Impact of Adverse Events on Soldiers’ Mental Health

Suicide Risk Factors in Army Units

Adverse events within military units, particularly suicidal incidents, can significantly impact the mental health of soldiers. A recent study focused on suicide risk factors in the US Army highlights that an increase in past suicide attempts within a unit correlates with a heightened risk of suicide attempts among its soldiers.

Understanding Army Unit Dynamics

Army units play a crucial role in shaping a soldier’s experience. Soldiers face common stressors in these units, including training, bullying, combat, and injuries, which can adversely affect their mental well-being. A critical aspect of this issue is the phenomenon of suicide contagion, where exposure to suicidal behaviors influences others in the community. This has not yet been systematically assessed, prompting a longitudinal cohort study published in JAMA Psychiatry. The study aimed to evaluate whether a history of suicide attempts within an army unit affects the likelihood of future suicide attempts and how various individual and unit characteristics relate to this risk.

Study Methodology

The data for this analysis was sourced from the Army Study to Assess Risk and Resilience in Service Members (STARRS) Historical Administrative Data Study (HADS), which encompasses information on active-duty soldiers from January 1, 2004, to December 31, 2009. The study utilized records from the US Army and the US Department of Defense to identify soldiers who had attempted suicide. The sample consisted of 9,512 enlisted soldiers who had attempted suicide, excluding person-months with large unit sizes (greater than 600 soldiers) and those unlinked to a unit. A total of 151,526 control person-months were selected, omitting soldiers with recorded non-lethal suicidal events or suicide attempts, as well as those with soldier deaths. The demographic breakdown revealed that 86.4% of individuals were male, 68.4% were under 30 years old, 59.8% identified as white, and 62.6% were under 21 when they enlisted.

Findings on Suicide Attempts

The analysis indicated that as the number of suicide attempts in a unit over the past year increased, so did the likelihood of a soldier attempting suicide. Specifically, the odds ratio for a unit with one past-year suicide attempt was 1.6, while it rose to 3.9 for units with at least five past-year attempts. This relationship persisted even after adjusting for factors such as occupation, unit size, and age at entry into the army. Further examination by excluding soldiers undergoing rehabilitation for significant physical or mental health issues and focusing on the number of past-year suicide attempters in a unit confirmed the same trend.

Influence of Other Variables

The study found that the number of past suicide attempts was unaffected by unit deaths by suicide, combat incidents, or unintentional injuries within the previous year. However, it was influenced by prior mental health diagnoses. Stratifying the data by occupation revealed a consistent trend across all army roles: as the number of past-year suicide attempts increased, so did the likelihood of suicide attempts. Notably, combat arms soldiers in units with a minimum of five past-year suicide attempts faced a higher risk than those in other occupations.

Conclusions and Future Directions

In conclusion, the presence of previous suicide attempts within an army unit is a significant risk factor for subsequent attempts among soldiers, particularly in smaller units. The study acknowledges several limitations, including the potential for the records to represent only severe cases of suicide attempts, which may not accurately reflect all incidents. Additionally, the selected time frame restricts generalizability to other periods of military conflict. Future research should consider examining the impacts of leadership quality, unit cohesion, and the recency of suicide attempts within units. Providing adequate support to soldiers following these incidents may enhance recovery efforts and prevent future suicides.

References

Ursano, R.J., Kessler, R.C., Naifeh, J.A., Herberman Mash, H., Fullerton, C.S., Bliese, P.D., Zaslavsky, A.M., … & Stein, M.B. (2017). Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts. JAMA Psychiatry, Retrieved August 6, 2017, from http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2645496.