Soldiers who deploy to overseas wars are no more likely to commit suicide later in life than military personnel who remain at home, say Department of Defense researchers. Suicide risk for soldiers is still 41 percent to 61 percent higher than the rate among civilians, but a new study of nearly four million U.S. military service members may clear up debate about whether deployment is a meaningful factor in evaluating a soldier’s suicide risk.
A possible link between deployment and suicide was first raised as the suicide rate among soldiers increased by 80 percent from 2004 to 2008, during a period when American soldiers were deployed to both Iraq and Afghanistan. In the first half of 2012, the number of soldiers that the military lost to suicides was higher than those killed in combat. Two analyses published by the Department of Defense over the past two years had found conflicting results on this matter and the scope of each was limited. That disagreement provided the impetus for a study led by Mark A. Reger of the National Center for Telehealth and Technology at the Joint Base Lewis-McChord in Tacoma, Washington.
“I think easy answers are very compelling, especially for as something as important as suicide prevention," Reger says. "But in the history of medicine, we know many easy answers that have not panned out and this appears to be one of them."
Reger worked with staff at the Department of Veterans Affairs and a researcher with the University of Washington to search for death records of former soldiers through the Department of Defense’s Mortality Registry and the National Death Index. The 3.9 million soldiers analyzed in their work were enlisted during the two major U.S. military operations of the past decade. The researchers used death records matched with military files to look for factors that would most strongly predict a suicide.
The team found that 3,879 of the 5,041 service members who committed suicide over an eight-year period had never deployed. They also found that service members who spent less than four years in the military were at greater risk of suicide than those who served for more than four years, which is a typical term. Furthermore, soldiers who spent less than a year in the service were about twice as likely to commit suicide as those who spent between four and 20 years with the military.
“For someone who leaves after less than four years of service, that's typically going to indicate that something went wrong in their career,” Reger says. “When you consider -- what are the things that would cause someone to leave military service early, you think of things like misconduct, substance abuse and some of those are known risk factors for suicide.” Military service members with a dishonorable discharge were about 21 percent more likely to commit suicide than those with an honorable discharge.
Soldiers who leave the military early may also suffer from a loss of identity that is associated with military life, or have difficulty finding work or financial support outside of the service, the authors suggest. Reger is currently working with the Centers for Disease Control to study a few of these potential links in greater depth.
Brian Kinsella is a retired army captain and energy specialist for Goldman Sachs who founded an organization called Stop Soldier Suicide that runs a crisis line for veterans. So far this year, his team has fielded 58 calls from veterans who were considering suicide. He says this research will help to inform his group's work.
“I can give this to my triage and assessment coordinator and say, ‘Ok – if someone who comes to our organization has early military separation or a dishonorable discharge, then we need to pay closer attention to that client,” Kinsella says. However, Kinsella says that the analysis would be even more useful if it took that next step and helped his team to develop a better sense of the personal drivers that push a soldier to take his or her own life. Without a deeper grasp of that decision, his staff might not know whether to focus their efforts on finding jobs for clients or addressing a different issue in their life.
Kinsella also notes that while the risk is heightened for soldiers who serve for less than a year, most veterans who commit suicide are in their mid to late 50s. “It all comes back to how we transition people from active duty, reserve duty or guard duty into veteran status,” he says. “It's not just in year one, it's for many, many years.”
The authors were careful to state that their study did not look at whether soldiers who faced combat during their deployment were at higher risk for suicide, or whether other aspects of deployment such as suffering from post-traumatic stress disorder or a combat-related injury may boost a soldier’s risk. Their work was published to JAMA Psychiatry on Wednesday and supports the findings of a smaller study that was published earlier this year.