHS).

“America,” the report’s authors concluded grimly, “is losing its battle against suicide by veterans and service members … To honor those who have served and to protect the future health of the all-volunteer force, America must renew its commitment to its service members and veterans. The time has come to fight this threat more effectively and with greater urgency.”


Turning the Tide

Lawmakers and professionals at all levels of government, however, are refusing to accept the idea that they’re losing. Congress, in its 2012 defense authorization, directed the DoD to enhance its suicide prevention program in cooperation with the VA, the National Institutes of Health (NIH), the Department of Health and Human Services (HHS), universities, and other public and private entities. In September 2012, DoD and HHS, as part of the public-private National Action Alliance for Suicide Prevention, revealed a national strategy for reducing the number of deaths by suicide that detailed a series of goals and objectives for reducing suicides over the next decade. The national strategy included four immediate priorities – including an improvement in the quality of data on suicidal behaviors – in order to develop better prevention efforts.

Army Wounded Soldier and Family Hotline

Sgt. Robin Duncan-Chisolm, U.S. Army Reserve, is one of many operators on hand to help at the Army Wounded Soldier and Family Hotline, a call center that is based at Army Human Resources Command in Alexandria, Va. The hotline is designed to give soldiers and their families a place to call with questions about the medical issues they face. Photo by Sheila Vemmer/Army Times

VA National Suicide Prevention Coordinator Janet Kemp, RN, Ph.D., has spent the last 20 years working with veterans, now at the Center of Excellence for Suicide Prevention at the VA’s medical center in Canandaigua, N.Y. She contributed to “Losing the Battle,” and sees the lack of quality data as a fundamental weakness in the fight against military and veteran suicides. “That truly is a huge issue,” she said. “And it pervades not only the military and veteran populations, but other populations in the country – we don’t have a robust, up-to-date database that we can look at to understand exactly who is killing themselves, and perhaps identify groups of people we could target.”

In late July 2012, DoD and VA announced that they were teaming to create a joint suicide data repository, to be in place by the end of the calendar year. Providing a central site for detailed and cross-referenced information about suicidal behavior, Kemp said, will enable the military and the government to “really start to follow people over time and to identify groups of people that we should be paying more attention to, where and when and how are people killing themselves, where can we intervene, whether there are diagnostic attributes, and so which treatments and therapies would be most effective in enhancing both of our systems.”

In the long term, having an exhaustive data set to help design strategies will be great – but in the meantime, everyone devoted to the problem is aware that service members and veterans are in pain, and more are dying by their own hands than ever before.

The Pentagon – an organization accustomed to prompt results – has taken two recent steps toward identifying evidence-based interventions that will help troops in crisis: First, it commissioned a study by the RAND Center for Military Health Policy Research into suicide risk factors and existing best practices in suicide prevention. “The War Within: Preventing U.S. Suicide in the Military,” was released in 2011 and provided DoD with 14 concrete recommendations to be implemented across the service branches.

DoD also established the Military Suicide Research Consortium (MSRC), a public-private partnership to enhance the military’s ability to identify at-risk service members and provide effective evidence-based prevention and treatment. Thomas Joiner, Ph.D., a clinical psychologist and professor at Florida State University who serves as a co-director of the MSRC, said the consortium’s focus is a new direction for him; he has spent his career trying to determine root causes, and written a book, Why People Die by Suicide.

As co-director of the MSRC, Joiner has found that understanding why is, to the Pentagon, a luxury to be realized at some future date; for now, the military wants evidence-based research it can use. “It’s consistent with military culture to roll things out quickly,” he said, “but at the same time, we want to be deliberative and scientific.” The treatments being researched by MSRC, Joiner said, tend to focus on short-duration interventions, and many of them are deliverable with or without a nearby DoD or VA health facility: They are available, in other words, on mobile data devices such as Blackberries® and iPhones®.

Another criterion for MSRC is that the treatment generally be viewed as acceptable within the military culture. For example, interventions that focus on the improvement of sleep – a significant factor in determining suicide risk – are, for the time being, going to be viewed more favorably than talk therapy for depression.

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Craig Collins is a veteran freelance writer and a regular Faircount Media Group contributor who...