The U.S. Army's report that its 2006 suicide rate was the highest in the 26 years it has been keeping records was greeted with concern by experts, but also with some circumspection.
Some suggested that it might reflect stress from the duration of the wars in Iraq and Afghanistan, but no one immediately jumped to major criticism of the military or its efforts at mental health provision and promotion.
The “report underscores even more powerfully the urgency of getting our soldiers the care and assistance they need before they deploy, while they are in combat, and most importantly, when they return,” Sen. John Kerry (D-Mass.) said in a statement.
“Although a 1-year increase does not make for a significant and lasting increase from a scientific perspective, it's certainly alarming, particularly when you take into consideration the documented high rates of posttraumatic stress disorder and depression among those having served in combat in Iraq and Afghanistan,” M. David Rudd, Ph.D., chair of the department of psychology at Texas Tech University, Lubbock, said in an interview.
“This problem is certainly different from the Gulf War, when I was an Army psychologist,” added Dr. Rudd, a past president of the American Association of Suicidology. “The prolonged nature of the conflict and limited troops has resulted in some challenging and unforeseen mental health consequences.”
According to the 2006 Army Suicide Event Report, there were 99 suicides among active-duty personnel in 2006, with two more suspicious deaths still under investigation. Twenty-seven of those suicide deaths occurred in Iraq, and three occurred in Afghanistan. The report also counted 948 serious suicide attempts that were not successful.
Of the suicides, 71% involved the use of firearms. Seventy percent of the individuals were under 25 years of age, and 10% were female. Ninety-eight percent of the persons were enlisted, and 91% were from the regular army.
In announcing the report, Col. Elspeth C. Ritchie, MC USA, a psychiatry consultant to the Army Surgeon General, said that the investigators were unable to find a direct relationship between deployment, combat, and suicide, although they looked closely.
Instead, the common features were those associated with suicide in general: financial problems, previous mental illness, and failed marital relationships. In fact, a failed marital relationship accounted for 55% of the completed suicides and 40% of the attempted suicides.
“Very often, a young soldier gets a 'Dear John' or a 'Dear Jane' letter and then takes his weapon and shoots himself,” Dr. Ritchie said at a Pentagon news conference.
She did note, however, that repeated deployment put a strain on relationships.
The suicide rate for the entire 500,000-person Army, the report said, was 17.3 per 100,000 persons. That is the highest rate since the Army began counting in 1980.
That rate, however, is not that different from what one sees in the general population, if one considers only those of the same demographic of young males, Army officials and others have said. The rate for males of a comparable age is 18.6 per 100,000.
The highest number of suicides in the Army was 102 in 1991, the year of the Persian Gulf War. The lowest rate was 9.1 per 100,000 in 2001. In 2005, the Army had 88 suicides.
A few days after the Army report, the Army National Guard's Suicide Prevention Program announced that the National Guard has had 42 suicides through Aug. 13 for fiscal year 2007, which ranks suicide as the third most common cause of death behind combat and accidents.
Since the start of the Iraq War, the Army and the Veterans Administration have been overwhelmed by the mental health needs of military personnel. Both have come in for criticism, but both also have worked to increase funding and services and, in the case of the Army, to reduce some of the stigma that has been attached to seeking mental health help in the military.
The Army is currently seeking to recruit an additional 250 mental health professionals, including psychiatrists, but both the Army and the VA have reported that they are having a hard time finding such personnel.
It is estimated that 20% of soldiers returning from the current wars have signs of posttraumatic stress disorder.
The Army's contention that suicides are not tied to combat and deployment is very plausible because it is consistent with what is seen in other branches of the service, said Dr. (Lt. Col.) Steven Pflanz, chief of the Air Force Suicide Prevention Program, which is seen as a model for all the military branches.