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Keeping Soldiers From Suicides
The Scope of the Problem
Suicide has become a significant problem in the U.S. armed forces. A 2007 report noted that for civilians in the period of 1980 to 2004, the raw suicide rate for civilians was between 10.4 to 12.4 deaths per 100,000 U.S. population residents. In contrast, in those same years, the active military deaths due to suicide were 9.0 to 15.0 per 100,000 person-years, and the suicide rate of recruits in basic training was only 4.8 deaths per 100,000 recruit-years (in the years 1977 to 2001). While those statistics sound reasonably optimistic in the sense that military suicides appear to be approximately comparable to civilian suicide rates, yet a 2011 report noted that in both 2009 and 2010, more soldiers were lost to suicide than to combat in Iraq and Afghanistan combined.
Worse, this same report noted that while 381 active-duty suicides occurred in 2009, in 2010, the number of such suicides significantly increased to 434. By comparison, in 2009 combat-associated deaths were fewer than the 381 active-duty suicides—and these numbers were artificially low because the Air Force and Marines did not include non-mobilized reservists in their statistics, and none of the armed services include Individual Ready Reservists (approximately 123,000 in all) who are not assigned to specific units. Nor did the Department of Defense (DOD) include suicides of veterans who leave the services after deployment to Iraq or Afghanistan—such suicides are tracked only if they occur among the mere 25% of veterans who enroll in the VA healthcare system. For example, simply including the excluded mobilized reservists results in the suicides in 2010 to leap upward to 468, again more than the 462 who died in combat-associated injuries in 2010.
Another source reports that in 2005 6,256 U.S. veterans committed suicide, or 17 per day, whereas in the period from 2003 (the start of the Iraq invasion) through 2005, only 3,863 American military personnel had died in Iraq, or only 2.4 per day. By 2010, the suicide rate for veterans had increased to 18 per day. Suicide, in fact, is such a problem in the U.S. military that it is the second leading cause of death, after accidents.
While most military suicides may be associated with male troops, statistics also show that female troops suffer dramatically increased risk of suicide if deployed to a war zone, with the rate increasing from approximately 5 per 100,000 to 15 per 100,000 female soldiers—a rate still somewhat lower than for male soldiers in the same war zone.
Military personnel are subject to many of the same psychosocial stresses of civilians of similar age, but in addition have other risk factors. These include the highly stressful influences of military life events, and stress has been well documented as a significant trigger for suicide. In particular military deployments, and also the stress of returning from such deployments are potent stressors for deployed troops. In addition, certain stressors that afflict civilians and that can trigger suicides are especially important for military personnel, including failed relationships due to extended separations, alcohol abuse or dependency, access to firearms, and legal problems. In addition, military personnel often may experience traumatic brain injuries and demonstrated impulsivity, which may be a result of concussion or other similar result of head trauma as a result of blasts, vehicle accidents, falls, or gunshots. Post-traumatic stress disorder (PTSD) is another potential cause of military suicide if it is both severe and untreated. In contrast with those risk factors, military personnel may have some protective factors against suicide, including trained resiliency, sense of purpose, and supportive culture.
Some other reasons for military suicides may be identified from studies of the suicide risk factors in the military. In particular, there are several such factors that are specific to soldiers who have been deployed to war zones. Such factors include simple exposure to the violence and atrocities of a war zone, but also the soldiers’ habituation to the fear of death. Such habituation may make the likelihood of suicide greater by removing that sense of terror over death. Furthermore, exposure to one particular Muslim concept, “In sha’Allah,” which means, roughly, “as God wills” may increase the sense of powerlessness or resignation to death.
Soldiers in war zones typically have very ready access to lethal means of death, something that is not easily avoided if the base is to remain secure from outside threats. Soldiers get very used to being armed, to the point where they may feel incomplete without their weapons. Even when the tour of duty ends, and the soldiers face a return to the U.S., there is an ongoing issue of not feeling able to fit into their previous world and relationships. The simple despair, lack of hope, and expectation of not fitting in with “normal” American society upon their return to the U.S. makes clear that suicide is a risk for many such veterans.
Another veteran wrote about his tour in Baghdad an d his return home by noting that he returned addicted to Valium given to him in Baghdad. He also noted that upon his return, he “delighted” in turning into a drunk and that in spite of that, he fared better than some of his war zone buddies.
Hearing about the successful suicides of other soldiers they know or who were posted in the same base, may well increase the likelihood of others considering that as an option to deal with their frustrations and concerns for their future.
It is apparent that modern warfare is extraordinarily stressful on soldiers. One place where that can be seen is Fort Hood, TX, the largest U.S. Army base with approximately 48,000 soldiers and their families. In late 2009 a psychiatrist there shot 13 soldiers, wounded 30 others. In the 9 months following that event, more than 10,000 soldiers had asked for mental health care for everything from combat stress, substance abuse, marital and family issues, or other emotional problems. The small 12-patient psychiatric ward on base has stayed full nearly all the time. Virtually one soldier out of four on the base asked for help on mental health problems in that nine-month period in spite of the pervasive culture that stigmatizes such requests. In 2009 statistics provided by Fort Hood, 2,445 soldiers experienced PTSD compared to only 310 in 2004, and on a monthly basis 585 soldiers every month were referred to private mental health clinics due to lack of space within the Army’s counselors, compared to only 15 per month receiving such referrals in 2004. In 2009, a surprising 6,000 soldiers were on antidepressants and another 1,400 were on antipsychotic medications, meaning about one soldier in six was on some form of psychoactive medication.