Risk Factors Associated With Suicide Completions Among US Enlisted Marines

Abstract

US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05).

Military Deployments and Suicide: A Critical Examination

“…A retrospective population-based cohort study that included all suicides from the start of OEF through 2009 found no relationship between suicide and any deployment to OEF or OIF and no relationship between suicide and multiple deployments, even after including individuals who separated from the military (e.g., because of postdeployment mental-health problems; Reger et al, 2015). Similar results were obtained in other studies with OEF and OIF service members (Griffith & Bryan, 2017; Kang et al, 2015; Phillips, LeardMann, Vyas, Crum-Cianflone, & White, 2017).…”

Identification of socio‐demographic, occupational, and societal factors for guiding suicide prevention: A cohort study of Swiss male workers (2000–2014)

“…Because the Swiss Army is a militia organization with an only small proportion of professionals, civil security workers are much more numerous to be involved in Defense activity. Defense workers constitute a high‐risk group regarding suicide in many countries (Cohidon et al, 2010; Encrenaz et al, 2016; Gomes et al, 2018; Grassi et al, 2019; Mahon et al, 2005; McIntosh et al, 2016; Phillips et al, 2017; Reisch et al, 2013; Violanti, 2010), but not in Finland (Laukkala et al, 2016) and Denmark (Agerbo et al, 2007; Hawton et al, 2011) and Military and police work is generally considered dangerous because of increased risk of homicide and exposure to trauma and incidents such as witnessing death, encountering abused children, and street combats (Violanti, 2010). Moreover, relationship problems, culturally approved alcohol use and maladaptive coping, and especially, firearm availability are common in this occupation.…”

Special Needs of and Promising Solutions for Incarcerated Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn

“…According to the U.S. Veterans Administration (U.S. Department of Veterans Affairs, 2016), in 2014, although 8.5% of the population were veterans, 18% of U.S. adult suicides were among veterans. Deployment by itself has not emerged as a risk factor for suicide (Kang et al, 2015;Phillips et al, 2017).…”

“…Recent studies indicate that TBI (Fonda et al, 2017;Simpson & Tate, 2007), PTSD (Britton et al, 2012;Ilgen et al, 2012;Kang & Bullman, 2008;McKinney et al, 2017;Ramchand et al, 2015), bipolar disorder (Britton et al, 2012), depression (Britton et al, 2012;Cohen et al, 2017;Doran et al, 2018;McKinney et al, 2017;Phillips et al, 2017), schizophrenia (Britton et al, 2012), and alcohol/drug use disorders were associated with increased risk of suicide (Britton et al, 2012).…”

“…In a study of suicides at a VA hospital, 63% were by firearms and 20% were by hanging (Mills et al, 2011). Phillips et al (2017) identified the suicide rate and risk factors for completed suicides among a cohort of 108,930 male marines. In this sample, of the 790 deaths that occurred between 2001 and 2010, 15.6% were suicides.…”