Suicide in the Military
Suicide in the military is a very serious problem. Historically the suicide rates have been lower in the military than those rates found in the general population. However, with the continued wars in Iraq and Afghanistan, military suicide rates have been increasing and surpassing the rates for society at large.
The Army has had the highest proportional number of suicides compared to the other services. However, Admiral Mullen noted that the rates in all the services have been creeping upwards (Knight Ridder Washington Bureau, 2010). Wiebe et al 2006 examined the rates of suicide from 1993-2002 and found that suicide was the first leading cause of death for female veterans and the second leading cause of death for male veterans. Kaplan et al 2009 found that military veterans were twice as likely to die of suicide compared to male non-veterans in the general population. In addition, the researchers found that individuals who were White, had greater than 12 years of education, and had activity limitations were at a greater risk for suicide completion. Other studies have also identified that failed intimate relationships, occupational, legal, financial, and psychiatric problems are top stressors for Service members. Therefore, it is important to become aware of these risk factors and proactively intervene to help Service members that are having difficulty coping.
The Department of Defense has taken steps to increase suicide prevention efforts. They have ordered command stand downs, mandated classes on suicide prevention, created videos, and encouraged leadership to ensure that all commanders are taking care of the Service members under their care.
What are some other strategies that can be used to help Service members who are struggling with suicidal thoughts? The first strategy is to work on increasing protective factors as early as possible. This means intervening during and right after boot camp. It is important to have clear goals that the Service members are striving to meet. An example of some goals would include obtaining further education, developing technical skills, travelling, and getting promoted. These goals would be instrumental in creating hope and future oriented thinking for our Service members. The second strategy that can be used to help Service members is to create an environment where there is no stigma associated with receiving services for mental health problems. Offering mandatory counseling to units that have been involved in intense combat situations may alleviate the stigma of each soldier having to ask permission for counseling. In addition, it is important to have well trained and adequate numbers of staff available to work with our Service members when they are ready for treatment. If a Service member is having fleeting suicidal thoughts today, it may not be helpful to get an appointment in three weeks. The third strategy we can use to help service members struggling with suicidal thoughts is to ask the difficult questions that will help one determine the Service member’s risk for suicide.
You may want to ask the following questions:
Are you currently having any thoughts of hurting yourself?
Do you currently have any desire to kill yourself?
Do you currently have any specific plan to kill yourself?
It is important to note that a suicide assessment is not a one time screen, but rather should be regularly used especially if there is a significant change in symptoms. Service members should also be asked about their access to fire arms and recommendations should be made for removal of weapons while they are experiencing suicidal ideation.
The fourth strategy that we can use to prevent suicide with Service members is to have clear knowledge of how everyone at the command will act when faced with a potentially suicidal Service member. There should be a clear plan of action of who to contact and how to react. For example, suicide notes should be immediately reported up the chain of command and taken very seriously. Medical teams should be contacted to intervene as soon as possible.
One of the most important things we can offer a Service member with suicidal thoughts is a safety plan. This plan should be collaboratively developed by both the Service member and his/her clinician. This plan should include the Service member’s specific warning signs that he/she is feeling worse, strategies that the Service member will use to cope with their suicidal thoughts, telephone numbers of friends or family that the Service member can call for support, and the telephone numbers for emergency contacts such as the clinic number, suicide hotline number, nearest hospital and 911. It is important to take every suicide threat seriously. Not taking a threat seriously can lead to an exacerbation of symptoms or a possible accidental suicide. Regardless of the type of suicide behavior, it is important to try to understand the meaning behind that behavior.