The War Within: Preventing Suicides in the Military

The increase in suicides among members of the military has raised concern among policymakers, military leaders, and the population at large – especially over the past few years. While the Defense Department and the military services have had a number of efforts under way to deal with the increase in suicides among their members, in 2008 the Assistant Secretary of Defense for Health Affairs specifically asked the RAND National Defense Research Institute (NDRI) to identify best practices and determine if the Defense Department and service programs employed such practices. RAND focused on the following research activities:

■Review of the current evidence detailing suicide epidemiology in the military

■Identification of “best-practice” suicide-prevention programs

■Description and catalog of suicide-prevention activities in the Defense Department and across each service

■Recommendations for ways to ensure that the activities in the Defense Department and across each service reflect best practices

“Throughout the Defense Department the issue of suicide is taken very seriously. The RAND study helps us to identify areas that need improvement so that we can continue to provide the most comprehensive health care for our service members – from the inside out,” said Director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Navy Capt. Paul Hammer.

From September 2008 to November 2009, RAND conducted a literature search, reviewed relevant policies, interviewed subject matter experts within the Defense Department and in the field of suicidology, and assessed Defense Department and service programs based on information gathered.

The report contains information on the epidemiology of suicide; reviews of scientific evidence and suicide prevention activities; a summary of funding and responsibilities within the services; an assessment of service prevention programs; and a number of specific recommendations for suicide prevention.

“Suicide is a tragic event, and, although evidence is scant, comments from the experts we interviewed, in addition to the literature we reviewed, suggest that it can be prevented,” said Dr. Rajeev Ramchand, a RAND researcher who led the study. “Our investigation into the suicide-prevention programs in DoD and across the services revealed examples of programs following best practices as well as those lacking in a number of domains. The recommendations we provide represent the ways in which the best available evidence suggests that even more of these untimely deaths could be avoided.”

The report was written for health policy officials and suicide prevention program managers in order to update program managers and to inform program and policy developers regarding suicide prevention strategies in the military. However, the results should also be of interest to health policy officials within the U.S. Departments of Veterans Affairs (VA) and Health and Human Services and the U.S. Congress.

“This report will help inform how Defense Department can improve suicide prevention programming and efforts to prevent further suicides in the military,” said Hammer. For questions, please contact CDR Janet Hawkins at Janet.Hawkins@tma.osd.mil.