Between 2005 to 2010, a U.S. service member took his or her own life every 36 hours, according to a new report by the Center for a New American Security (CNAS) .

“Although only 1 percent of Americans have served in the military, former service members represent 20 percent of suicides in the United States,” the report stated.

Military suicide has risen over the past 10 years, with an estimated 18 veteran suicides a day. However, the report’s authors say the true number is unknown.

“As more American troops return home from war, this issue will require increasingly urgent attention,” the report summary warned.

The report, entitled “Losing the Battle: The Challenge of Military Suicide” is CNAS’s first as part of the White House’s Joining Forces initiative .

The report focused on areas that contributed to the problem, and provided recommendations.

• First, the report said military personnel transfers complicated efforts to seek mental health care, since moving could cause a disruption in health care, and patients are often reluctant to begin treatment anew.

• Second, personnel transfers occur too soon after deployment, resulting in a lack of unit stability with “unfortunate implications for individuals struggling with reintegration,” the report stated.

• Third, the report said that even though unit commanders were “best able” to help their troops when they knew that individuals were struggling, they had limited visibility into service members’ medical problems, since health information laws precluded medical professionals from sharing information with them.

• Also, the report said, commanders are not always aware when subordinates are dealing with difficult problems, such as legal or criminal issues, since it is not required that commanders be notified.

• And due to legal restrictions, commanders are not able to discuss privately owned weapons with their subordinates, even though studies indicate that preventing easy access to firearms is an effective form of suicide prevention.

• In addition, infrequent interaction between unit leaders and guardsmen and reservists limited their ability to help subordinates struggling with mental health issues. Even postcards or text messages from unit leaders between drill weekends can help prevent suicides, the report said.

• The report also stated that the cultural stigma attached to mental health care prevents many service members from seeking help, and that military hazing also caused a small percentage of military suicides.

• The mental health screening process following deployments was problematic, the report said, since service members’ answers did not always reflect reality and were sometimes based on how quickly they wanted to get home.

• The report also stated that the lack of mental health care and behavioral health care professionals was a factor linked to higher rates of suicide.

• Excess prescription medication in the military community was a problem. 45 percent of accidental or undetermined Army deaths from 2006 to 2009 were caused by drug or alcohol toxicity, and 29 percent of Army suicides between 2005 and 2010 included drug or alcohol use, the report said.

• The report also stated the National Guard has too many suicide prevention programs, complicating the ability to assess which suicide prevention strategies are effective.

• Lastly, the report said there was incomplete accounting of veteran suicide, complicating the ability to quantify veteran suicide and contribute an understanding of suicides.

At an event on Wednesday afternoon launching the report, Vice Chief of Staff of the Army Gen. Peter Chiarelli said reducing suicides in the Army has been the most difficult challenge in his 40 years in the military.

He added that if there was one thing the Army could do, it would be to better understand the brain, and how brain injury affects the symptoms of suicide.

“Individuals with traumatic brain injury (TBI), for instance, are 1.5 times more likely than healthy individuals to die from suicide,” said the report.

Chiarelli said he disagreed with the title of the report and with any implication that little has been done to combat suicide. He said that every incidence of suicide in the Army was reviewed by a board.

“I do not believe we are losing the battle,” Chiarelli said, adding that he believes the Army has made “tremendous progress” in understanding military suicide.

“The circumstances surrounding each suicide are as unique as the individuals themselves. That’s what makes this so incredibly tough,” he said.

According to the report, additional factors that heighten risk of suicide include chronic pain, and post-traumatic stress disorder symptoms such as depression, anxiety, sleep deprivation, substance abuse and difficulties with anger management. These factors are also widely associated with deployment experience in Afghanistan and Iraq, the report said.

Co-author of the report and director of the Joining Forces initiative at CNAS Dr. Margaret Harrell said the rising incidence of suicide among service members threatened the health of the all-volunteer force.

“Military suicide is a national security issue,” Harrell said, since future military recruitment depended on how vets of earlier wars are perceived. She also disagreed with Chiarelli, saying that she believed the battle against suicide was being lost “multiple times a day.”

Dr. Janet Kemp, National Mental Health Program Director for Suicide Prevention, took  a middle stance.

“As long as any vet or service member dies by suicide, we are in fact losing the battle,” Kemp said at the event. “But, we’ve made huge strides toward winning the war.”