Army Suicide: Tip of the Service’s “Mental Health Iceberg”

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Nearly half of the Army’s suicides may have been caused by the wars in Afghanistan and Iraq, a new Army assessment of the problem says. Tracing the roots of suicide is always an inexact science, but the authors conclude:

Rates of suicide in the US Army increased more than 80% from 2004 to 2008. They thereby surpassed comparable civilian rates of suicide, which remained relatively stable during this time period. This increase, unprecedented in over 30 years of US Army records, suggests that approximately 40% of suicides that occurred in 2008 may be associated with post- 2003 events following the major commitment of troops to Iraq in addition to ongoing operations in Afghanistan.

The study, Mental health risk factors for suicides in the U.S. Army, 2007-8, was published this week in Injury Prevention, a British medical journal. Its key author is Dr. Michelle Canham-Chervak of the U.S. Army Public Health Command.

The study also questions Army officials’ claims that because one of every three who kills him or herself has never deployed, the wars didn’t have anything to do with that suicidal subset:

In the present study, 31% of suicides were committed by soldiers who had never deployed, implying that psychopathology and stress other than combat exposure may contribute to suicide incidence in this population. Predeployment stress, such as anticipatory anxiety and preexisting trauma, may play an important role.

The study combed through reams of Army data to find that as suicide nearly doubled in the ranks, so did rates of mental illness:

The overall rates of mental illness among active duty soldiers also nearly doubled since the major commitment of troops to Iraq and Afghanistan, mirroring the increase in rates of suicide from 2003 to 2008. This suggests a possible association between the increase in mental health disorders and suicide in a population under severe stress. The 2008 rate indicates that more than one fifth of all active duty soldiers had an ambulatory visit for a mental health disorder, implying a prevalent public health problem.

The increase in suicide rates may be viewed as the tip of the ‘mental health iceberg’. While suicide remains a relatively rare event, its increase signals more prevalent underlying mental health problems among soldiers in the US Army. The parallel during the years 2003-8 suggests that army operations during this time period may have affected the nature and extent of mental health problems, including suicide.