Suicide, Mental Illness Climb in Military

By Kristina Fiore, Staff Writer

MedPage Today

Published: March 07, 2012

Just one ambulatory visit for a mental health disorder may warn that a soldier is at risk for suicide, researchers said.

Those who sought such help were about four times more likely to commit suicide than those who had not made any mental health visits (RR 3.9, 95% CI 3.0 to 4.9), Michelle Canham-Chervak, PhD, of the Injury Prevention Program of the U.S. Army Public Health Command, and colleagues reported online in Injury Prevention.

Patients who were hospitalized with mental illness had more than a 15-fold higher risk of suicide than those not hospitalized (RR 15.5, 95% CI 11.2 to 21.5).

"Soldiers seeking treatment for mental disorders and substance abuse should be a focus for suicide prevention," they wrote.

Soldier suicides have been on the rise since 2004, a trend that has been paralleled by increases in mental illness. In 2008, suicide rates among soldiers surpassed civilian rates that were adjusted for characteristics of a military population, including male gender and younger age (20 per 100,000 versus 18 per 100,000).

Although suicide has long been one of the leading causes of death among those in the military, army operations between 2004 and 2008 -- including the major commitment of troops to Iraq as well as continuing operations in Afghanistan -- likely affected the nature and extent of mental health problems, the researchers said.

To assess the associations between suicide and mental health disorders, Canham-Chervak and colleagues looked at U.S. military data from 2007-2008, during which time 255 soldiers committed suicide.

Factors associated with a higher suicide risk included being male, younger, and Caucasian, as well as having a lower enlisted rank.

The entire story is here.

Marine Fights Conviction for Suicide Attempt

Pvt. Lazzaric T. Caldwell

Associated Press
Originally Published February 3, 2012

HAGERSTOWN, Md. - A discharged Marine private who slit his wrists in a suicide attempt is fighting his military conviction for deliberately injuring himself, arguing the punishment is inconsistent with the armed forces' efforts to battle a rise in suicides during the wars in Iraq and Afghanistan.

It's not clear how often the Marines or any other service branch prosecute active duty members for trying to kill themselves. But the defense lawyer for Pvt. Lazzaric T. Caldwell says it's wrong to punish service members with mental health problems for genuine suicide attempts. Suicide prevention has become a priority across the military as numbers climbed in the past decade with the increasing stress of combat and multiple deployments in the wars.

Caldwell, 25, of Camp Pendleton, Calif., never deployed to a war zone but was diagnosed in 2009 with post-traumatic stress disorder and a personality disorder, according to court records. In 2010, he slashed his wrists in his barracks at Camp Schwab in Okinawa, Japan.

He pleaded guilty at a court-martial that year to "intentional self-injury without intent to avoid service," a criminal charge that the government says helps maintain good order and discipline in the armed forces. The charge is sometimes used in self-injury cases when there isn't enough evidence to prove malingering, military justice experts say.

Caldwell was sentenced to 180 days in jail and a bad conduct discharge. Military rules allow an appeal after a guilty plea in some cases, but Caldwell's initial appeal to the Navy-Marine Corps Court of Criminal Appeals was denied in December. His lawyer, Navy Lt. Mike Hanzel, said this week he will ask the military's highest court, the U.S. Court of Appeals for the Armed Forces in Washington, to hear the case.

"I think it definitely touches important issues which are affecting all the branches of the armed forces right now," Hanzel said in a telephone interview from Bremerton, Wash.

Military prosecutors didn't immediately respond to requests for comment on the case. In an appellate brief, the government stated that Caldwell "was not charged with, or convicted of, attempting suicide. He was charged with, and properly convicted of, intentionally injuring himself to the prejudice of good order and discipline or the discredit of the service."

The entire story is here.

Losing the Battle: The Challenge of Military Suicide

Policy Brief
Center for a New American Security

Dr. Margaret C. Harrell and Nancy Berglass

This policy brief has four objectives. First, it examines the phenomenon of suicide within the U.S. military community, including both the frequency of suicide and the extent to which suicide is related to military service.  It outlines steps taken by the Department of Defense (DOD), the armed services and the Department of Veterans Affairs (VA) to reduce suicide in the armed forces and among veterans. It then identifies obstacles to reducing suicides further and makes recommendations to address each of those obstacles.

The entire publication can be found here.

Help for Service Members, Veterans and Military Families

Veterans Crisis Line: 1.800.273.TALK (8255), Press 1

As military struggles with suicides, a push for seeking help

By Adam Ashton
Tacoma News Tribune

A Washington state social worker is circulating a petition urging federal lawmakers and the military to adopt a policy declaring that service members shouldn't be punished if they seek help for behavioral health issues, such as post-traumatic stress.

Patricia Bailey, 45, believes the lack of a firm policy on whether service members could be held back in their careers for seeking counseling is one of the main obstacles keeping people in the military from pursuing treatment.

"It will give reassurance to him that if he seeks mental health counseling nothing will be in jeopardy," said Bailey, whose 13-year marriage to a Joint Base Lewis-McChord soldier ended in 2008 as stress built during his deployments to Iraq.

She's targeting a gray area in the military's evolving suicide prevention and post-traumatic stress programs. Leaders at the Pentagon and at Lewis-McChord insist service members won't face professional repercussions for seeking counseling, but it's not clear how well that message reaches down the ranks.

An April study on military suicides released by the nonprofit RAND Corporation pointed out that the Defense Department hasn't taken concrete steps to reverse a perception that service members might be retired for medical reasons or lose out on a promotion if they ask for counseling. The study received funding from the Defense Department.

Bailey got a close view of Lewis-McChord's behavioral health services both as a part-time counselor between 2002 and 2004 and as someone who later reached out for help in keeping her marriage together. She'd like to see a greater emphasis on preventive programs instead of ones that kick in after an outburst, such as an arrest.

"When my husband and I were going through everything, I asked people for help," she said. "I wasn't shy. And they said 'We can't do anything for you.' You're frustrated because you can't do anything. I didn't want my marriage to end."

She's one of many people in the South Sound who are raising their voices to draw attention to the psychological toll 10 years of warfare have taken on military families. In the past year, service clubs have organized retreats for Army couples and the United Way of Pierce County put forward a proposal to deliver more resources to military families.

The military, likewise, is looking for new approaches. Madigan Army Medical Center increased its ranks of behavioral health specialists last year. Lewis-McChord recently hired a new suicide prevention officer.
Yet the Army and the base continue to struggle with how to reach distressed service members.

The Army reported that it was investigating 32 possible suicides in July, the most in any month over the past two years. Lewis-McChord officials told Sen. Patty Murray, D-Wash., that nine soldiers took their lives this year.

Read more here.