Researchers have analyzed data from 9,791 Army personnel who attempted suicide during the wars in Afghanistan and Iraq, identifying risk factors for enlisted soldiers and officers.
According to the study in JAMA Psychiatry, from 2004 through 2009, the Army experienced the longest sustained increase in suicide rates relative to the other US military branches (Navy, Marines and Air Force). Nonfatal attempts rose sharply in line with an increase in fatal attempts.
Dr. Robert Ursano, of the Uniformed Services University of the Health Sciences in Bethesda, MD, and coauthors identified risk factors among the data. Enlisted soldiers had higher odds for a suicide attempt if they were:
- Female
- Had entered the Army at age 25 years or older
- Were currently 29 years old or younger
- Had not completed high school
- Were in their first 4 years of service
- Had a mental health diagnosis during the previous month.
The research finds that female enlisted soldiers are more than twice as likely as male enlisted soldiers to attempt suicide in spite of accounting for only 13.7% of the active-duty regular Army – so may be considered for risk assessment interventions, say the authors.
The researchers’ estimates showed that soldiers were more likely to get into a suicidal state than their managing officers.
Enlisted women had nearly 13 times the risk of female officers for a suicide attempt; and enlisted soldiers who entered the Army at 25 years or older had more than 16 times the risk of officers in the same age group.
The authors conclude:
“Enlisted soldiers in their first tour of duty account for most medically documented suicide attempts. Risk is particularly high among soldiers with a recent mental health diagnosis.
A concentration of risk strategy that incorporates factors such as sex, rank, age, length of service, deployment status and mental health diagnosis into targeted prevention programs may have the greatest effect on population health within the US Army.”
Dr. Ursano and team used data on documented suicide attempts in active-duty US Army members during the wars in Afghanistan and Iraq from the Army Study to Assess Risk and Resilience in Service members (Army STARRS).
While enlisted soldiers constituted 83.5% of active-duty regular Army soldiers, they accounted for almost all cases of suicide attempt (98.6%, or 9,650 cases).
This equated to an overall rate of 377 per 100,000 person-years during the study period.
Officer ranks (both commissioned and warrant) accounted for 16.5% of the regular Army but only 1.4% of suicide attempts (141 cases), equating to an overall rate of 27.9 per 100,000 person-years.
The peak time for suicide risk in enlisted soldiers was the second month of duty, after which the risk fell as length of service increased.
The groups showing lower likelihood of a suicide attempt were:
- Black, Hispanic or Asian race or ethnicity
- Currently deployed enlisted soldiers (as compared with other enlisted soldiers).
The study authors make this recommendation:
“Future studies should examine suicide attempt risk in the context of other military characteristics (for example, military occupational specialty, number of previous deployments, history of promotion and demotion) and mental health indicators (for example, number and types of psychiatric diagnoses, treatment history).”