army suicides

[newpsych]

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http://m.cnn.com/primary/_co37qo-i69esadf4I

Of course being in the military is stressful, but after reading this article, it almost seems that maybe the high suicide rate may say something about the type of people that enlist in the army...any thoughts?

 

[Daedra22]

I would like someone to look into suicide rates in spouses. When my husband was in the military, there was an epidemic of suicide attempts and successes in spouses of our unit. I've never been able to find concrete numbers on military spouses as a whole, though.

 

[235750]

Suicides are the #2 cause of death in the armed forces, only behind accidents.

In my opinion there are three big problems:

(1) Limited access to healthcare providers. There are hardly any psychiatrists in the armed forces. For example, in 2008 at Lakenheath for example there was 1 psychiatrist for all of England. In Korea there were 2. I can't remember how many tens of thousands of troops they were responsible for, but it was a lot

(2) No confidentiality. The electronic scheduling system (patient appointments and scheduling (PAS) component of CHCS) is incredibly flawed. Anyone with access to the hospital can look up what sort of doctor you have an appointment for. Even though the bases can be fairly large, it's a fairly small community, especially if you're overseas. Imagine having to worry about your coworkers/neighbors spying on you on top of your problems

(3) Vulnerable populations. Only the air force requires a high school degree. You take these young, uneducated people and separate them from their families for years at a time.

 

[whopper]

The military is supposed to employ a psychological autopsy in the event where a death is considered a suicide or an equivocal death (reason to believe it was a suicide but could also be an accidental death).

Grabbing all of the psychological autopsies done in the last 10 years by the military could yield data that could help the medical arm of the military determine measures that can be taken to prevent future suicides.

 

[OldPsychDoc]

Suicides are the #2 cause of death in the armed forces, only behind accidents.

In my opinion there are three big problems:

(1) Limited access to healthcare providers. There are hardly any psychiatrists in the armed forces. For example, in 2008 at Lakenheath for example there was 1 psychiatrist for all of England. In Korea there were 2. I can't remember how many tens of thousands of troops they were responsible for, but it was a lot

(2) No confidentiality. The electronic scheduling system (patient appointments and scheduling (PAS) component of CHCS) is incredibly flawed. Anyone with access to the hospital can look up what sort of doctor you have an appointment for. Even though the bases can be fairly large, it's a fairly small community, especially if you're overseas. Imagine having to worry about your coworkers/neighbors spying on you on top of your problems

(3) Vulnerable populations. Only the air force requires a high school degree. You take these young, uneducated people and separate them from their families for years at a time.

4) 24/7 access to firearms. Seriously--one of my colleagues just returned from a year with a Guard unit in Iraq. It's instant stigma if a soldier's gun is taken away. They do sometimes remove the firing pin, but that just postpones the situation--plus requires, for example that the soldier be visibly reassigned. E.G.--can't take sentry duty or go out on escort missions, etc...

 

[whopper]

Link didn't work for me.

Agree with OPD. There is a higher degree of suicides in professions with access to the means to do it. Remember, suicides are often unsuccessful. For example, someone who attempts to hang himself often times in the process breaks the rope, or during the process finds it too painful and stops it but they did want to die.

A gun on the other hand---bang and usually it's over with that.

So it's(edit: not a) surprise that some sources suggest police officers and medical professionals (after all, we know how to kill ourselves right) at the top among professions that commit suicide. It could be that it's not so much that these professions have a higher incidence of suicidal ideation vs the population. It could just be that the people in the profession are better at completing the job.

For those of you who don't believe it's hard to complete the act, you haven't read the medical data. Many people attempt to do it but are unsuccessful.

 

[newpsych]

http://www.cnn.com/2011/US/01/19/army.suicide.rate/index.html?iref=storysearch

Maybe that one will work. Sorry about that.

I agree that the ease of actually committing suicide is most definitely a contributing factor, but do you suppose that certain personality traits are common in people that sign up for the Army, and that those traits make them more vulnerable to attempting (and with guns, likely succeeding) in committing suicide?

 

[235750]

4) 24/7 access to firearms.

I was going to add that, but I didn't want to get into the 'gun ownership is a risk factor' debate again 🙂 Think I harped enough on that already!

 

[notdeadyet]

(3) Vulnerable populations. Only the air force requires a high school degree. You take these young, uneducated people and separate them from their families for years at a time.

I don't know how much of it I'd put on education. The big majority of the enlisted have at least a high school degree.

I do think demographics play a role. The Army (the subject of the article and the only branch I have much familiarity with) skews towards the lower end of the socioeconomic brackets. Soldiers have much higher rates of physical/sexual abuse and trauma growing up than your average college kid. Much higher rates of drug abuse, personal and witnessed, as youths.

4) 24/7 access to firearms. Seriously--one of my colleagues just returned from a year with a Guard unit in Iraq. It's instant stigma if a soldier's gun is taken away. They do sometimes remove the firing pin, but that just postpones the situation--plus requires, for example that the soldier be visibly reassigned. E.G.--can't take sentry duty or go out on escort missions, etc...

I'd be more believing of that, but for the fact that the number of soldiers killing themselves with service weapons is a fraction of the number. A vast majority kill themselves in the U.S. and off-base. The biggest rise has been among reservist, who rarely have easy access to firearms until deployed.

Firearms play a big role, as personal handgun is one of the leading causes of death. This probably plays again into the demographic, since private handgun ownership is higher in the Army than in civilian sector.

 

[OldPsychDoc]

...The biggest rise has been among reservist, who rarely have easy access to firearms until deployed.
....

There has been a huge increase in utilization of reservists in the current conflicts as well--likely contributing to the increased rate in this population.

 

[DrGachet]

I do think demographics play a role. The Army (the subject of the article and the only branch I have much familiarity with) skews towards the lower end of the socioeconomic brackets. Soldiers have much higher rates of physical/sexual abuse and trauma growing up than your average college kid. Much higher rates of drug abuse, personal and witnessed, as youths.

I had heard somewhat similar things about physicians who commit suicide (history of trauma) but the person telling me this could not recall where he had read that. Do you have any references that back up your views regarding soldiers? I'm specially interested in possibly history of trauma and also the socioeconomic background. Thank you.

 

[notdeadyet]

There has been a huge increase in utilization of reservists in the current conflicts as well--likely contributing to the increased rate in this population.

Absolutely. And their circumstances are a lot more conducive to PTSD and suicide. The combat experienced by active and reserve Army is the same. It changes on the return home.

Active Army returns to their base as a company or battalion; you come back with people who have had the same shared experience. You demobilize together. You go back to stateside service together. As you struggle with any sequella you have from the war, you do so in the company of others doing the same. You also have sister units on different deployment schedules around you. Folks who came back 1-2 years ago see your struggles and can provide guidance. They can let you know what services are worthwhile, which chaplains are good listeners. You can just unofficially jaw with others who've been through it. You are surrounded by people with shared experiences literally every day.

Reserve Army sometimes returns to their base as a company or battalion, but often as individual augmentees. After demobilization, you are thrown back in civilian life. You're surrounded day-to-day by people who have no concept of what your war experience was like. The public is largely supportive of your veteran status in a very superficial way, but the war is not much talked about anymore and certainly not dominating the news. But it's still very relevant to you. You have VA coverage for any mental health issues for 2 years after your return, but most reservists return to civilian healthcare and your average civilian physician does not screen for whether you're a veteran and even if he does, knows little about your experiences and not much about PTSD. You have a support network that meets only one weekend per month and the rest of the time, you're largely on your own.

 

[notdeadyet]

I had heard somewhat similar things about physicians who commit suicide (history of trauma) but the person telling me this could not recall where he had read that. Do you have any references that back up your views regarding soldiers? I'm specially interested in possibly history of trauma and also the socioeconomic background.

The data I've come across before shows that compared to the U.S. population at large, African Americans are over-represented at about 26% (though that number's dropping), Asian Americans/Latinos are underrepresented. The South is over-represented compared to the East. Education is slightly higher in the military than civilian world for the enlisted (though this number might be misleading, as the Army is pretty liberal with awarding education units and they are often pursued for the sake of advancement). Post-9/11, the number of folks from higher incomes started joining at higher numbers, but this leveled off with the war ongoing.

In regards to physical trauma backgrounds, there were higher levels of physical abuse compared to the general population. I would attribute that to coming from the backgrounds they did, not as a selector influence for the Army.

For sexual trauma, I have the info more top of mind because of some research I've been doing. Female veterans are more likely to have had pre-Army exposure to sexual abuse than their civilian counterparts (33% vs. 17-22%). For men, past sexual trauma was comparable. A good article for this is:

Street A, Vogt D, Dutra L. A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan.
Clinical Psychology Review 29 (2009): 685-694

 

[ieatpizza]

Interesting series of posts by a blogger on Army suicides:
1. Perniciously blaming low morale for soldier suicide http://petulantskeptic.blogspot.com/2011/01/perniciously-blaming-low-morale-for.html
2. Breaking down the Army's suicide data http://petulantskeptic.blogspot.com/2011/01/breaking-down-armys-suicide-data.html
3. The future of the Army's suicide & PTSD problems http://petulantskeptic.blogspot.com/2011/01/future-of-armys-suicide-ptsd-problems.html