In the wake of suicide, basic questions evade easy answers. Why did it happen? How could it have been prevented? It's hard to get inside a dead person's mind to sort the puzzle out. The satisfying answers die with them.
So, how do you make sense of 325 such deaths? That's how many active and non-active personnel the U.S. Army reported committed suicide last year — a record number.
In 2003, a disturbing and persistent trend began in the military. It used to be that the Army had lower suicide rates than the overall population. But several years into the Iraq and Afghanistan wars, those rates flipped. It's remained that way since.
Like the pall surrounding a single suicide, the reasons why this trend has continued are still much of a mystery. But we are gaining a clearer picture on what factors are most correlated (or not) with suicide.
For one, it does not appear that combat experience or posttraumatic stress disorder is related to suicide. A recent report on suicides in the National Guard (which has the highest rate for all Army branches) could find no conclusive correlation between active service and suicide. "Soldiers who reported suicide intentions during deployment generally reported the same intentions after deployment, and the association of combat experiences with suicide symptoms was negligible," the researchers concluded.
PTSD is a real and damaging consequence of deployment, and on the surface it might seem related to suicide. But more than half of service members who have died by suicide have never been deployed. "So clearly it's not a combat issue," says Craig Bryan, a psychologist at the University of Utah who focuses his research on Army suicides.
Departed Secretary of Defense Leon Panetta had said the persistent rates were "perhaps the most frustrating challenge I've come across" while at the Pentagon. But the frustration is not that the Pentagon isn't acting, it's that the needle hasn't budged. "We have been trying lots and lots of things for 10 years now and nothing really seems to be working yet," Bryan says about prevention efforts. The Army offers a whole array of mental-health services, and has provided extensive suicide prevention training to officers and Army personnel. Last summer, Panetta announced a renewed four-part suicide prevention plan. "Just as we helped foster the jet age, the space race and the Internet, I want us to break new ground in understanding the human mind and human emotion," Panetta said when the plan was unveiled. This will be no small effort.
But we are getting a clear picture of who is most at risk for suicide. Here's what we know. White males 17-24 are most in danger. Suicides are largely happening outside of the military context. Ninety percent of the cases in the National Guard study were taking place while in civilian status, which is to say outside of a military atmosphere.
The demographics of it aren't completely surprising, as they mirror the population at large. Blacks commit suicides at much lower rates than whites. According to the Centers for Disease Control and Prevention, their rates are about half that of the overall population. For females, the risk drops by 75 percent.
What seems to be happening is that young white men are entering the military with preexisting distress, and that distress manifests over the course of their service. And the Army isn't addressing trouble signs at critical moments.
Going forward researchers will try to put a magnifying glass to this at-risk group: What drives one person to kill themself and another in a similar situation and demographic background to not? "We honestly, we don't know that yet." Bryan says. "We can't differentiate that in the short term in a way that is actually meaningful."
Contrary to what the conventional wisdom might be, the military can actually protect a person's mental wellbeing, which is why some think suicide rates used to be lower than the overall population.
The power of social bonds is real and protective. Strong communal ties are correlated with longer and healthier lives, and are a protective factor against mood disorders such as depression. One wonderfully simplistic study found that being surrounded by friends causes a person to judge a hill to be less steep. Yes, friends literally make obstacles appear less severe. Likewise, "things like strong sense of pride, optimism, sense of value, and feeling respected by others protects against suicide risk and these are the values of the military system," Bryan says. "There are other aspects of the military culture that are preventing things from getting worse from what they would otherwise be."
For now, we don't have a satisfying answer as to why the rates jumped over the last decade. It could also be that a prolonged war with a military comprised of such a small (and volunteer) segment of the population creates a scenario we've never seen before, as Bryan suggests. It's an unprecedented situation, so it's brave new world. It's also the case that there is often a disconnect between recognizing potential soldiers in crisis and giving them support.
According to a 2012 review of Army suicide "knowns," a quarter of the people who had committed suicide had reported at least one symptom on Army health assessments. "Yet few soldiers had been referred to behavioral health care providers," the report states. Only 5 percent were referred for help.
The military has made it clear that sorting out this problem is a priority, and have funneled lots of money to researchers like Bryan. (They also fund things like a $10 million study into whether fish-oil supplements can help prevent suicide. It's a kitchen-sink approach.) "Without a doubt the military has done more for suicide prevention in the past 10 years than we have done in the entire world, throughout human history," Bryan says.
But we still haven't figured it all out.
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