Suicide Attempts by U.S. Army Soldiers Greatly Increased

The rate of suicide attempts by enlisted U.S. Army soldiers has significantly increased during the last 10 years of war in Iraq and Afghanistan.

A new study published in JAMA Psychiatry found that the Army has the longest stretch of continual increases of suicide attempts as compared to the other military branches — Air Force, Marines, and Navy.

U.S. Army enlisted soldiers make up 83.5 percent of active-duty regular soldiers. Those enlisted Army personnel accounted for 98.6 percent (9,650 cases) of all suicide attempts, with an overall rate of 377 per 100,000 “person-years” during the study period of 2004 – 2009.

“Mental health diagnoses, which are among the most consistent risk factors for suicidal behaviors, increased dramatically in the US military during the past decade of war,” according to the study authors led by Robert J. Ursano, M.D., of the Uniformed Services University of the Health Sciences, Bethesda, MD. “In the present study, suicide attempts among enlisted soldiers and officers were associated with a history of receiving a mental health diagnosis.”

Researchers found that enlisted soldiers had higher odds for a suicide attempt if they were female, had entered the Army at 25 or older, did not complete high school, were in their first four years of service, and had a mental health diagnosis during the previous month.

“We found that 59.8% of enlisted soldiers (5774 of 9650 suicide attempts) and 70.2% of officers (99 of 141 suicide attempts) received a diagnosis before their suicide attempt, suggesting that many at-risk soldiers have already been identified by the Army health care system as needing mental health services and providing opportunities for further risk assessment and intervention,” said the authors.

The risk for enlisted soldiers was highest in the second month of service and declined as the length of service increased. Currently deployed enlisted soldiers were less likely than other enlisted soldiers to attempt suicide, with higher odds of suicide attempts among never deployed and previously deployed enlisted soldiers. Non-Hispanic, white soldiers were found to be at greater risk than black, Hispanic, or Asian soldiers.

The authors note their study focused only on suicide attempts documented by the Army health care system, which means undocumented suicide attempts, including self-pay treatment at civilian health care facilities, may have different risk factors. The authors also were unable to examine suicide attempts among those individuals who recently left the Army.

The authors conclude that “a concentration of risk strategy that incorporates factors such as sex, rank, age, length of service, deployment status and mental health diagnosis into targeted prevention programs may have the greatest effect on population health within the U.S. Army.”

-Alan Lyndon