For years, the news has been full of the seemingly ever-increasing Army suicide rate, well known to readers here at Battleland. There is good news and bad news:
Bad news: the suicide rate is unacceptably high.
Good news: we know a lot about risk factors of those who suicide.
Bad news: we have not been able to effectively use that knowledge to decrease suicides.
Dr. Joseph Rothberg was the pre-eminent Army researcher of suicides and father of the military’s analysis of completed suicides. He died this past January, as noted here, and I attended his memorial service on Florida’s Anna Maria Island in February. I wanted to share some reflections about his legacy.
Although psychological autopsies were first described in the 1950s, they seemed to be rare and uneven. The first description of how to do a psychological autopsy was described in an Army pamphlet in 1988, here.
Psychological autopsies then were supposed to be done on all Army suicides. They were long narratives, painstakingly typed on 20 to 30 pages. Good information, which initially too often ended up in a desk drawer.
Dr. Rothberg became the recipient these psychological autopsies when he began his work at the Walter Reed Army Institute of Research (WRAIR) in the 1970s. He and other researchers synthesized the information.
He produced numerous reports of Army suicides, many of which are very relevant today. His reports from the 1970s showed that:
— Suicides are mainly committed by young white males.
— There are certain stressors which lead to suicide, including romantic break-ups and job stressors.
— There is little relationship between deployment and suicide.
This sounds familiar, does it not? The dynamics are similar today, but the numbers are higher.
Dr. Rothberg’s psychological autopsy findings influenced Army research on soldier marriage and divorce, both of which occur at much higher frequency than suicides. Field studies and surveys demonstrated behavioral factors linked to soldier suicides were also involved in the dynamics of divorce in deploying Army units.
Divorce rates were highest for young, white junior enlisted male soldiers, with only high school education, and new, young spouses, especially in childless marriages. Soldiers’ self-reported well-being and depression were often associated with frequency of divorce. Some divorce risk factors were similar to those linked to soldier suicide.
The psychological autopsies were replaced in 2003 by the Army Suicide Event Report, and then the DoD Suicide Event Report several years ago. For a fuller description of the history of the evolution of the military suicide report, see these slides, here, which I presented at DoD VA Suicide Prevention Conference.
We should be grateful to Dr. Rothberg for developing a systematic way of studying the tragedy of suicide, and learning all we can about the dynamics and risk factors for suicide in the Army.
His legacy should help us get the numbers down.