Suicide Among Regular-Duty Military Personnel: A Retrospective Case-Control Study of Occupation-Specific Risk Factors for Workplace Suicide

Mahon, Martin J.; Tobin, John; Cusack, Denis A; Kelleher, Cecily; Malone, Kevin

doi:10.1176/appi.ajp.162.9.1688

Cited by 100 publications

(75 citation statements)

References 53 publications

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“…Suicide is the second most common cause of death in the United States military and also accounted for substantial mortality in the Russian military, among British veterans of the Falkland war and during the recent Iraq conflict. 1 In the United States Military, where the active-duty military is comprised reported 66 suicides between January 1990 and July 1995, with one third of the victims having peacekeeping experience. 4 This was the first demonstration that interpersonal traumatic events of peacekeeping operations, are associated with suicide attempts in a representative sample of active Canadian military men and women.…”

Section: Introductionmentioning

confidence: 99%

Suicide Prevention and Management in the Sa National Defence Force: A Psychological Discussion

Koopman

Dyk

2012

Sci.Mil.

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Suicidal behaviour is a challenge for military forces around the world. Suicide can be a reaction in peacekeeping operations or conventional warfare, because the stressful nature of both types of operations can force military members to such a catastrophic end. This article focuses on the necessary knowledge and skills for a better understanding of suicidal behaviour in the South African National Defence Force (SANDF) for members on different levels. It discusses the operational environment, with specific reference to peacekeeping operations or conventional warfare as contributing factors, risk factors, and the prevention and proper management of suicide by means of educating commanders and members of the multi-professional team (MPT).

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Section: Introductionmentioning

confidence: 99%

Suicide Prevention and Management in the Sa National Defence Force: A Psychological Discussion

Koopman

Dyk

2012

Sci.Mil.

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“…For example, the loss of friends, particularly those assigned to the same unit, can have a deep impact, whether in combat or not (Kang & Bullman, 2008). Stress may be greater in the Army population because of increased dependence on social support provided by friends and coworkers in the military environment (Mahon, Tobin, Cusack, Kelleher, & Malone, 2005). Externalized psychopathology (drug and particularly alcohol abuse or dependence) may be more evident in the military due to greater cultural acceptability of these behaviors (Hills, Afifi, Cox, Bienvenu, & Sareen, 2009).…”

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confidence: 99%

“…Studying the effects of stress-load on suicide is particularly relevant in the Army, where stress-load may increase more rapidly, with less time for coping and adjustment. This stress may not simply be the result of increased op tempo but may be due to guilt, anger, or humiliation that can accompany the stress of a relationship breakup, legal problems, or poor work performance (Mahon et al, 2005).…”

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confidence: 99%

Prevalence and Risk Factors Associated With Suicides of Army Soldiers 2001–2009

Black

Gallaway

Bell

et al. 2011

Military Psychology

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Prevalence and risk factors associated with soldiers' suicides 2001-2009 (N = 874) were examined. Army suicide rates increased from 9 per 100,000 in 2001 to 22 per 100,000 in 2009. Soldier suicides were lower than civilians from 2001 to 2007, but higher than civilians after 2007. Army suicides were disproportionately higher for men, deployment experience, and a history of a mental health diagnosis/treatment; and lower for African Americans. Many involved planning (38%), communication (21%), alcohol (19%), or drugs (8%). Many had legal problems (31%), high stress loads (90%), a history of self-injury (10%), and other contributing factors prior to entry into the Army (31%). Implications for understanding suicide among military personnel are discussed.Contemporary research on suicide in the general population has shown that biological, psychosocial, and environmental factors interact to influence suiciderelated deaths each year (Brown,

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“…The authors suggest that recent self-harm is associated with a 1% risk of suicide, although there is a very low positive predictive value for any method of risk assessment for suicide even in groups of patients considered to be at high risk [26,27]. In a small study of serving Irish military personnel, only 10% of those who died as a result of suicide had a documented history of previous self-harm [28], which is broadly consistent with our finding of 9% in people under 30. Our findings are also supported by the Oxford study which has has demonstrated that the risk of subsequent suicide after self-harm changes with age, being rare in teenagers (less than 1 in 200), but increasing to more than 1 in 10 in people over 60 [29].…”

Section: Discussionmentioning

confidence: 99%

Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

Bergman

Mackay

Smith

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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Purpose Although suicide risk in veterans has been widely studied, there is little information on the risk of non-fatal selfharm in this population. We used data from the Scottish Veterans Health Study to conduct an epidemiological analysis of self-harm in veterans, in comparison with people who have never served. Methods We conducted a retrospective, 30-year cohort study of 56,205 veterans born 1945-1985, and 172,741 people with no record of military service, and used Cox proportional hazard models to examine the association between veteran status and cumulative risk of non-fatal self-harm, overall and stratified by birth cohort, sex and length of service. We also examined mental and physical comorbidities, and association of suicide with prior self-harm. Results There were 1620 (2.90%) first episodes of self-harm in veterans, compared with 4212 (2.45%) in non-veterans. The difference was statistically significant overall (unadjusted HR 1.27, 95% CI 1.21-1.35, p < 0.001). The risk was highest in the oldest veterans, and in the early service leavers who failed to complete initial training (unadjusted HR 1.69, 95% CI 1.50-1.91, p < 0.001). The risk reduced with longer service and in the intermediate birth cohorts but has increased again in the youngest cohort. Conclusions The highest risk of non-fatal self-harm was in veterans with the shortest service, especially those who did not complete training or minimum engagement, and in the oldest birth cohorts, whilst those who had served the longest were at reduced risk. The risk has increased again in the youngest veterans, and further study of this subgroup is indicated.

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Suicide Among Regular-Duty Military Personnel: A Retrospective Case-Control Study of Occupation-Specific Risk Factors for Workplace Suicide

Cited by 100 publications

References 53 publications

Suicide Prevention and Management in the Sa National Defence Force: A Psychological Discussion

Suicide Prevention and Management in the Sa National Defence Force: A Psychological Discussion

Prevalence and Risk Factors Associated With Suicides of Army Soldiers 2001–2009

Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

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