Suicide Risk

Suicide Risk

Suicide Risk Resources for Providers

In June of 2018, the Centers for Disease Control and Prevention (CDC) released their 2015 data on suicide in the United States (U.S.). More than 44,000 Americans died by suicide in 2015. Importantly, data revealed that 54 percent of Americans who died by suicide in 2015 had no known history of a mental health disorder. This matches well with what has been reported about military suicide decedents via the DoDSER for many years – that about half of military decedents have no known mental health diagnoses (53 percent in 2016, 50 percent in 2015, 49 percent in 2014). Overall general and military suicide rates are similar when rates are adjusted for the different sex and age distributions between their populations: 17.3 per 100,000 in the general population vs. 17.0 per 100,000 in the Active Component military population (p. iv, 2016 DoDSER).

Both CDC and DoDSER data are also consistent on the relative frequency of certain psychosocial stressors in those who die by suicide. For example, the CDC found relationship problems in 42 percent of those who died by suicides in 2015 and job or financial problems in 16 percent. Similarly, - according to the 2016 DoDSER, 44 percent of service members who died by suicide had relationship problems, while only 17 percent had workplace problems.

Similarities aside, we know that military service members’ lives are generally very different from the lives that civilians lead. Service members can be subject to frequent relocations, overseas deployments, and combat environments and experiences that can compound stresses associated with significant time away from one’s family and the stigma associated with seeing “the wizard” for help. The Department of Defense and its partners continue to examine how these military-specific stressors could contribute to suicidality in the force.

Despite the complexity of the issues that may be affecting them, the behaviors of suicidal service members prior to their deaths give hope. In 2016, 59 percent of service members who died by suicide used some form of military health care in the three months prior to death (p. 60, 2016 DoDSER).  Services used ranged from medical treatments to mental health treatments to family assistance programs. 

Although suicide is a serious public health problem, it is preventable. All providers in the Military Health System should be attuned to suicidality in their patients and refer them to mental health specialists whenever suicide may be an issue.

Military Health Care Services Used within 90 Days of Death by CY 2016 Suicide Decedents from the Active Component and the Selected Reserves


References

  1. Centers for Disease Control and Prevention. (2013). Fatal injury and nonfatal injury 2013, Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved from http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html.

  2. Armed Forces Health Surveillance Center. (2012). Death by suicide while on active duty, active and reserve components, U.S. Armed Forces, 1998-2011. Medical Surveillance Monthly Report, 19(6), 7-10.
    LeardMann, C.A., Powell, T.M., Smith, T.C., Bell, M.R., Smith, B., Boyko, E.J., …Hoge, C.W. (2013). Risk factors associated with suicide in current and former U.S. military personnel. Journal of the American Medical Association, 31(5), 496-506.

  3. Armed Forces Health Surveillance Center. (2012). Death by suicide while on active duty, active and reserve components, U.S. Armed Forces, 1998-2011. Medical Surveillance Monthly Report, 19(6), 7-10.

  4. Reger, M.A., Smolenski, D.J., Skopp, N.A., Metzger-Abamukang, M.J., Kang, H.K., Bullman, T.A., …Gahm, G.A. (2015). Risk of suicide among U.S. military service members following Operation Enduring Freedom or Operation Iraqi Freedom deployment and separation from the U.S. military. Journal of the American Medical Association Psychiatry, 72(6), 561-569.