Suicide in the United States Air Force: Risk factors communicated before and at death

Abstract

Background: Over the last decade, suicide rates in the U.S. military have steadily increased, resulting in a call for suicide-related research with military populations. The present project aimed to describe and evaluate the communications (i.e., verbally and in suicide notes) of 13 suicide risk factors in the suicide death investigation files of 98 active duty U.S. Air Force (USAF) members. Methods: Two-hundred thirty-seven suicide death investigation files were coded. Ninety-eight decedents left suicide notes and were included in the current analyses. Descriptive statistics were computed to evaluate the types of risk factors most commonly communicated prior to and at the time of death as well as the medium for their communication. Specifically, verbal and note communications were compared to evaluate which medium decedents most often used to communicate risk factors. Also, the frequency that interpersonal compared to intrapsychic risk factors were communicated was evaluated. Results: Hopelessness (35.7% of cases) and perceived burdensomeness (31.6% of cases) were the risk factors most often communicated in suicide notes but not verbally. Thwarted belongingness (29.6% of cases) was the risk factor most often communicated verbally and in the suicide note. Further, evaluated risk factors were more frequently communicated in suicide notes than verbally. Finally, interpersonal risk factors were more often communicated than intrapsychic risk factors. Limitations: The validity of the data relies on interviews of decedents' acquaintances and various medical/military records. Conclusions: Our findings support emphasizing certain risk factors over others in USAF suicide prevention efforts. Further, interpersonal risk factors appeared to be more salient than intrapsychic risk factors in the minds of decedents.

Relative Impact of Risk Factors, Thwarted Belongingness, and Perceived Burdensomeness on Suicidal Ideation in Veteran Service Members

“…Cox et al. () provided further support for the applicability of the IPTS in military populations in their study of suicide decedents in the U.S. Air Force. Studying thematic commonalities in the suicide notes and final verbal communications of these decedents, they found that the psychological constructs of hopelessness, perceived burdensomeness, and thwarted belongingness were all themes evident in those who died by suicide.…”

Use of Demographics to Predict High Risk Individuals for Suicide

“…military members experience unique barriers to behavioral healthcare that jeopardize opportunities for intervention. In an evaluation of service members deployed to Iraq or Afghanistan, results indicated that only half of those in need of behavioral healthcare received treatment (Cox, 2011). Table 4 shows some of the most common barriers to mental health in the military population (Ramchand, 2011).…”

Optimizing Screening and Risk Assessment for Suicide Risk in the U.S. Military

“…Thwarted belongingness has been found to be associated with suicidal ideation in military samples (Bryan, 2011). It has also been found to be a common theme in suicide notes left by military personal who died by suicide (Cox et al, 2011).The second component of suicidal ideation in IPT is perceived burdensomeness. This domain consists of misperceptions of the individual that he or she is a burden to others around him/her, failing not only to make meaningful contributions to society, but also serving as a liability to others.…”