Military

Suicide among veterans and active duty service members is not just a mental health problem, it's a public health problem. It is important that other soldiers and civilians are aware of risk factors and warning signs, as well as how to get help for someone expressing suicidal statements or showing warning signs. Male veterans are more than twice as likely to die by suicide as non-veteran male counterparts. It is important to remember to take care of the "invisible wounds" of our military and veteran population as we would physical wounds. Suicide is a concern in all branches of the military and of currently serving members and veterans alike. Suicide risk has been noted in both deployed service members and those that have never been deployed.

Risk factors

There are several risk factors that appear to be slightly different with our military and veteran population than risk factors in other populations. Research continues to show that the greatest time of risk for a service member is during time of deployment. While risk factors don't predict who will complete suicide, they do provide guidance on situations to pay special attention to:

• Male
• Caucasian
• E-1 to E-2 rank
• Younger than 25
• GED/less than a high school education
• Divorced
• Regular component
• Drug and alcohol abuse
• Relationship problems
• Legal, administrative and financial problems
• Diagnosis of Post Traumatic Stress Disorder (PTSD)

While the above are specific risk factors, it is important to note that not everyone will display those specific risk factors. It is important to know general risk factors and warning signs of suicidal behavior as well.

Warning signs

• Increased substance use (alcohol or drugs)
• No reason for living
• No sense of purpose in life
• Anxiety
• Agitation
• A change in sleeping patterns, sleeping too much or too little
• Feeling trapped, like there is no way out
• Hopelessness
• Withdrawal from friends, family and society
• Rage, uncontrolled anger and seeking revenge
• Acting reckless or engaging in risky activities, seemingly without thinking
• Dramatic mood changes

Rates of suicide in our military may be linked to a number of factors including:

• Multiple deployments.
• Combat injuries.
• Extreme stress on marriage and family relationships.
• Reluctance of service members to seek treatment.

Protective factors

Protective factors can decrease the risk of suicide. Enhancing or reinforcing protective factors can help make a person safer. Currently specific protective factors that may reduce suicide among active duty military are not known, but there have been several general protective factors that have been found to help.

• Strong connections to family and other supports
• Access to effective clinical interventions
• Restricted access to lethal means
• Skills in problem-solving and conflict resolution
• Frustration tolerance and ability to regulate emotions
• Positive beliefs about future, ability to cope and life in general
• Cultural or religious beliefs discouraging suicide

Stigma

Reducing stigma is a very real piece of getting help for those that are thinking about suicide in all populations. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) offers several programs such as the Real Warriors Campaign and www.afterdeployment.org to provide services to service members and veterans and assist in reducing stigma.

It is important to address suicidal thoughts with service members In addition to getting help for them, it is important to understand that some service members may feel that if they get help they will be seen as "unstable" or "weak." They may also worry about job repercussions. It is important to listen openly to their fears, but to not let these fears dissuade you from getting someone help. An open, honest conversation about their fears with someone they trust may be enough of a reassurance to convince the service member to get help.

As with any population, some may be vocal about expressing thoughts of suicide, others will suffer in silence. If you notice warning signs and risk factors in those around you, it is important to ask if they are considering suicide. You may save a life.

Information adapted from the American Foundation for Suicide Prevention, National Institute of Health and the Defense Centers of Excellence.