Suicides in the military have increased over the last ten years. Much effort has been focused on suicide prevention and treatment, as well as understanding the reasons for the sharp increase in military suicides. Despite this effort, the definitive causes of military suicides remain elusive. Further, highly effective suicide prevention and treatment approaches have not yet been developed. The purpose of this article is to present a short review of the current state of suicide prevention interventions within the context of the military. The root causes of suicidal behavior and the role of combat in the military are each discussed. Interpersonal-psychological theory of suicide and the military transition theory are introduced as guiding frameworks for understanding suicides and suicidal behavior amongst active military personnel and military veterans. The article concludes with a set of recommendations for moving forward in understanding and addressing suicides in the military.

The combat veteran paradox proposes that most changes individuals experience resulting from combat exposure are normal, and not indicative of a mental health disorder. Yet, because of the number and complexities of these changes, the combat veteran paradox states that combat veterans who are healthy can benefit from counseling. Counseling should focus on helping the combat veteran understand how combat experiences might influence their thoughts, emotions and behaviors. Counseling can also help combat veterans understand the numerous paradoxes often experienced during and after deployment. Combat veterans also encounter numerous dilemmas, most prominent being the military mental health dilemmas, consisting of multiple double binds imposed on the combat veteran by their partner, the military culture, and him/herself; all of which impede the combat veteran from receiving much needed mental health care support. If left unchecked, these can lead to more significant mental health issues requiring professional intervention. Veteran helping organizations also face dilemmas and paradoxes, which are important to understand to ensure veterans receive maximum care and assistance. Although many dilemmas are unavoidable and many paradoxes unsolvable, a holistic approach to understanding and ameliorating veteran paradoxes and dilemmas is necessary to optimize the veterans transition home. There are also similarities between combat trauma and other types of trauma, and between the military and other occupations with inherent danger. Recognizing these will further aid in the development of interventions that will allow trauma survivors to thrive and grow after traumatic events.

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