By most accounts, mental health in the military is a steadily worsening problem. With current conflicts in Iraq and Afghanistan forcing multiple deployments and increased combat exposure, 10 to 15 percent of soldiers come home with post-traumatic stress disorder. And, because of the military stigma associated with mental illness, many will never get treatment, increasing their risk for violent behavior and suicide.
But data published this month in the American Journal of Public Health suggests that programs targeting suicidal behavior in the military, particularly one initiated by the Air Force, may be making a dent in the otherwise grim statistics.
Dr. Kerry L. Knox of the University of Rochester Medical Center led a review of the success of the Air Force Suicide Prevention Program, comparing suicide rates before 1997, when the program went into full effect, with those collected through 2008. The program was designed to promote early identification of suicidal risk factors and encourage those at risk to seek help by reducing the stigma associated with mental illness and providing enhanced privacy for members that do get treatment. Mean suicide rates dropped over 20 percent in the years analyzed, from 3.033 per 100,000 in each quarter (3 months) before the program was implemented to 2.387 per 100,000. The authors were unable to take into account the affect that current and recent wars may have had on suicide rates.
According to material published through the Air Force program, the total number of suicides has also dropped 28 percent since 1996. At its highest toll, suicide was the cause of 68 Air Force deaths in 1994; at its lowest it took the lives of 20 in 1999.
Still, a survey by the Department of Defense released last December showed that suicide is an increasing problem in the military. While the Air Force has lower attempted suicide rates (1.6 percent per year) than the Army (2 percent), Marine Corps (2.3 percent), and the Navy (2.8 percent), these rates doubled in total in 2008 compared the previous DoD study, conducted in 2005.
Last August, the Department of Defense announced its new Task Force on the Prevention of Suicide by Members of the Armed Forces, and psychologists are increasingly recognizing the need for more comprehensive mental health treatment for soldiers. Knox and her colleagues recognize the challenges of implementing and maintaining a program like the one showing success in the Air Force, but remain encouraging:
“The enduring pubic health message from 12 years of this program is that suicide rates can be reduced, and that program success requires interventions to be consistently supported, maintained, and monitored for compliance.”