Military Suicides

When American men and women make the courageous choice to join the armed forces, they realize that they may sacrifice their lives for their country. What they may not realize is that they are now more likely to commit suicide than they are to die in military combat.

The incidence of suicide in the military has increased steadily since the Iraq war began in 2003. There were 67 suicides in 2004, followed by 85 in 2005, 102 in 2006, and 115 in 2007. The 2008 statistic – 128 suicides – is the highest we’ve seen since record keeping began in 1980. Shockingly, military suicides outnumbered combat fatalities during the month of January 2009.

A recent APA Online article entitled Uncertainty about Military Suicides Frustrates Services describes the military’s attempt to understand this devastating suicide epidemic and how they plan to address it.

I am frustrated and saddened, though not surprised, to learn about the alarmingly high rate of military suicides. A combination of circumstances has created the perfect storm for suicides in the military. Consider the following:

• Service members are usually between the ages of 18-24. Neurological changes, developmental issues, and psychosocial stressors make individuals in this age group particularly vulnerable to mental illness.

• Service members are separated from their family, friends, and natural support systems for many months at a time. These extended absences contribute to homesickness, loneliness, depression, financial strain, marital problems, and infidelity.

• Service members are exposed to horrific violence on a daily basis. Their lives are constantly in jeopardy, and many are wounded in the line of duty. They witness their friends being shot, maimed, and killed.

• Service members are fighting a protracted, poorly managed, generally unpopular war with no clear end in sight.

• Military leaders and medical personnel are insufficiently trained in identification of psychological problems.

• There is a huge stigma associated with seeking mental health treatment amongst service members. The stigma often prevents service members from seeking the care they need.

• Service members are worried, often justifiably, that seeking mental health services may have a detrimental impact on their military career.

• Service members do not have sufficient access to adequate psychological services.

• Excessive drinking is deeply engrained in military culture.

• Service members have easy access to deadly weapons.

Given these conditions, it is not at all surprising that suicide is a problem in the military.

Lieutenant Justin D’Arienzo, Psy.D., a naval psychologist, described these systemic problems in a recent issue of the APA’s Monitor on Psychology. When D’Arienzo was serving on an aircraft carrier, he was solely responsible for the mental health of 8,000 people. He quickly discovered that he did not have time to see everyone who needed his services. In comparison, the ship carried 5 physicians, 4 dentists, and 40 medical assistants. To make matters worse, military psychologists are poorly compensated in comparison to other healthcare professionals in the service. The salary for a navy psychologist is about half that of a navy physician. This scenario sends the following not-so-subtle messages: psychologists are less valuable than physicians and dentists, psychologists are not needed as much as physicians and dentists, and service members’ physical health and dental health are more important than their psychological wellbeing. None of these messages are true.

The recent increase in military suicides is just one of many factors that points to the glaring need for improved mental health care for our service members. I have a few ideas as to how to improve this situation. Let me preface this by noting that, as an optimist and an idealist, I often have ideas that are less than practical. Nonetheless, here are my thoughts:

• The military hires more psychologists so that the number of military psychologists is commensurate to the number of military physicians. This will ensure that there are enough psychologists to meet the mental health needs of all service members.

• Military psychologists are paid the same salary as military physicians. Let’s face it: money talks. Higher salaries will increase the competition for these jobs and attract the best and brightest psychologists in the field. It also sends a clear message that soldiers’ mental health is valued as much as their physical health and dental hygiene.

• Every service member is required to attend weekly therapy sessions before, during, and after deployment. If all service members are required to attend therapy as a matter of course, this will eliminate the inner conflict troubled soldiers experience when considering whether to seek help, and it will remove the stigma of seeking mental health services. Further, mandatory weekly therapy is a preventative measure – soldiers can process their emotions and learn healthy coping skills before they reach the point of major depression or full-blown PTSD. Soldiers go through mandatory physical training to ensure that they are in top shape for combat. Mandatory therapy will help the troops stay psychologically fit for duty.

• More frequent therapy (e.g., 2-3 times per week) is available for those who are having great difficulty coping or who are beginning to show signs of mental illness.

• Confidentiality is maintained in the same manner as it is for civilian therapy clients.

• The length of deployment is shortened for all service members.

• Troops who develop major depression, PTSD, or other psychiatric problems are sent home to their families for more intense treatment with no adverse effect on their military career.

• Military leaders and military medical personnel are provided with more training on how to spot mental health issues in troops.

Regardless of my political beliefs and personal views on this war, I have tremendous respect for the brave men and women of our armed forces. The troops deserve high-quality, accessible mental health care. They have risked their lives serving and protecting our country. Isn’t it about time we serve and protect them?

1. Military Suicide Rate. Chicago Tribune, May 29, 2008.
2. Army says suicides among soldiers at highest level in decades. Paula Jelinek, Boston Globe, January 30, 2009.
3. Army Official: Suicides in January ‘Terrifying.” Barbara Starr & Mike Mount,, February 5, 2009.
4. Uncertainty about military suicides frustrates services. APA Online. July 31, 2009.
5. Pentagon: Military’s Mental Health Care Needs Help. June 15, 2007.
6. The Military’s War on Stigma. Sadie F. Dingfelder. APA Monitor on Psychology. June 2009.
7. Stahre et al. (2009). Binge Drinking Among US Active-Duty Military Personnel. American Journal of Preventative Medicine, Volume 36, Issue 3.

3 Replies to “Military Suicides”

  1. I think that it is also important and a bit more realistic (versus changing the system outright) to offer psychological treatment to military personal through the private sector. The stigma inside the military community in regards to mental health is pretty high and there are a lot of fears regarding confidentiality and how it will affect their status. It will take a long time to correct these issues and truly address the serious need, not just in writing and policy, but actually in belief within the ranks… a very hard concept to grasp for those who live to tough it out.

    My sister has recently returned from Iraq, her second deployment where she was a Black Hawk crew chief and gunner. Before this deployment, they threatened to kick her out due to low weight/anorexia. It was an empty threat. When she returned, she was having serious PTSD symptoms. They refused to diagnose her with PTSD because she couldn’t think of one single event when she believed her life was in danger. My sister has a difficult time talking to begin with and being bombarded by a list from a man she did not know… it frightened her. As she rambled to me all stirred up, she listed off at least a dozen such moments.

    I was able to find her a program for private counseling that aims to serve military men and women. The therapist volunteers an hour per week and then the client goes out and volunteers an hour in the community which I am hoping will allow her to feel more connected once again. She has the power and control to choose her own provider and what is said remains private which is a new concept for her.

    If it is ok, here is the link:

  2. Cera,

    Thanks for your comment. I’m so sorry to hear about what your sister went through. It’s especially appaling that they refused to diagnose her with PTSD becaue she couldn’t pinpoint one single incident in which her life was in danger. As if her life wasn’t in danger the entire time she was in Iraq. By DSM-IV standards, traumas that are less severe than military combat are sufficient grounds to consider a PTSD diagnosis. I’m glad you’ve been able to find good treatment for your sister, and I wish her all the best.

  3. The scenario you’re proposing of one therapy session per week for all recruits would be wonderful, but I doubt the resources are really available for that. Maybe a more realistic goal would be for each recruit to have one or two meeting with the therapist on their aircraft carrier, etc. That way, they’d be comfortable with the person already and be more likely to reach out if they needed help… Cera’s idea of psychological help through the private sector is also appealing, but might be difficult when troops are overseas.
    I think that through bonuses, etc. psychiatrists in the navy are actually paid more than general practitioners in the service, though I’m not sure on that. So, I’m not sure that the salary differential between the psychologists and physicians on board is really sending the message that physical health is more important than mental health. The military’s salaries tend to echo those in the private sector, just at a lower level and with better benefits. So, as long as there’s a salary differential in the private sector, there will be in the service as well.
    The military needs to provide better mental health care for its members, but to multiply the number of psychologists serving five fold and then double the salaries of those individuals is a very pricey solution.

Comments are closed.