Suicide Risk for Soldiers May Start in Boot Camp


The suicide rate for soldiers more than doubled during some of the most difficult fighting in the Iraq and Afghanistan conflicts; between 2004 and 2009, the suicide rate for US soldiers rose steadily, to the point where it surpassed the suicide risk for civilians in 2008.  Now, a major US study has revealed that the suicide risk for soldiers may actually start in boot camp.

The study, which is published in JAMA Psychiatry, considered some 5,428 active duty soldiers who consented to participate.  The study found that many of the soldiers had pre-enlistment psychiatric disorders such as intermittent explosive disorder and attention deficit hyperactivity disorder.  Even those soldiers who had post-traumatic stress disorder admitted the onset of the disorder was likely prior to their enlistment.

The study has incorporated research from military, civilian and government researchers, and began shortly after the suicide rate in the armed forces surpassed that of civilians in 2008.  From 2004 to 2009, there were 569 soldier deaths that were ruled suicides; Dr. David Brent says that the emotional baggage people bring with them into the military likely interacts with the stresses of deployment and ultimately the soldiers cannot handle the combined stresses.

Among those active duty soldiers who met the criteria for mental health disorders, three-quarters of those said they had an onset of symptoms prior to enlistment.  31 percent of those who experienced pre-enlistment mental health disorders attempted suicide for the first time after they enlisted.  41 percent of those who said they experienced symptoms after enlistment attempted suicide, thereby supporting the notion that the suicide risk for soldiers may start in boot camp.

The study has left the military with the problem of trying to identify those at risk for attempting suicide without sending them into hiding because of the stigma still attached to suicide.  Experts involved with the study suggested that a program or several programs designed to enhance soldiers’ mental toughness might be a good first step, but a program was recently implemented in military personnel, and that was deemed ineffective.

Dr. Matthew J. Friedman of the National Center for PTSD says that generally, there are a number of recruits that do not disclose past suicide attempts or mental health issues when going through the recruiting process, and this could have a serious impact on the suicide rate that soldiers are currently experiencing.

Friedman suggests that the Army is likely not going to be able to keep individuals with psychiatric disorders out of military service, but if there is an individual discovered to have a psychiatric disorder after they have gone through the recruitment process, it is important to determine the absolute best course of action as soon as it is discovered that the soldier has a psychiatric disorder.

In learning that the suicide risk for soldiers may start in boot camp, it was indicated that roughly a quarter of those had symptoms consistent with the DSM-IV group of mental health disorders within the previous 30 days.  The top disorder was intermittent explosive disorder, then PTSD, attention deficit hyperactivity disorder, and the group was rounded out by general anxiety disorder and major depression.

By Christina St-Jean


JAMA Psychiatry

National Center for PTSD


New York Times

Med Page Today

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