Many Servicemembers Who Commit Suicide Have Never Seen Battle

by U.S. Medicine

October 6, 2011

Jonathan Woodson, MD

WASHINGTON — When servicemembers commit suicide, a common misperception is that the extreme act is a response to traumatic battlefield experiences.

In reality, many, if not most, military personnel who kill themselves have never been deployed, according to recent testimony before the House Armed Services’ Military Personnel Subcommittee.

Air Force Lt. Gen. Darrell Jones, Air Force deputy chief of staff for Manpower, Personnel and Services, said 68% of those individuals in the Air Force who have committed suicide have not deployed. The Marine Corps reported that in 2008 and 2009 during the peak years of suicide, fewer than 20% had ever seen combat.

Rear Adm. Anthony Kurta, U.S. Navy Director of Military Personnel, Plans and Policy, said that the Navy has not seen a causal relationship between deployments and suicide rate. On the other hand, he said, suicide rates often spike historically after periods of a drawdown of Navy personnel.

“We have seen that three times over the past 20 years, so it makes us remain ever vigilant as we go into a period of potential end strength reductions,” he said.

That trend existed in the Army in previous years, with soldiers who had no deployment or one deployment at greater risk for suicide, according to Lt. Gen Thomas Bostick, Army deputy chief of staff. This year, however, suicides among those who have gone on multiple deployments are starting to increase. “We don’t know why that is happening, but we are looking at it very closely,” he said.

Overall, rates of suicide have risen steadily over the last decade in the military, and those rates may even now surpass those in the civilian sector, Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD told a House subcommittee.

“The [DoD] has invested tremendous resources to better understand how to identify those at risk for suicide, treat the at-risk individuals and prevent suicide,” Woodson testified. “We continue to seek the best minds from both within our ranks, from academia, other federal health partners, and the private sector to further our understanding of this complex set of issues.”

Woodson, along with the representatives from the services, gave the subcommittee an update on suicide statistics in the military:

  • Army: In 2010, there were 155 active-duty suicide deaths, with 300 across the total Army. To date in 2011 that number appears to be leveling off, according to Bostick. He said that, as of June 30, there were 76 active-duty suicide deaths. For the same period last year there were 79.
  • Marines: During 2010, 37 Marines died by suicide, down from 52 in 2009. Thus far this year, through July 31, 21 Marines have died by suicide.
  • Air Force: There had been 56 Total Force Airmen and civilian suicides as of the September hearing. This is slightly lower than the 63 Air Force suicides for the same period last year.
  • Navy: This is the only branch of service  reporting an increasing trend in suicides. There were 46 active-duty and six Selected Reserve Sailor (SELRES) suicides in 2009 and 39 active-duty and four SELRES deaths in 2010. Already in 2011 there have been 36 active-duty and four SELRES Sailors lost to suicide, the Navy reported.
Many Servicemembers Who Commit Suicide Have Never Seen Battle Cont.

Evaluation of Prevention Programs

Woodson said more research is needed, including using metrics to evaluate suicide prevention programs in the military.

“One of the things that we have to be careful of in a resource-constrained environment is that we don’t fund programs that are not effective, and we allow others that would be effective to wither on the vine,” he said.

Some prevention programs seem to work better than others, Woodson said. For example, servicemembers in custody following arrest are at higher suicide risk, making more critical programs to evaluate their mental-health status.

Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD explained in his written testimony that just providing sufficient mental-health providers and programs for troops is not enough. Awareness of who is at risk is also vital.
Field testing is complete on the behavioral health component of DoD’s electronic health record, the Armed Forces Health Longitudinal Technology Application (AHLTA), and will be implemented later this year, he said. The system will allow a provider to flag a patient by entering a “Behavioral Health Alert” that designates a patient as either a danger to self or to others.
“Once the alert is put in the system, AHLTA users will see the alert when the patient’s record is reviewed, and all providers will be able to see the treatment plan established by the mental-health provider,” he explained in his written statement.
Woodson also said the joint VA/DoD Clinical Practice Guideline for the Assessment and management of Suicidal Behaviors is under development by the VA/DoD CPG committee’s panel of subject matter expert.
“The guideline will provide clinicians with evidence-based or evidence-informed guidance on the assessment and management of an individual with suicidal ideation,” he wrote.

Peer-to-peer programs seem to work, Woodson said, adding that a key factor is for troops to have access to high-quality mental health care by mental health professionals who understand how to evaluate and treat for suicide risk.

Hazing and Suicide

Near the end of the hearing, Rep. Judy Chu, (D-CA), told the subcommittee and military witnesses about the death of Lance Corp. Harry Lew, a marine who killed himself in Afghanistan in April.

Chu said that Lew was found sleeping on watch one evening while serving in Afghanistan, something that had happened before. At 11:30 p.m., his sergeant called for “peers to correct peers,” she said.

“At 12:01 pm, Lance Corp. Lew was beaten, berated and forced to perform rigorous exercise,” she continued. “He was forced to do pushups and leg lifts wearing full body armor and sand was poured in his mouth. He was forced to dig a hole for hours. He was kicked, punched and stomped on, and it did not stop until 3:20 a.m. At 3:43 a.m., Lance Corp. Lew climbed into the foxhole that he just dug and shot himself and committed suicide.”

Chu then revealed that Lew was her nephew.

“He was 21 years old, and he was looking forward to returning home after three months. He was a very popular and outgoing young man, known for joking and smiling and breakdancing,” she said.

Chu wanted to know whether hazing was expressly prohibited by the services and how the services were preventing “suicide from hazing.”

The military leaders insisted hazing was not tolerated.He HHddd

“This is unfortunate,” said Lt. Gen. Robert E. Milstead Jr., USMC deputy commandant for manpower and reserve affairs. “Hazing is inconsistent with the Marine Corps core values. It is expressly prohibited.”

Woodson expressed his sorrow for Chu’s loss and also said that hazing was “inconsistent” with DoD policy.

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