“If you think you know the one thing that causes people to commit suicide, please let us know, because we don’t know what it is.”
-Army Vice Chief of Staff Gen. Peter Chiarelli
A few weeks ago, a friend of mine posted a link on his Facebook wall announcing his participation in a group called The National Alliance to End Veteran Suicide. Their mission, as the name suggests, is to do something about the massive surge in veteran suicides since the invasion of Iraq in 2003. Articles describing the massive scope of the problem can be found here, here, and here. His posting asked for help with a brainstorming session about how best to deal with the problem. I, feeling snarky, replied “we can always stop sending our servicemen to some god forsaken hellhole for no reason”.
By the next day, my conscience was starting to bother me, not because I felt bad about my anger over the manner in which the wars in Iraq and Afghanistan have been prosecuted, but because politics aside, veteran suicide is a serious problem and perhaps I could’ve been more constructive in my comment. I therefore decided to educate myself a bit about the situation with the hope of offering my friend something useful to bring to his group. After delving into the data, I was surprised to discover that Occam’s Razor, the axiom which posits the simplest explanation is most likely the correct one, might be applicable. Ironically, the most effective means of ending veteran suicide may well be to stop sending soldiers to war.
Before I begin, I want to make it clear I absolutely and whole heatedly support the military’s efforts to both better understand the scope and nature of the issues that arise when people are put into a situation where the threat of death or dismemberment is a palpable possibility. My goal in writing this is simply to point out that, in light of the available evidence, it’s possible that the most likely cause of the increase in suicides among veterans is simply their participation, either directly or indirectly, in the endeavor of war.
When I began my research (note I was only looking at the numbers for completed suicides, not suicide attempts), I expected to find that a major contributing factor to the increase in suicides was the increase in number of deployments. In light of articles like this, this, and the recent tragedy in Afghanistan in which Army Staff Sgt. Robert Bales faces murder charges for allegedly shooting seventeen unarmed civilians, I was more than a little surprised to discover that, according to the 2010 Department of Defense Suicide Event Report (herein DoDSER), 89.32% of those who committed suicide had no direct combat history and 81.49% were not diagnosed with Post Traumatic Stress Disorder. Another study, Mental health risk factors for suicides in the U.S. Army, 2007-8 (herein MHRF), published this month in the British medical journal Injury Prevention, posts similar findings. 31% of the suicides were committed by soldiers who had never been deployed, and only 8.9% were diagnosed with PTSD ( I should point out that there is cause for concern that the statistics involving the number PTSD suicides might be skewed due to the military’s alleged practice of purposefully not diagnosing soldiers with it to get them out of the military and prevent them from being awarded VA disability benefits – more on that here, and here).
So if it’s not the repeated deployments what’s going on? Could it be related to the military’s repeated lowering of recruitment standards between 2003 and the present? According to both of the aforementioned studies, while the number of suicides among the junior enlisted ranks was higher, there still were a significant number of senior enlisted and some officers in the mix (161jr/118sr/15off in 2010 according to the DoDSER and 137jr/90sr/28off (2007-2008) according to MHRF). It’s doubtful that a significant number of Category IV recruits, whose abysmal performance on aptitude tests (between the 10th and 30th percentile) used to disqualify them from military service, would attain senior enlisted or even officer rank. Therefore, given the fact that a significant number of the victims weren’t junior enlisted personnel, the above statistics indicate the lowering of standards isn’t a stand-out factor.
Beyond the fact that whatever is happening obviously has something to do with the wars, and the presence of some other uninteresting characteristics (uninteresting given the gender/ethnic composition of our armed forces) common to the majority of the victims (most were Caucasian, male, and active duty members), the apparent lack of helpful data is damn frustrating – especially in light of the seriousness of the problem. I did, however, uncover three key pieces of information that have been largely overlooked and might help shed some light on the matter:
1) The military has only been keeping track of the number of suicides since 1980.
2) According to Dr. Antonette Zeiss, the Veteran Administration’s chief consultant of Mental Health Services, there is no apparent change in the number of incidences of PTSD among veterans of previous wars (WW2, Korea, Vietnam) and veterans of the present conflict.
3) According to a study in the Irish Journal of Medical Science, there was a similar upswing in the number of suicides in members of the security forces in Northern Ireland between 1984 and 1989.
The first piece of information is crucial. Our military is currently engaged in the longest war in the history of the nation. Between the present and 1980, there have been no sustained military conflicts that serve as analogues. In other words, until (God forbid) there’s another war like this one which would afford us an opportunity to juxtapose suicide data collected then against what we have now, we have no way of knowing whether or not the numbers we are seeing are unusual given the sustained and brutal conflict our military men and women are enduring.
*Note, while there seems to be very little reliable data as to military suicide rates prior to 1980, I did find this report detailing Army suicide rates from 1975-1976. As this is just after the Vietnam War, I’m including it here, with the caveat that its relevance may be limited to to the fact the study’s data set included only active members of the army, not the hoards of recently discharged combat veterans.
The second piece of information is germane because it is evidence against the contention that somehow this conflict is uniquely stressing our service members with respect to their mental health. The third is further evidence in support of the same. Here is a similar conflict (with respect to it being prolonged, violent, struggle fought between an insurgency and an institutionalized military force) producing a similar increase in suicide rates among the surviving belligerents.
Therefore, as we endeavor to find a cause for the significant increase in veteran suicides in recent years, it behooves us to remember Occam’s Razor: the simplest explanation is most likely the correct one. Beachhead, jungle, or desert – no matter what the circumstance, war is unspeakably horrific and as such, it shouldn’t surprise us when those who live through it come home deeply wounded inside.
Below is a response to an email I sent the Army Public Affairs Office asking them whether or not the recruitment standards had changed with regard to mental health since the beginning of the war in Iraq:
“The Behavioral health standards were tightened in July 2009 with a suspension of waivers for several distinct behaviors and behavioral health problems such as mood disorders and drug and alcohol dependence. Twelve additional mental health screening questions were added in 2009 to the USMEPCOM packet. The screening of the questions occurs at the Military Entrance Processing Station (MEPS).”
photo by IIona Meagher via flickr