Combat doesn't raise military suicide risk, study finds

Thursday , March 06, 2014 - 1:07 PM

Elizabeth Lopatto

SAN FRANCISCO — Neither combat or being stationed abroad increases the likelihood that U.S. soldiers will die by suicide, according to a seven-year study of active and former military members.

Rather, the risk factors for suicide are similar to those seen in the civilian population, according to the study in the Journal of the American Medical Association. People at higher risk of dying by suicide were male, were depressed or bipolar, and had alcohol-related problems.

The suicide rate in the U.S. Army surpassed that of similar civilians in 2007, according to research published last year in the journal Injury Prevention. The number of suicides has been rising since 2004. Tuesday’s finding suggests that the approaches used to curb suicides by civilians will also work in the military, said Charles Engel, a colonel in the Army Medical Corps who wrote an accompanying editorial.

“In the military, we don’t have to reinvent the wheel to prevent suicide,” Engel said in a telephone interview. He wasn’t involved in Tuesday’s study. “There are things tested in the civilian sector that we have been making big efforts to implement.”

One of the biggest problems in getting soldiers mental health care is that they know their careers are on the line when they see doctors, said Engel, who also is an associate professor of psychiatry at Uniformed Services University in Bethesda, Md. Clinicians can remove men from a job or recommend early retirement discharge. That makes the soldiers less likely than the general population to seek mental health services.

“The answer has to be an effort to approximate civilian standards of confidentiality,” Engel said. “Unless we’re dealing with an imminent risk to combat or a tactical mission, really we should be using civilians’ standards.”

About 150,000 current and former members of the military, including the Army Reserve and National Guard, participated in today’s study. By the end of 2008, there were 83 suicides. That’s about equivalent to 12 people out of 100,000 current and former members of the military dying by suicide each year.

While a study published by the Journal of Psychiatry Research in 2011 suggested that deployment increased the likelihood of risky behavior and psychiatric problems, the authors’ findings suggest that isn’t the case as far as suicide is concerned. The length and numbers of deployments and combat experiences weren’t directly associated with an increased risk of suicide.

Studies have shown that diagnosed mental illnesses have risen among those in active-duty service since 2005, the authors wrote in their paper. That increased risk factor may explain why the suicide rates are the same for military members and civilians.

The steepest increases in suicides have been since 2008, a period the authors’ data doesn’t cover. Today’s finding doesn’t rule out that the psychological aftereffects of multiple and long deployments may be delayed.

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