Minding the Minds of the Military

Curbing mental illness may help prevent suicides among members of the armed forces

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Many military personnel face extraordinary levels of on-the-job stress. While some have linked those stresses to suicide, a new study contends that treatable mental illness is more to blame for such deaths than military service itself.

Led by a US Department of Defense researcher, this study noted that suicides among people in the military have increased in recent years, and markedly so since 2005. Military leaders also have ramped up their focus on suicide prevention.

The authors of this new study suggested that stresses indirectly related to work and stresses at home may be increasing the rate of several mental disorders that they linked to these suicides.

"Get help for those at risk for suicide."

Cynthia A. LeardMann, MPH, of the Naval Health Research Center in San Diego, CA was lead author of this study.

"The findings from this study do not support an association between deployment or combat with suicide, rather they are consistent with previous research indicating that mental health problems increase suicide risk," the researchers wrote.

"Therefore, knowing the psychiatric history, screening for mental and substance use disorders, and early recognition of associated suicidal behaviors — combined with high-quality treatment — are likely to provide the best potential for mitigating suicide risk," they wrote.

LeardMann and her team of researchers reviewed medical records of more than 151,000 active and formerly active members from all military branches, the US National Guard and military reserve units in 2001, 2004 and 2007. Of those service members, 646 had died by the end of 2008. And 83 of the 646 deaths — or 12.8 percent of deaths — were by suicide.

Being male, binge-drinking alcohol, having other alcohol-related problems or diagnoses of depression or manic-depressive disorder increased a person's risks of suicide, the researchers wrote.

Of the 83 suicide victims, 68 were men. The researchers found that being male raised suicide risks by 44 percent.

Some of the suicide victims had been diagnosed with mental illnesses and, in some cases, more than one mental disorder:

  • Nine of the 83 suicide victims were diagnosed with post-traumatic stress disorder (PTSD), while the other 74 were not diagnosed with PTSD.
  • Nineteen had been diagnosed with depression, while 64 were not diagnosed with depression.
  • Five were diagnosed with manic depressive disorder, while 76 were not diagnosed with manic depressive disorder.
  • Five had panic attacks or other anxiety problems, while 77 did not.
  • Fifty-five were binge-drinkers, while 28 were not.
  • Twenty-five had other alcohol-related problems, while 58 did not.

The researchers concluded that preventing or eliminating the alcohol issues and depression would have reduced suicide risks by 18 percent among those with alcohol-related problems and 11 percent among those with depression, if the alcohol issues and depression were cured, the researchers wrote.

Because there were fewer cases of manic depression in the entire study group, eliminating that illness would reduce suicide risk by only 5 percent, the researchers wrote.

"The findings from this study indicate that the largest potential for mitigating suicide risk is by screening for and treating depression and alcohol-related problems," LeardMann told dailyRx News.

"While it is also important to screen and treat those with manic depressive disorder, due to the lower prevalence of this condition in the military population, [such screening] has less potential to decrease the total number of suicides," LeardMann said.

"The researchers speculate that [suicides] may largely be a product of an increased prevalence of mental disorders in this population, possibly resulting from indirect cumulative occupational stresses across both deployed and home-station environments over years of war,” according to a press release about the study.

The study follows the Department of Defense's own reports of steady increases in suicides among active and former military personnel. In 2012, the number of suicides among active military employees exceeded the number of those killed in battle.

Defense officials operate a 24-hour suicide prevention crisis hotline that, among other offerings, tells troubled active members of the armed forces and veterans where and how to get mental health care that could help them stay alive.

Suicide rates among active military personnel and veterans are higher than those of the overall population. In 2009, for example, there were 18.5 suicides per 100,000 people in the overall population. That same year, the suicide rate for all military branches was 18.8 per 100,000, according to a joint Army-National Institute of Mental Health research team.

Researchers on this new study placed the rate even higher in some military branches. They calculate a suicide rate of 19.9 per 100,000 active members of the Marine Corps and 19.3  per 100,000 people in the Army in 2008.

The researchers also said that, because their study ended in 2008, it may not capture the full complexity of the issue. They wrote: "It is possible that the cumulative strain of multiple and lengthy deployments only began to be reflected in suicide rates toward the later stages of the [recent military] conflicts, although the overall evidence points to the lack of any specific deployment-related effects."

This new study by naval researchers was published online August 6 in JAMA.

The US Departments of Defense and Veterans Affairs funded the study. One of the 10 researchers for this study disclosed having accepted funds from a global pharmaceutical company.

Review Date: 
August 6, 2013
Last Updated:
August 8, 2013