Suicide in the Military

August 16, 2013, 2:06 pm

The suicide rate in the military has been in the news over the last few years. Last year’s total number of suicides, 349, were higher than the number of combat fatalities for the year. More members of the military killed themselves than were killed by their official enemies. The traditional explanation for this has been that the stress of war and repeated deployments away from family has taken its toll. See, e.g., here. A new article in The Journal of the American Medical Association can’t find that linkage:

The findings from this study are not consistent with the assumption that specific deployment-related characteristics, such as length of deployment, number of deployments, or combat experiences, are directly associated with increased suicide risk. Instead, the risk factors associated with suicide in this military population are consistent with civilian populations, including male sex and mental disorders. Studies have shown a marked increase in the incidence of diagnosed mental disorders in active-duty service members since 2005, paralleling the incidence of suicide. This suggests that the increased rate of suicide in the military may largely be a product of an increased prevalence of mental disorders in this population, possibly resulting from indirect cumulative occupational stresses across both deployed and home-station environments over years of war. In addition to screening for and addressing mental health problems, further research is needed to more clearly understand the interrelationship of multiple risk factors leading to suicidal behaviors and the types and timing of interventions that may reduce or prevent death by suicide.

The three major flaws in the study are that the period it studied only went through 2008, and thus didn’t cover the entire period of the wars, that there were only 83 suicides during that period, a fairly small sample size, and that it didn’t look specifically at a veteran population as well. Nonetheless, it’s a striking find.

To take one example that highlights both the strengths and weaknesses of the report, the suicide rate for those who had deployed to either Iraq or Afghanistan for more than 180 days was less than half that of those who never deployed at all. That’s exactly the opposite of the conventional story (that increased deployment leads to increased suicide rates). The problem? The number of suicides in the 180+ population was 18 (out of 57,000+ person-years). That’s a really small sample size. If just 2-3 suicides in that population were not categorized that way, then the rate changes quite substantially.

So the report is, in some ways, a preliminary result, but still one that complicates the standard narrative of the consequences of combat stress.

See also: On Civil War Suicides.

Citation: CA LeardMann, Powell, TM, Smith, TC, and et, al, “Risk Factors Associated With Suicide in Current and Former US Military Personnel,” JAMA 310, no. 5 (2013): 496-506.

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