Magazine article Clinical Psychiatry News

Fink! Still at Large: A Recent Report on Suicide in the U.S. Army Shows That Suicidal Behaviors Are More Common among Young, Unmarried Soldiers. What Factors Might Make Young People More Vulnerable?

Magazine article Clinical Psychiatry News

Fink! Still at Large: A Recent Report on Suicide in the U.S. Army Shows That Suicidal Behaviors Are More Common among Young, Unmarried Soldiers. What Factors Might Make Young People More Vulnerable?

Article excerpt

When the Army released its report, newspapers across the country (and perhaps around the world) ran headlines like this: "More U.S. Soldiers Committed Suicide in 2007 Than at Any Time Since the First Gulf War." For those of us who tend to the mental health of others, these suicides are particularly tragic.

We are sending young people to war at a time in their lives when, developmentally, they want to be autonomous. The majority of these young people--most of whom are men--have never witnessed death before, certainly not to the extent that they see it while in combat.

We can only speculate about the underlying reasons for their decisions to take their lives. One factor could be the extended amount of time in which they are deployed. Our volunteer Army needs manpower, and we do not have a plethora of men and women waiting in the wings to fight. One major supposition about the suicides is that they could be related to these redeployments. The Army's data show that 7% of the soldiers who either had completed or attempted suicide last year had a history of multiple deployments to Iraq or Afghanistan. It must be very disheartening to wait for the day when you expect to be sent home to your family--and then find out that you have to return to active duty in a month.

These young men are dispatched to a land that is foreign and hostile. The justifications for the war have been ambiguous at best, and this probably has made it difficult for some soldiers--particularly the younger ones--to develop the kind of patriotism that their grandfathers had during World War II.

When today's soldiers arrive in the theater, many see their buddies get killed, and they have no recourse--other than to get angry or to get out. And this desire to get out can lead to suicide. After all, a soldier cannot just announce to his sergeant that he is leaving.

So, one of the causes of suicide might be survivor guilt. This phenomenon has been written about extensively and was eloquently portrayed by Rod Steiger in "The Pawnbroker," a powerful 1965 film about the inner life of a Jewish pawnbroker and concentration camp survivor. When someone you care for dies, the question often becomes: Why him and not me? Certainly, the pain prompting such a question is palpable in the armed services, where the soldier has spent months in close quarters with, and often developed close emotional ties to, his comrades.

The Army has developed an exquisite data system--the Army Suicide Event Report (ASER)--aimed at recording suicidal events. In the report, the Army has been very careful to record whether the suicide occurred during the soldier's deployment or after the return home. For many, the realities of their lives at home might have been drab, compared with the constant state of tension and excitement of war. Life events such as broken love affairs, unhappy marriages, and other issues on the home front can overwhelm and depress anyone.

We know that depression is almost always a factor in suicide, as it was with these young people. Although the Army lists depression as making up only 10% of the motivators, it also lists depressive symptoms such as hopelessness (11%), emotional relief (11%) and avoidance or escape (8%), so one could conclude that a large number of those soldiers were depressed when they took their lives.

The record shows that 30% of the suicide victims had used alcohol or drugs during the event. When they eliminated the responders who listed "I don't know," the percentage went up to 46. A significant number had told people of their intent to take their lives, and that should have been enough to alert coworkers and families of real danger. We must help people become more responsive to the potential of suicide.

The psychiatric literature on suicide both in adults and children is robust. Many young soldiers are still children in many ways. About 40% of those who died had been separated or were having relationship issues at the time of the suicide. …

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