Preventing Suicides in US Service Members and Veterans: Concerns After a Decade of War

By Charles W. Hoge, MD, & Carl A. Castro, PhD
JAMA. 2012;308(7):671-672. doi:10.1001/jama.2012.9955

Before the wars in Iraq and Afghanistan, the incidence of suicide in active duty US service members was consistently 25% lower than that in civilians, attributable to "healthy-worker" effects from career selection factors and universal access to health care.

Between 2005 and 2009, the incidence of suicide in Army and Marine personnel nearly doubled.
From 2009 through the first half of 2012, the incidence of suicide among Army soldiers remained elevated (22 per 100 000 per year), with the number dying of suicide each year exceeding the number killed in action.

High rates of suicide have also been reported for US veterans, although incidence studies in veteran populations have drawn conflicting conclusions.

(cut)

"Examining communication strategies is also critical. Stigmatizing attitudes may be unwittingly reflected in cliches, such as 'zero tolerance' or 'one suicide is one too many,' expressed by well-intentioned VA or military leaders.  These slogans convey an implicit message: suicides are different from any other medical condition, the result of a bad 'choice' by the individual or negligence by peers or leaders.  These types of communications would not be used to describe attitudes toward depression, PTSD, or cancer."

The entire article is here.

Thanks to Ken Pope for this information.

As records go online, clash over mental care privacy

By Liz Kowalczyk
The Boston Globe - Health and Wellness
Originally published June 21, 2012

At her weekly therapy sessions, Julie revealed her most uncomfortable secrets: depression, debt, childhood sexual abuse. Her psychiatrist at Massachusetts General Hospital would then type a summary into Julie’s computerized medical record.

With that, more than 200 pages of sensitive notes became available to any doctor who cared for her within the sprawling Partners HealthCare system. She discovered this only when one doctor later referenced the notes.

Julie, a 43-year-old lawyer, was unnerved, then angry. “The details are really nobody’s business,” she said.

But Partners disagrees. Doctors must have a complete picture to make accurate diagnoses, the organization argues. And having different rules for psychiatric records contributes to the stigma of mental illness.

The entire story is here.