Date Published: March 3, 2009
Publisher: Public Library of Science
Author(s): Jitender Sareen, Shay-Lee Belik
Abstract: Jitender Sareen and Shay-Lee Belik discuss the implications of a new study showing an increased suicide risk in young men who left the UK Armed Forces.
Partial Text: There has been increasing concern about suicide in active service members. In the US military, suicide is the second most common cause of death . Although mental health problems have clearly been associated with deployment to combat and peacekeeping operations [2,3], the literature on suicide has been mixed. Some studies in armed forces have found that the rate of completed suicide was lower than in the general population , while other studies have found higher rates  or no difference in suicide rates [6,7].
These findings should be interpreted within the context of a number of limitations of the study. First of all, it is important to note that the overall prevalence of suicide in soldiers was very low. Among the 233,803 soldiers who had left the Armed Forces, there were 224 suicides (a prevalence of 0.096%). Thus, although the findings in the study are novel and important, they are based on a relatively small sample size of completed suicides and require further replication. Second, the present findings in the UK Armed Forces may not be generalizable to other countries, where there may be differences in selection of soldiers and in accessibility to health services post-discharge from the military. Third, although the rate of suicide was higher among young males who had left the Armed Forces than among the general population, it remains unclear whether being in the Armed Forces had any specific relationship to suicide. For example, it remains unknown whether the suicides were specifically associated with deployment-related mental health problems or physical injury during service.
Kapur and colleagues’ study is specifically useful for the UK Armed Forces in developing a suicide prevention strategy for those at highest risk for suicide. It provides evidence that young males with short length of service need to be targeted in screening and suicide prevention programs. Considering the original work of Émile Durkheim , one of the main causes of suicide from a social perspective is that the individual committing suicide has lost a sense of connection with society. Thus, the actively suicidal person who may be feeling disconnected from society is unlikely to make significant efforts to seek out mental health care. In addition, mental health problems are clearly a major risk for suicide, and recent data from US and Canadian military surveys show that most service members suffering from a mental disorder do not receive care [11,12]. Similarly, Kapur and colleagues found that only one in five of the ex-military personnel who committed suicide had any contact with specialist mental health care.