Rising suicide rates in the army are analyzed in a new initiative

Rising suicide rates in the army are analyzed in a new initiative

Three new studies published simultaneously in JAMA Psychiatry investigate mental health issues within the Army. The studies look at mental disorders among non-deployed soldiers, suicidal behavior among soldiers and predictors of suicide among soldiers.

The new studies were conducted by members of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) initiative.

Army STARRS was launched in 2009 to address the Army's concern over the rising suicide rate among soldiers.

Previously, the suicide rate for Army personnel has been lower than the suicide rate in the general population. But since 2002, the suicide rate among soldiers has risen, reaching record heights in 2007, 2008 - when it exceeded the civilian rate for the first time - and 2009, before receding slightly in 2010.

To form Army STARRS, the Army partnered with the National Institute of Mental Health and investigators from the Uniformed Services University of the Health Sciences in Maryland, Harvard Medical School in Massachusetts, University of Michigan and University of California.

The Army STARRS team created a secure database with more than 1 billion Army records and 3,000 types of information. In addition to historical data, Army STARRS collects new data from American soldiers posted all over the world.

Mental disorders among non-deployed soldiers

The youngest soldiers have an increased risk of suicide during and after deployment, while married soldiers or soldiers with children have a lower risk of suicide risk during deployment.

For this study, the Army STARRS team analyzed data from 5,428 surveyed soldiers.

The researchers found that a quarter of active duty, non-deployed soldiers met the criteria for at least one psychiatric disorder, with 11% meeting the criteria for multiple psychiatric disorders.

Out of the soldiers who met the criteria for psychiatric disorders, 49.6% had "internalizing disorders," such as major depressive, bipolar, generalized anxiety, panic, and post-traumatic stress disorders, and 81.7% had "externalizing disorders," which include attention-deficit/hyperactivity disorder (ADHD), intermittent explosive anger disorder, or drug and alcohol problems.

Symptoms of these disorders were present in 76.6% of these soldiers prior to enlisting. The Army already screens for emotional problems in pre-enlistment health examinations, so it is likely that Army recruits deny psychiatric disorders in recruitment interviews.

Nearly 13% of the soldiers reported that their disorder severely impairs their ability to carry out their duty.

The study concludes:

Knowledge that new recruits have high externalizing disorder rates (even if denied in recruitment interviews) might be useful to the Army in developing targeted outreach intervention programs for new soldiers, such as interventions for ADHD and for problems with anger management."

Suicidal behavior among soldiers

This study found that about one third of suicide attempts by soldiers (after enlisting) are associated with mental disorders that predate the soldiers' enlistment. Female soldiers, soldiers of a lower rank and soldiers that have previously been deployed are the most likely to attempt suicide after enlisting.

About 13.9% of the 5,428 non-deployed soldiers who were surveyed reported having suicidal thoughts, with 5.3% having made plans to end their life and 2.4% having attempted suicide.

The study concludes:

The possibility of higher fatality rates among Army suicide attempts than among civilian suicide attempts highlights the potential importance of means control (i.e., restricting access to lethal means [such as firearms]) as a suicide prevention strategy."

Predictors of suicide and accidental death among Army soldiers

This study found that white soldiers, male soldiers, junior soldiers, soldiers that have been recently demoted and soldiers that are currently or have previously been deployed are the most likely to commit suicide.

The researchers analyzed the data of 975,057 Army soldiers on active duty between 2004 and 2009. Within this group, 569 soldiers committed suicide and there were 1,331 deaths classified as accidents.

Although the Army STARRS investigation into suicidal behavior among non-deployed soldiers found that women were more likely to attempt suicide, this study reported that women are consistently less at risk of committing suicide than men.

The youngest soldiers have an increased risk of suicide during and after deployment, while married soldiers or soldiers with children have a lower risk of suicide risk during deployment.

The study concludes:

These results set the stage for more in-depth analyses aimed at helping the Army target both high-risk soldiers and high-risk situations, as well as at developing, implementing and evaluating preventive interventions to reverse the rising Army suicide rate."

Comments on all three studies

The three Army STARRS studies are accompanied by an editorial from Dr. Matthew J. Friedman of the Geisel School of Medicine at Dartmouth in Hanover, NH.

"These findings have major implications for screening, assessment, recruitment and retention of volunteers seeking military enlistment," Dr. Friedman says.

"These are only the first articles to come from the groundbreaking Army STARRS initiative," he continues.

"Future articles will hopefully provide finer-grained measurements and more in-depth analyses of the variables already mentioned, as well as new information on psychological, neurocognitive, social, biological and genetic factors. They will also investigate the impact of intervention."

Military Suicide Rate Continues to Rise at Alarming Rate (Video Medical And Professional 2020).

Section Issues On Medicine: Psychiatry