The Military Has A Suicide Problem
Suicide has become a bigger threat to members of the military and veterans than combat. That needs to change.
In a column at The New York Times, Carol Giacomo notes that suicide has become a bigger threat to members of the military than combat:
Suicide rates for active-duty service members and veterans are rising, in part, experts say, because a culture of toughness and self-sufficiency may discourage service members in distress from getting the assistance they need. In some cases, the military services discharge those who seek help, an even worse outcome.
More than 45,000 veterans and active-duty service members have killed themselves in the past six years. That is more than 20 deaths a day — in other words, more suicides each year than the total American military deaths in Afghanistan and Iraq.
The latest Pentagon figures show the suicide rate for active-duty troops across all service branches rose by over a third in five years, to 24.8 per 100,000 active-duty members in 2018. Those most at risk have been enlisted men under 30.
The data for veterans is also alarming. In 2016, veterans were one and a half times more likely to kill themselves than people who hadn’t served in the military, according to the House Committee on Oversight and Reform. Among those ages 18 to 34, the rate went up nearly 80 percent from 2005 to 2016. The risk nearly doubles in the first year after a veteran leaves active duty, experts say.
The Pentagon this year also reported on military families, estimating that in 2017 there were 186 suicide deaths among military spouses and dependents.
Military officials note that the suicide rates for service members and veterans are comparable to the general population after adjusting for the military’s demographics — predominantly young and male. But given the military’s size and influence, it is an institution that is well placed to lead the nation in suicide prevention.
Other than pointing to national trends, officials have offered few explanations for why military suicides are rising. Studies seeking more answers are underway.
Experts say suicides are complex, resulting from many factors, notably impulsive decisions with little warning. Pentagon officials say a majority of service members who die by suicide do not have mental illness. While combat is undoubtedly high stress, there are conflicting views on whether deployments increase risk.
Where there seems to be consensus is that high-quality health care and keeping weapons out of the hands of people in distress can make a positive difference.
Studies show that the Department of Veterans Affairs provides high-quality care, and its Veterans Crisis Line “surpasses most crisis lines” operating today, according to Terri Tanielian, a researcher with the RAND Corporation. (The Veterans Crisis Line is staffed 24/7 at 800-273-8255, press 1. Services also are available online or by texting 838255.)
But Veterans Affairs often can’t accommodate all those needing help, resulting in patients being sent to community-based mental health professionals who lack the training to deal with service members.
The rate of suicide for active-duty service members and veterans isn’t that far removed from those for the general population, and the recent increases appear at least in part to the increases that we have seen in suicide among the population as a whole. A study by the Centers for Disease Control, for example, found the following:
- rom 1999 through 2017, the age-adjusted suicide rate increased 33% from 10.5 to 14.0 per 100,000.
- Suicide rates were significantly higher in 2017 compared with 1999 among females aged 10-14 (1.7 and 0.5, respectively), 15-24 (5.8 and 3.0), 25-44 (7.8 and 5.5), 45-64 (9.7 and 6.0), and 65-74 (6.2 and 4.1).
- Suicide rates were significantly higher in 2017 compared with 1999 among males aged 10-14 (3.3 and 1.9, respectively), 15-24 (22.7 and 16.8), 25-44 (27.5 and 21.6), 45-64 (30.1 and 20.8) and 65-74 (26.2 and 24.7).
- In 2017, the age-adjusted suicide rate for the most rural (noncore) counties was 1.8 times the rate for the most urban (large central metro) counties (20.0 and 11.1 per 100,000, respectively).
- From 1999 through 2017, the age-adjusted suicide rate increased 33% from 10.5 per 100,000 standard population to 14.0 (Figure 1). The rate increased on average by about 1% per year from 1999 through 2006 and by 2% per year from 2006 through 2017.
- For males, the rate increased 26% from 17.8 in 1999 to 22.4 in 2017. The rate did not significantly change from 1999 to 2006, then increased on average by about 2% per year from 2006 through 2017.
- For females, the rate increased 53% from 4.0 in 1999 to 6.1 in 2017. The rate increased on average by 2% per year from 1999 through 2007 and by 3% per year from 2007 through 2017.
In addition, the study found the following:
During this period (1999-2017), the age-adjusted suicide rate increased 33% from 10.5 per 100,000 in 1999 to 14.0 in 2017. The average annual percentage increase in rates accelerated from approximately 1% per year from 1999 through 2006 to 2% per year from 2006 through 2017. The age-adjusted rate of suicide among females increased from 4.0 per 100,000 in 1999 to 6.1 in 2017, while the rate for males increased from 17.8 to 22.4. Compared with rates in 1999, suicide rates in 2017 were higher for males and females in all age groups from 10 to 74 years. The differences in age-adjusted suicide rates between the most rural (noncore) and most urban (large central metro) counties was greater in 2017 than in 1999. In 1999, the age-adjusted suicide rate for the most rural counties (13.1 per 100,000) was 1.4 times the rate for the most urban counties (9.6), while in 2017, the age-adjusted suicide rate for the most rural counties (20.0) was 1.8 times the rate for the most urban counties (11.1). The age-adjusted suicide rate for the most urban counties in 2017 (11.1 per 100,000) was 16% higher than the rate in 1999 (9.6), while the rate for the most rural counties in 2017 (20.0) was 53% higher than the rate in 1999 (13.1).
In other words, suicide is a problem in both the civilian and military worlds. The fact that the suicide rate for the population as a whole has risen so significantly since the start of the 21st Century is, at least in part, one of the reasons why we’re seeing similar increases for a specific segment of the population such as active-duty military and veterans. However, it’s also likely that there are reasons for this phenomenon that are specific to the military. One of the most obvious reasons that many people point to are issues such as Post-Traumatic Stress Disorder (PTSD) and other mental health issues that impact soldiers who have served in any of the numerous theaters where the United States has soldiers in the middle of active combat. While the Veterans Administration and other government agencies are supposed to be devoted to the health of active-duty soldiers and combat veterans, the reality is that far too many people have been allowed to fall through the cracks. At the very least, we owe these men and women who have fought for their country the care they need, even in cases where we now oppose the war that they were fighting. Anything less is dishonorable and shameful.
Giacomo closes here column with this, and I think it’s appropriate to post it here:
[T]he crisis line for veterans is 1-800-273-8255 (press 1). Another resource for those having thoughts of suicide is the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
And if you know someone, whether active-duty, veteran, or civilian who appears to need help, reach out to them.