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This report presents key findings from the first year (1999) of implementation of the Department of the Navy Suicide Incident Report (DONSIR). The DONSIR represents the first systematic attempt to collect epidemiological and risk factor data on all suicides that occur among active-duty Navy and Marine Corps personnel. This is the first in a planned series of annual reports that summarize DONSIR data. The intent is to provide line and medical personnel with information on suicide trends within Department of the Navy and to assist leaders in improving local suicide prevention efforts. In 1999, 40 Navy and 26 Marine Corps personnel died by suicide. This report includes all 1999 DONSIRs received by Navy Personnel Command and Headquarters Marine Corps by 31 March 2000. Data were entered into a database created and maintained by the Naval Health Research Center. Findings are summarized according to demographics, military career information, casualty data, medical and psychological status, and major risk factors. This report concludes with information on special issues pertaining to the DONSIR, and recommendations for further action.

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SUMMARYProblem: Since 1999, the Department of the Navy (DON) has conducted an extensive suicide surveillance program, using the DON Suicide Incident Report (DONSIR) to collect data on completed suicides in the U.S. Navy (USN) and Marine Corps (USMC). The long-term goal of this program is to improve suicide prevention by identifying and modifying military-specific risk factors. The DONSIR significantly improves the capability of the DON to track and analyze data on completed suicides. It provides the DON with consistent data that can be compared across both the USN and the USMC. It establishes baselines for suicide rates and suicide event characteristics that can be used to track trends over time. It also evaluates military-specific correlates of suicide, which cannot be evaluated using civilian, academic literature.Objective: This is the fourth annual report on the DONSIR. The objectives are to present findings from the data collected since the program was initiated in 1999 and to summarize the conclusions and recommendations that can be drawn based on the results to date. Decedent Demographic Profile"* Suicide rates were significantly higher among men than among women. "* There were no significant differences in suicide rates based on age or race. Decedent Career Profile"* The suicide rate for officers was significantly lower than the rate for enlisted personnel."* There were no significant differences in suicide rates based on regular/reserve status, length of service, or enlisted paygrade. 1999-2002 DoN Suicide Incident Report 3 Suicide Event Characteristics"* There were no significant differences in duty status at time of suicide, method of suicide, location of suicide, or use of alcohol comparing USN with USMC personnel or comparing decedents across calendar years. "* Thirty percent of USN decedents were assigned to a ship or submarine. USMC personnel are not assigned to ships or submarines. "* Significantly more USN than USMC decedents had been deployed within the 3 years prior to suicide, but USN (5%) and USMC (4%) decedents were equally likely to be deployed at time of suicide. "* Most suicides took place while decedents were on liberty and occurred at a residence. "* The most common method of suicide was the use of a firearm. However, decedents who were on government property at the time of suicide were more likely to choose hanging. Risk Factors for Suicide"* There were no significant differences by service in the total number of key suicide risk factors or recent associated stressors reported for decedents. "* The key risk factors most commonly noted in the DONSIR were depression, a history of mental health problems, feelings of anxiety, feelings of guilt, and evidence of alcohol abuse within the previous year. "* The five most commonly noted associated stressors were problems in a primary romantic relationship, physical health problems, job dissatisfaction, other work issues such as poor performance, and pending military legal or disciplinary action.

These findings affirm the presence of this naming latency effect in children, explore the duration of this effect over the course of recovery, and add nuance to inconsistently reported chronic naming deficits following concussion, informing recommendations for return to full academic and recreational participation.