Canadian military personnel have higher rates of suicidal thoughts and suicide attempts, but they are also more likely to access mental health support than civilians, found new research in CMAJ (Canadian Medical Association Journal).
Suicide prevention has been a focus in Canada in recent years, with initiatives such as the Mental Health Commission of Canada and major investments in military and veteran mental health aimed at reducing this cause of death. Despite these initiatives, suicide rates have remained mostly unchanged.
The media in Canada has criticized the Canadian Armed Forces (CAF) about the lack of mental health services for military personnel. However, the CAF has engaged in greater investments in mental health services renewal over the past decade, relative to the Canadian public system. Over the same general period, more than 40,000 CAF personnel were deployed in support of the mission in Afghanistan. There is a lack of information on the relative trends in suicidality and use of mental health services in the two populations.
Researchers from Canada and the United States looked at data from four nationally representative surveys in 2002 and 2012/13 to compare rates of suicidal thoughts and help-seeking in military and civilian populations. They found that in 2012/13, personnel in the CAF had a 32% increased odds of thinking about suicide and 64% increased odds of planning suicide than the civilian group.
"Trends of an increasing lifetime prevalence of suicide attempts over the 10-year period and of a higher prevalence of suicidal ideation and plans among military personnel than among civilians in 2012/13 is a concerning and important observation with public-policy ramifications," writes Dr. Jitender Sareen, Department of Psychiatry at the University of Manitoba, Winnipeg, Manitoba, with coauthors.
The authors also found that suicidal ideation in women, but not men, who served in the military decreased over time.
"The prevalence of lifetime and past-year suicidal ideation among male military personnel did not change over time; however, female military personnel had a significant decrease in lifetime suicidal ideation," write the authors. They suggest it may be that women are more likely than men to seek help for mental health issues.
People in the military with suicidal thoughts were significantly more likely than civilians to seek help and accessed more types of professionals for help. Care-seeking for suicidality increased in both populations, but the increase was significantly greater in the CAF.
"This study supports the criticism that the Canadian public health care system is not universal but has significant inequities, inefficiencies and varying levels of service," states Dr. Sareen. "It also speaks to potential value of incremental investments in the public system, similar to those made in the CAF."
Article: Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations, Jitender Sareen MD, Tracie O. Afifi PhD, Tamara Taillieu MSc, Kristene Cheung MA, Sarah Turner BHSc, Shay-Lee Bolton MSc, Julie Erickson MA, Murray B. Stein MD MPH, Deniz Fikretoglu PhD, Mark A. Zamorski MD MHSA, CMAJ, doi: 10.1503/cmaj.151047, published 24 May 2016.