Suicide Attempts in the US Army During the Wars in Afghanistan and Iraq, 2004 to 2009

Medically Documented Suicide Ideation Among U.S. Army Soldiers

“…These ideators have been identified by the medical care system and, importantly, are therefore available for intervention. Consistent with research on suicide attempts(Ursano, Kessler, Stein, et al, 2015) and suicide deaths(Gilman et al, 2014) among soldiers, risk of ideation was far greater in enlisted personnel than officers. Enlisted soldiers comprised approximately 83% of the Army, but nearly 98% of suicide ideators, with an overall rate of 587.9 per 100,000 person-years versus 68.2 per 100,000 person-years for officers.…”

“…Although the influence of deployment on adverse mental health outcomes is well supported,(Bray et al, 2010; Gadermann et al, 2012; Jacobson et al, 2008; Shen, Arkes, & Williams, 2012; Wells et al, 2010) the association of deployment with suicidal thoughts and behaviors has generated inconsistent results. (Bryan et al, 2015) Prior mental disorders are a robust predictor of both fatal(Black, Gallaway, Bell, & Ritchie, 2011) and nonfatal(Ursano, Kessler, Stein, et al, 2015) suicidal behaviors in service members, findings in line with a large body of civilian research. (Harris & Barraclough, 1997; Nock, Hwang, Sampson, & Kessler, 2010)…”

“…Analyses were conducted separately for enlisted soldiers and officers owing to their different socio-demographic profiles, Army training and career experiences,(Segal & Segal, 2004) and risk of mental health problems,(Bray et al, 2009; Lapierre, Schwegler, & LaBauve, 2007; Smith et al, 2008) suicide attempt,(Ursano, Kessler, Stein, et al, 2015) and suicide death. (Gilman et al, 2014; Hyman, Ireland, Frost, & Cottrell, 2012) Logistic regression analyses examined multivariate associations of socio-demographics (gender, age at entry into Army service, current age, race, education, and marital status) with SI, followed by separate models evaluating incremental predictive effects of time in service (1-2 years, 3-4 years, 5-10 years, >10 years), deployment status (never deployed [ND], currently deployed [CD], previously deployed [PD]), and presence/recency of mental health diagnosis (none vs. 1, 2-3, 4-12, and 13+ months since most recent diagnosis).…”

“…In recent years, there have been several large-scale efforts to understand the sharp increase in fatal(LeardMann et al, 2013; Reger et al, 2015; Schoenbaum et al, 2014) and nonfatal(Nock et al, 2014; Ursano, Kessler, Heeringa, et al, 2015; Ursano, Kessler, Stein, et al, 2015) suicidal behaviors among U.S. military personnel that occurred during the wars in Iraq and Afghanistan. Suicide ideation (SI) is an important outcome as both an indicator of distress and as a predictor of more serious suicidal behavior.…”

“…(Borges, Angst, Nock, Ruscio, & Kessler, 2008; Kessler, Berglund, Borges, Nock, & Wang, 2005). Risk of attempting or dying by suicide is higher among enlisted soldiers in the their first tour of duty,(Gilman et al, 2014; Ursano, Kessler, Stein, et al, 2015) but the relationship of time in service with SI is not yet known. Although the influence of deployment on adverse mental health outcomes is well supported,(Bray et al, 2010; Gadermann et al, 2012; Jacobson et al, 2008; Shen, Arkes, & Williams, 2012; Wells et al, 2010) the association of deployment with suicidal thoughts and behaviors has generated inconsistent results.…”