WASHINGTON September 16, 2012 - The primary reason for death in the US Army is not vehicle accidents or combat; it is suicide.
Army suicides rose 18% during the first six months of 2012, when compared to the same period in 2011. In the 26 year period of 1977 to 2003 there were 80% fewer suicides than between 2004 and 2008. This year, about 25 veterans have taken their own life for every soldier lost in combat.
Although there are outpatient facilities available for army personnel, they are underutilized. The primary reason, according to soldiers, is the fear of being stigmatized and putting careers in jeopardy. Some (maybe many) military personnel believe that asking for mental-health help is a shameful weakness.
The issue of suicides in the US Army has been studied by Dr. Timothy Lineberry, and his findings were recently published in the Mayo Clinic’s journal Proceedings. His research may help reduce military suicides, and public awareness of the information can help.
1. Veterans commit suicide using firearms 70% of the time and are more likely to own a firearm than non-veterans. Deaths may be reduced by making sure veterans with psychiatric problems have restricted access to their gun(s). Taking the weapon out of the home or putting it in safe storage is recommended.
2. After controlling for mental health diagnoses such as depression and PTSD, researchers discovered that inadequate or disturbed sleep is a suicide red flag. Sleep disturbance in military personnel needs to be considered a possible sign of suicidal ideation (thoughts), even if other symptoms such as hopelessness are not evident.
3. The use of opioids (or opiates) increases a veteran’s risk for overdose, substance use related accidents, and injuries resulting from violent behavior or self-harm. There is a concern that opioids are over-prescribed to veterans with psychiatric diagnoses such as PTSD, contributing to the rise in suicide, and accidental deaths from risky behavior.
4. It is recommended that all physicians have more training in the diagnosis of psychiatric problems and signs of suicidal behavior. Prior studies revealed that many people who commit suicide had visited a primary care physician during the month preceding their death. Increased doctor awareness of psychiatric symptoms may save lives.
Because soldiers are trained to be strong and persevering, some will never choose to seek help for emotional or mental issues. If they do request assistance, it may be after their symptoms have become intense or debilitating. Some will have waited too long.
It makes sense to quit waiting for army (and other military) members to come forward for help, and to address soldiers’ mental and emotional fitness on par with their physical fitness. It makes even more sense when you consider that many veterans, though not suicidal, sometimes suffer and struggle for years without utilizing available help; many are disabled by their invisible wounds.
Our military’s mental health treatment is primarily a reaction to problems that have already developed. However, there is at least one army that chooses to nip problems in the mental and emotional bud.
The efficient Israeli Defense Force takes a proactive approach to military mental health. Their personnel are mentally prepared for military operations, and they receive counseling for the duration of that activity. Considering the costly mental health issues facing our military this approach is worth considering.
Lineberry, Timothy W., MD, & O’Connor, Stephen S., PhD, (Sept 2012) Suicide in the US Army, Mayo Clinic Proceedings, 87:9, 871-878.
Thompson, Mark (9/2012) Military mental health: An outsider takes a peek inside, http://nation.time.com/2012/09/11/military-mental-health-an-outsider-takes-a-peek-inside/#ixzz26ewEsVco