Military Suicide: Developing an Understanding of Basic Issues to Provide a Lower Risk Force - Subpopulation of Recruits Enters Service With Disposition Toward Suicide or History of Suicidal Behaviors

This report has been professionally converted for accurate flowing-text e-book format reproduction. The U.S. military has historically experienced a much lower suicide rate compared to the general US population. In the last decade, the suicide rate for military personnel exceeded that of the general population; additionally, the suicide rate for military personnel more than doubled. This dramatic increase in suicide rates for the military gained significant public attention and the military then focused on preventing suicides for currently serving service members. However, the suicide prevention efforts placed little emphasis on preventing the induction of high risk subpopulations. An exploration of available research and demographic data identifies specific subpopulations at increased suicide risk prior to entering service. Comparisons of the Army Study to Assess Resilience and Risk in Servicemembers (STARRS), national mortality data, and national census data provided a more detailed view of the suicide decedent population. Both the general and military decedent populations present specific trends in behavior and demographics that lead to suicidal behaviors. The common issue affecting both populations is that the young adult age groups are the most affected by suicide. This suggests that a significant proportion of new service members enter service possessing the characteristics that will lead to suicidal behavior. These findings imply that the current suicide prevention programs may not fully address the underlying mental health issues associated with the young adult population. As a result, the services may be inadvertently recruiting service members with increased risk. The military services have a history of conducting psychological screening in times of conflict, and have developed additional testing aids that may assist in efforts to provide a more resilient force. Unfortunately, the military services currently do not place significant effort on reducing the population with highest suicidal behavioral risk at the point of accession for service. Efforts to identify and reduce these specific subpopulations will both reduce the military suicide rates and enable military medical resources to focus better on the currently serving population to enhance suicide prevention and intervention efforts.

Despite the low probability of suicide, the public pays particular attention to military and veteran suicides. Until recently, the military had enjoyed a considerably lower rate of suicide among its members than the rest of the American society. Soldiers died at rates that were typically less than half that of their civilian counterparts. The likely explanation for the historically lower military suicide rates in previous generations was the greater scrutiny in induction standards, a strong sense of social network, and ready access to health care. Military suicide rates increased in the 1990's until they surpassed civilian suicide rates in the early Twenty-First Century. Suicide rates among service members grew from approximately ten per 100,000 service members in 2003 to almost twenty per 100,000 service members in 2009. The suicide rate reached a high of 22.7 deaths per 100,000 members in 2012, and then decreased again to 19.9 per 100,000 service members by 2014. The fact that suicide rates doubled was unprecedented, and coincided with the military's entry into protracted conflict in Iraq and Afghanistan and the associated increased manpower requirements. In 2012, the proportion of veteran and service member deaths attributed to suicide exceeded deaths attributed to hostile fire. Thus, suicide became the second leading cause of military death, just behind accidents.