DR. GOLDBERG
PSY 101
NOV. 16, 2010
Suicide Among Members of the United States Armed Forces
Suicide has always been defined to me as a troubled individual’s answer for short term
problems by means of a long term solution. I have spent five years in the United States Marine
Corps on active duty and experienced nearly a dozen completed suicides in that time, with about
two dozen unsuccessful attempts. My personal experiences have led me to further explore this
topic of suicide among members of the United States Armed Forces. I want to better understand
the behavior behind suicidal individuals in the military, how many statistically service men and
women, as well as recent veterans, turn to suicide, the potential reasons why, and what the
Federal Government and Department of Defense is doing as a means of prevention.
On a global scale, suicide accounts for nearly half of all violence related deaths (qtd in
World Health Organization, 2006). According to an article in the Journal of Mental Health titled
“A Comparative Review of Military and Civilian Suicide Behavior,” by Jeffery Martin, “suicide
is a significant public health concern within the United States military.”
There can be a
multitude or reasons why a person serving in the military commits suicide due to their emotional,
psychological, or physical issues. Whether it is before, during, or after a military deployment
that may or may not have been directly related (Martin 101). Heightened periods of emotional
and physical stress is no stranger to each branch of the military. The Army, Air Force, Navy,
Marines, and Coast Guard all begin training in a stressful environment known notoriously as
boot camp. This basic military training usually includes an in-processing for three to seven days
and a specific preplanned training period of six to twelve weeks (Scoville 1024). Although each
branch varies on its basic training, stress is always apparent. Such an event to cause such
emotional and physical stress is defined as stressors which will lead some individuals to take
their own life in basic training.
According to Military Medicine’s article titled “Deaths Attributed to Suicide Among
Enlisted U.S. Armed Forces Recruits,” by Dr. Stephanie Scoville, “the suicide rate among U.S.
military recruits at basic military training sites was 4.8 deaths per 100,000 recruits-years from
1977 through 2001.” The median age of these recruits committing suicide, between the ages of
seventeen through thirty five, was nineteen. About eighty percent were Caucasian males that
were in a median training period of forty one days. The majority of suicides were committed
while the recruits were on regular training statuses, while few were either awaiting
administrative separation, inpatients in a hospital, or both (Scoville 1025). This article also
indicates that the method of suicide with the highest percentage of thirty nine was by gunshot,
especially in the Army and Marines. Other methods and percentages include hanging; 35%, fall
or jump; 22%, and drug overdose; 4% (Scoville 1025)
To counter suicide during recruit training starts before the individual even joins by
prescreening their mental health. Also, the basic military training environment needs to be
controlled and closely monitored by its instructors as well as its enlisted recruits. However, the
article by Scoville indicates that this does not stop recruits from falsifying information during
prescreen documentation as well as medical or criminal history and background. According to
this same article, “depressive disorders were the most frequent reason for mental health
discharges from the Air Force basic military training from January through July 1997 and that
many of the recruits had lied about or omitted important mental health information during their
military entrance processing.”
After basic military training, boot camp, service men and women usually report to their
basic or advanced Military Occupational Specialty school and train until they are assigned to a
particular unit after completion of that training.
The United States Military has historically had suicide as its second leading cause of
death after accidents (Martin et al, 101). Active duty military is mainly comprised of young
adult males between the ages seventeen and twenty six in which males are four more times likely
to die by suicide than females (Martin et al, 102; qtd in CDC, 2006). Many risk factors can be
attributed to suicide in the military that are not necessarily surprising considering how society
perceives military life, especially during wartime. These attributors and factors include exposure
to extreme stressors, Post Traumatic Stress Disorder (PTSD), impulsivity, and Traumatic Brain
Injury (Martin et al, 106). Combat deployments have been shown to display considerable risks
for psychiatric disorders such as PTSD, major depressive behavior, and substance or drug abuse,
which are all associated as increased risk factors for suicidal behavior (qtd in Hoge et al 2004;
Kang & Bullman, 2008)
Research evidence shows that military deployments in a combat environment are
significant stressful life events (Martin et al, 106). According to this same article, “19.1% of
troops returning from OIF (Operation Iraqi Freedom) met the Post Deployment Health
Assessment (PDHA) criteria for a mental health concern.” It also showed that about ten percent
of troops returning from the war in Iraq had signs of PTSD and a little over one percent had
“reported some suicidal ideation.” (Martin et al, 106)
Traumatic Brain Injury (TBI) may trigger impulsivity and may impact directly to
executive functions, most preciously an individual’s inhibitions (Martin et al, 108).
Approximately sixty four percent of Iraqi and Afghanistan war veterans wounded in action are
injured by blast events (Martin et al, 108). This is most commonly known as Improvised
Explosive Devices (IED), or road side bombs.
Severe and untreated PTSD can lead to a higher probability of substance abuse,
depression, and suicidal behavior. About twenty percent of troops who report at least one
suicide attempt suffer from PTSD. For the service men and women, especially in combat,
stressors in the military may be truly unavoidable (Martin et al, 109).
Other risk factors for suicidal behavior among service men and women include a
failing relationship with a significant other, alcohol abuse and dependence, easy access to
firearms, and legal difficulties (qtd in Patterson et al, 2001). Although this is apparent with
civilians it is especially relevant in the military (Martin et al, 106).
Another article found in Military Medicine titled “Surveillance of Completed Suicide in
the Department of the Navy,” by PhD Valerie A. Stander, shows specific statistics and data on
suicides in the Navy and Marine Corps. This is known as a DONSIR (Department of Navy
Suicide Incident Report) which was to show specifics on age, gender, race, and form of suicide
within the Department of the Navy from 1999 to 2001. The DONSIR showed “most suicides
occurred outside the military work environment…the use of a firearm…recent relationship
problem and did not use any military support services in the thirty days before suicide.”
However this research was conducted prior to Americas War on Terror, but can still identify the
main risk factors for military members other than PTSD and TBI. It is the first surveillance
system within the department of the Navy designed specifically to collect epidemiological and
risk factor data on suicides in active duty military personnel (Stander, 302). Between 1999 and
2001, two hundred cases of completed suicides were identified within the Department of the
Navy.
One hundred and twenty two Navy personnel and seventy eight Marines mainly
comprised of males, with only four females in each branch who committed suicide (Stander,
302-303).
Most suicides occurred on liberty, after work hours, which were one hundred thirty one
cases; other cases were on leave with a total of twenty five completed suicides. On duty; twenty
cases. Unauthorized Absence (UA); eighteen cases. Other; six cases. Most suicides occurred at
their home of residence followed by either an isolated or common public space. Most involved
the use of a firearm followed by self hanging. Sixty five of these suicide cases were considered
highly likely with the use of alcohol (Stander, 304).
The total number of suicides because of recent relationship problems was fifty eight.
Other risk factors include disciplinary and legal problems with forty five cases in regards to
conflicts with authority, being under criminal investigation, and military or civil legal
difficulties. Fifty two cases were considered work related issues either job dissatisfaction, job
loss, job stress, and other. All other cases were perceived as being school or mainly financial
problems (Stander, 304).
This article also displayed that most cases showed the obvious signs of depression and
risk factors of suicide. From change in moods, isolation, a strong desire to die, loneliness,
change in sleep patterns, change in weight, poorer work performance, frequent intoxication, and
even suicidal gestures (Stander, 305).
Through significant research, the military-specific high risk profile for suicide is an
unmarried twenty two year old Caucasian male who is serving their first term as a junior enlisted
(Martin, 107). But after serving in which ever particular branch, combat deployed or not, that
military member is under a new title as a Veteran.
The article titled “Veteran Suicide Prevention: Emerging Priorities and Opportunities for
Intervention,” by Robert Bossarte and others, show how shocking suicide rates are among the
military, veterans, and civilians. According to the article the authors state how the “annual U.S.
rate of suicide has varied by fewer than three deaths per one hundred thousand citizens.” That
indicates roughly thirty three thousand American citizens will commit self murder each year
(Bossarte et al, 416). What’s even more shocking is that according to the National Violent Death
Reporting System, twenty percent of United States suicides could be among veterans (qtd in
Sundararaman et al, 2008). But if my statistical information from the previous article wasn’t
enough, in 2008 the United States Army suicide rates surpassed civilian rates for the first time
ever (Bossarte et al, 461). However, the increase in suicides among Iraqi and Afghanistan war
Veterans is lower than historical evidence of suicide rates among veterans from previous
conflicts (Bossarte et al, 462).
To counter the high rate of suicide among the United States Armed Forces, the
Department of Defense is taking extreme measures to the fullest. The DONSIR report in 1998
was in response after a series of suicide which included Chief of Naval Operations Admiral
Jeremy Boorda (Stander, 302). It was then that the Secretary of the Navy requested a full view
of suicide prevention programs within the Department of Defense.
It was developed by
Psychologists from the Navy Personnel Command, Headquarters United States Marine Corps,
Naval Criminal Investigation Service, the American Association of Suicidology and experts from
the National Institute of Mental Health (Stander, 302). The DONSIR can be used to evaluate
military-specific risk factors as well as show the baseline data of completed suicides and its
characteristics to track trends over time (Stander, 306).
The Department of Veteran Affairs and Department of Defense have been committed to
preventing suicide by funding research on military suicide, setting up support groups within the
Department of Defense, and provide training such as the Military Suicide Prevention Conference
(Martin et al, 102-103).
The next step is in training and classes on suicide prevention for every member of the
military especially small unit combat leaders. Each individual must know the characteristics of
suicidal behavior in order for there to be prevention when you consider the mindset of the
military member.
Strength of character, resilience, discipline, and combat readiness all
contribute to the idea that someone seeking mental health would be considered weak and
shameful (Martin et al, 109-110). Therefore, someone seeking mental health may not even
attempt to. That is the primary reason why every member of the armed forces should know the
signs and symptoms of common suicide behavior. It is truly the number one way to statistically
lower suicide rates in the military. Overall the management and treatment of suicidal individuals
requires time and effort with careful consideration of clinical factors (Martin et al, 112).
My personal experience in regards to this topic comes first hand. I served between the
years of 2004 through 2009 and have received countless hours on suicide prevention. As a small
unit leader, it was one of the many responsibilities I had looking out for the well being of
marines under my leadership. Most suicides I experienced in the marines involved the use of a
firearm, substance abuse, had already served on a combat deployment in Iraq, and because of
recent relationship issues. I also learned that the United States Marine Corps has the highest
suicide rate among all the other branches. It is also considered the finest fighting force in the
world.
It is clear suicide is not only a major problem around the world and in the United Sates,
but more severe among members of the Armed Forces. Sometimes you just can’t stop a man
from doing the unthinkable, but it is our responsibility to know the signs so that troubled
individuals’ answer for whatever problems they may face does not become a regretful long term
solution.
Works Cited
Bossarte, Robert, Cynthia A. Claassen, and Kerry Knox. "Veteran Suicide Prevention:
Emerging Priorities and Opportunities for Intervention." Military Medicine 175.7
(2010): 461-462. Academic Search Complete. EBSCO. Web. 14 Nov. 2010.
Martin, Jeffery, et al. "A Comparative Review of U.S. Military and Civilian Suicide
Behavior: Implications for OEF/OIF Suicide Prevention Efforts." Journal of
Mental Health Counseling 31.2 (2009): 101-118. Psychology and Behavioral
Sciences Collection. EBSCO. Web. 14 Nov. 2010.
Scoville, Stephanie L., et al. "Deaths Attributed to Suicide among Enlisted U.S. Armed
Forces Recruits, 1980-2004." Military Medicine 172.10 (2007): 1024-1031.
Academic Search Complete. EBSCO. Web. 14 Nov. 2010.
Stander, Valerie A., et al. "Surveillance of Completed Suicide in the Department of the
Navy." Military Medicine 169.4 (2004): 301-306. Academic Search Complete.
EBSCO. Web. 14 Nov. 2010.