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Military Suicides Raise Concern for DoD Health Officials

Military Medicine, Summer 2004

The number of suicides in Iraq has the full attention of Defense Department health officials, who are asking soldiers suffering from combat related stress to seek medical assistance. In a recent interview with American Forces Radio and Television Service, Dr. David N. Tornberg, deputy assistant secretary of defense for clinical and program policy, said suicide deaths are a "primary concern" for his office.

While DoD officials have reported a drop in the number of suicides this year, with no suicides reported in January or February, and just one in March, there is remaining concern over the 2003 statistics that reflected a rate of 17.3 for every 1000 soldiers serving in Iraq and Kuwait verses an overall Army suicide rate of only 12.8 per 1000.

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Tornberg said last year the military conducted a first-of-its-kind study of service members in a battle zone. Mental health experts surveyed 756 soldiers in Iraq between late August and early October, The study consisted of hundreds interviews of soldiers, their leaders, and support forces such as behavioral health and medical-care providers and unit ministry staffs. "They learned a lot from that trip," he said. "First and foremost, it reaffirmed the fact that the battlefield today, despite all training, is a very stressful environment."

While a majority, 77 percent, of soldiers interviewed for the study think that their stress level is not excessive, work still needs to be done on the front lines. According to Tornberg, recommendations in the report have called for making behavioral health care more accessible to soldiers in combat and other high-stress environments "so that mental health professionals are actively available and ready down at the battle lines."

Programs to help soldiers handle combat stress include the following:

1. The program involving combat stress control teams has been increased, with plans to have teams fully integrated into the battlefield and available to provide intervention and support as close to the front lines as possible.

2. Stress management programs within each service

3. The Army's Applied Suicide Intervention Skills Training, or "ASIST" program is a computerized program that works in concert with classroom training to provide training involving suicidal behavior.

4. A program called "Soldiers, Leaders and Communities Saving Lives" aimed at teaching soldiers how to recognize early signs of suicidal behavior and respond appropriately was launched earlier this year.

5. In February, the Army set up a toll free crisis hotline to help curb suicides among soldiers during high-stress periods.

Though the military has comprehensive programs in place to help soldiers deal with combat stress, more emphasis will now be placed on suicide prevention before, during and after deployment. According to Tornberg, service members receive mental health screenings prior to deployment and support from mental health teams in the field during deployment. Following deployment, service members go through what is called a "re-integration" process designed to help smooth the transition back into family life. They are also re-screened for mental health problems. "Follow-on services are available if they should encounter any difficulties," Tornberg stated.

Tornberg urged service members who are having problems coping with stress to come forward and address their issues. He stated, however, that many service members do not seek help because they see that as a sign of weakness or believe a stigma is attached to it. "It is absolutely not," he said, "Reaction to stress is a condition experienced throughout society, not just in the military-particularly in the young, particularly in the aged," he explained. "It's something that we as a society have to address. And the stigma is something that we want to be removed."