Mental health risk factors for suicides in the US Army, 2007–8
- Kathleen E Bachynski1,
- Michelle Canham-Chervak1,
- Sandra A Black2,
- Esther O Dada1,
- Amy M Millikan2,
- Bruce H Jones1
- 1Injury Prevention Program, US Army Public Health Command, Aberdeen Proving Ground, Maryland, USA
- 2Behavioral and Social Health Outcomes Program, US Army Public Health Command, Aberdeen Proving Ground, Maryland, USA
- Correspondence to Dr Michelle Canham-Chervak, US Army Public Health Command, Injury Prevention Program, ATTN: MCHB-IP-DI, Aberdeen Proving Ground, MD 21010-5403, USA;
Contributors KEB made substantial contributions to the conception and design, acquired, analysed and interpreted the data presented in the manuscript, drafted the article and managed all revisions and production of the final manuscript. MCC made contributions to the conception and design, the analysis and interpretation of results, and provided critical reviews and intellectual input to manuscript drafts. SAB made contributions to the conception and design, assisted with acquisition of the data, and provided critical reviews and intellectual input to manuscript drafts. EOD made contributions to the conception and design, furnished critical analytic support, and provided critical reviews and intellectual input to manuscript drafts. AMM made contributions to the conception and design, the acquisition of data, and provided critical reviews and intellectual input to manuscript drafts. BHJ made substantial contributions to the conception and design, the analysis and interpretation of data, and provided critical reviews and intellectual input to manuscript drafts. All authors gave approval to the final version to be published.
- Accepted 17 January 2012
- Published Online First 7 March 2012
Objective Suicides among active duty US Army personnel have been increasing since 2004, surpassing comparable civilian rates in 2008. This analysis uses US military data to assess suicide rates for the 2-year period 2007–8, and examines relative risks (RR) of suicide associated with mental health disorders.
Methods Historical trends of US Army suicides were assessed using 1977–2008 data from Army G-1 (Personnel). Suicide rates, RR and the 2000–8 trends of mental health disorders were calculated using data from the Defense Casualty Information Processing System and Defense Medical Surveillance System.
Results A total of 255 soldiers committed suicide in 2007–8 (2008 rate 20.2 per 100 000). Factors associated with higher suicide risk included male gender, lower enlisted rank and mental health disorders treated on an outpatient basis (RR 3.9), as well as a number of mental health disorders (mood disorders, anxiety disorders, post-traumatic stress disorder, personality/psychotic disorders, substance-related disorders and adjustment disorder; RR range 4.7–24.5). Analysis of historical trends suggested that 25–50% of the suicides that occurred in 2008 might have been related to the major commitment of troops to combat beginning in 2003.
Conclusions The recent increase in suicides parallels an increase in the prevalence of mental disorders across the army. This finding suggests that increasing rates of clinically treated psychopathology are associated with increasing rates of suicides; these rates probably serve as sentinels for suicide risk in this population. Soldiers seeking treatment for mental disorders and substance abuse should be a focus for suicide prevention.
- descriptive epidemiology
- mental health
- public health
- risk factors
- suicide/self harm
Previous presentation: Force Health Protection Conference, Phoenix, AZ, 7–13 August 2010.
Funding This work was supported in part by an appointment to the postgraduate research participation program at the US Army Public Health Command (USAPHC) administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and USAPHC.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data for this article were obtained from the Army Behavioral Health Integrated Data Environment (ABHIDE). Requests for these data are handled by the US Army Public Health Command (http://phc.amedd.army.mil/). Data were also obtained from the Defense Medical Epidemiology Database (DMED). Requests for these data are handled by the Armed Forces Health Surveillance Center (http://afhsc.army.mil/).