Suicides, Mental Health Woes Soar Since Start of Iraq War, Study Finds

March 8, 2012— -- The study, an analysis of data from the Army Behavioral Health Integrated Data Environment, shows a striking 80 percent increase in suicides among Army personnel between 2004 and 2008. The rise parallels increasing rates of depression, anxiety and other mental health conditions in soldiers, the study said.

The high number of suicides are "unprecedented in over 30 years of U.S. Army records," according to the authors of the study, which was published Wednesday in the journal Injury Prevention. Based on the data and the timing of the increase in suicide rates, the authors calculated that about 40 percent of the Army's suicides in 2008 could be associated with the U.S. military escalation in Iraq.

"This study does not show that U.S. military operations in Iraq and Afghanistan cause suicide," said Dr. Michelle Chervak, one of the study's authors, a senior epidemiologist at the U.S. Army Public Health Command. "This study does suggest that an Army engaged in prolonged combat operations is a population under stress, and that mental health conditions and suicide can be expected to increase under these circumstances."

From 1977 to 2003, suicide rates in the Army closely matched the rates of suicide in the civilian population, and were even on a downward trend. But after 2004, the rates began to climb fast, outpacing the rates in civilians by 2008.

In 2007 and 2008 alone, 255 active duty soldiers committed suicide. The vast majority of the suicides since 2004 were by men; and 69 percent had seen active combat duty. Nearly half were between ages 18 and 24. And 54 percent of those who committed suicide were from among the lower ranks of enlisted personnel.

The study found that suicide rates were higher among soldiers who had been diagnosed with a mental illness in the year before their death.

Soldiers who had been diagnosed with major depression were more than 11 times as likely to commit suicide, and suicide was 10 times more likely among those with anxiety. More than 25 percent of the soldiers who took their lives had been diagnosed with adjustment disorder, a term for the immediate emotional fallout from proximity to stressful events.

The association between mental health woes and the risk of suicide is well known to mental health professionals, but Chervak said the purpose of the study was to validate mental health diagnoses as a major risk factor for the increasing number of suicides in the Army.

Studies have shown rising rates of mental illness among U.S. military service members in recent years. Dr. Amir Afkhami, a professor of psychiatry and global health at George Washington University, said it's uncertain whether or not there are truly more cases of mental illness among troops or if the military is simply more attuned to recognizing and reporting these issues.

"But the higher number of suicides is a rock-solid indicator that we do have a problem," he said. "There's no question about it."

Each branch of the military has suicide prevention programs in place. But the study's authors say there is a great need for more research and ongoing evaluation of these programs. Chervak said the current study provides a starting place for the Army to rethink its current approach to helping soldiers in need.

"By establishing that soldiers who are diagnosed with a mental health disorder are at greater risk of suicide, we then have a place to target prevention strategies," Chervak said.

Afkhami said reaching soldiers who are at risk of suicide means thinking creatively about how to get help to the soldiers who need it, including those returning from combat who bear emotional and psychological scars and have trouble readjusting to civilian life.

"While it's important to be focused on what's going on now, especially with the drawdown of troops, we really have to think about next steps, and what do we do for our troops once they return back home," he said.