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September 2017

Suicidal Behaviors Within Army Units: Contagion and Implications for Public Health Interventions

Author Affiliations
  • 1Center for Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
  • 2Behavioral Health Division, Office of the Army Surgeon General, Falls Church, Virginia
JAMA Psychiatry. 2017;74(9):871-872. doi:10.1001/jamapsychiatry.2017.1908

Between 2005 and 2009, during the peak war years in Iraq and Afghanistan, the US Army and US Marine Corps, the 2 services with the largest concentration of ground combat forces, experienced a significant increase in suicides. For the first time in decades, suicide rates surpassed civilian levels, and they have remained elevated since. This change precipitated considerable research by several teams to understand the causal factors,1 including the more than $65 million Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), a population-based epidemiological study to identify “actionable recommendations to reduce Army suicides.”2 However, these extensive efforts reached somewhat contradictory conclusions concerning key risk factors, such as the association of deployment with suicide.1 The Army STARRS effort was the most prolific but generated the harshest criticism for its core scientific assumptions, methods, conclusions, and lack of actionable relevance.3-5 To date, none of these studies have been able to definitively answer the overarching question of why suicide rates rose so sharply in Army and Marine personnel but not in Air Force and Navy personnel.1