Suicide is the second most common cause of death in the U.S. armed forces, and recent reports suggest military personnel and veterans are taking their own lives at increasing rates. A new scholarly analysis outlines the combination of factors that lead to suicide, connects them with the experience of serving in the military and suggests ways to improve risk assessment and treatment programs.
Writing in the Clinical Psychology Review, a research team including psychologists Edward Selby and Thomas Joiner of Florida State University note the suicide rate in the military — traditionally lower than that of the civilian population, at least during peacetime — has crept up in recent years, to between 9 and 15 deaths per 100,000 people, depending upon the individual service. (The civilian rate is 11 per 100,000 people.)
In an attempt to analyze this "alarming increase," the researchers apply Joiner's Interpersonal-Psychological Theory of Suicide (detailed in his 2005 bookWhy People Die By Suicide). "This theory proposes that three necessary factors are needed to complete suicide: Feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide," they note.
Of those three central concerns, "we believe that acquired capability is the most important factor in understanding suicide in the military," the researchers write. After all, they note, the first two factors can cut either way: Some active-duty soldiers undoubtedly feel like outsiders, but others find the military provides a sense of belonging. While perceived burdensomeness can be an issue for some, particularly disabled vets, "military service is likely to be a positive occupational experience for most individuals, instilling feelings of honor, accomplishment, contributing to society and having a sense of mission," they note.
That leaves the final factor: one's capability of actually committing the act. The researchers suggest this may be increased by both combat training and battlefield experiences. Training for combat, while essential and unavoidable, tends to "facilitate imperviousness to fears of death and injury," they write, making it easier for someone with suicidal thoughts to pull the trigger. For those who regularly experience combat situations, "the constant threat of loss and life and severe injury may also cause habitation to fear of death and pain."
They conclude by suggesting "regular screening of military personnel for suicidal symptoms." They note that while the acquired capability to withstand pain and fear may not be un-learnable, "explaining to combat veterans how their experiences may have contributed to (feelings of) invincibility or fearlessness toward pain and death may help them maintain awareness of their increased risk."
"It could be communicated to military personnel in general that they should seek help immediately when they feel suicidal," the researchers add, "not because they are weak, but to the contrary, because they may lack fear."
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