Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts

Abstract

Objective Soldiers’ mental health is adversely affected by the death and injury of other unit members, but it is not known if risk of suicide attempt is influenced by previous suicide attempts in one’s unit. Method Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records for all active duty Regular Army enlisted soldiers who attempted suicide from 2004–2009 (n=9,650) and an equal-probability sample of control person-months (n=153,528). Logistic regression analyses examined the number of past-year suicide attempts in one’s unit as a predictor of subsequent suicide attempt, controlling for socio-demographics, service-related characteristics, prior mental health diagnosis, and other unit variables, including suicide-, combat-, and accident-related unit deaths. We also examined whether the influence of previous unit suicide attempts varied by military occupational specialty (MOS) and unit size. Results In adjusted models, soldiers were more likely to attempt suicide if one or more suicide attempts occurred in their unit during the past year (OR=1.4–2.3; p<0.001), with odds increasing as the number of unit attempts increased. The odds of suicide attempt among soldiers in a unit with five or more past-year attempts was more than twice that of soldiers in a unit with no previous attempts (OR=2.3; 95% CI=2.1–2.6). The association of previous unit suicide attempts with subsequent risk was significant whether soldiers had a combat arms MOS or other MOS (OR=1.4–2.3; p<0.001). It was also significant regardless of unit size, with the highest risk for those in smaller units (1–40 soldiers) (OR=2.1–5.9; p<0.001). The population-attributable risk proportion for one or more unit suicide attempts in the past year indicated that if this risk could be reduced to no unit attempts, 18.2% of attempts would not occur. Conclusions Soldiers’ risk of suicide attempt increased as the number of past-year suicide attempts within their unit increased. This was true for both combat arms and other MOSs, and for units of any size, but particularly for smaller units. Units with a history of suicide attempts may be important targets for preventive interventions.

Intimate Relationships Buffer Suicidality in National Guard Service Members: A Longitudinal Study

“…A different study focused on suicidal thoughts and behaviors in National Guard members specifically and concluded that individuals knowing people who died by suicide were themselves at higher risk for recent suicidal thoughts (Bryan, Cerele, & Bryan, ). This is consistent with other studies that show the contagion of suicidality in military units (Hoge, Ivany, & Adler, ; Ursano et al., ). Multiple factors have been associated with the timing of postdeployment suicides among National Guard service members.…”

Documented family violence and risk of suicide attempt among U.S. Army soldiers

“…Assessment of suicide risk among soldiers would benefit from awareness of recent family violence events, and recognition of the association between family violence and suicide risk should be incorporated into evidenced-based family and marital therapies. There is a need for the development of interventions specific to suicidality following family violence and, more generally, suicide-specific interventions that consider context (e.g., Ursano et al, in press). It would also be beneficial to provide education on suicide risk to workers in the legal system and social support services.…”

Nonfatal Suicidal Behaviors in the Administrative Records of Activated U.S. Army National Guard and Army Reserve Soldiers, 2004–2009

“…Furthermore, survey research indicates that exposure to suicide is associated with increased risk of suicidal thoughts and behaviors among National Guard soldiers, particularly among those who were close to the decedent (Bryan, Cerel, & Bryan, 2017). Given evidence that previous suicide attempts within an AC Army unit increases subsequent risk of attempt among unit members (Ursano, Kessler, Naifeh, Herberman Mash, Fullerton, Bliese, et al, 2017), it will be important examine this question in the RC as well.…”