Suicide in the military is the act of ending one's life during or after a career in the armed forces.
While suicide rates in military organizations vary internationally, official statistics in several countries show a consistently higher risk in certain subgroups.
In the United Kingdom (UK), young serving personnel are markedly more likely than older personnel and same-age civilians to end their lives. [1] [2]
The risk among former military personnel is higher than among either serving personnel or the general population, according to research in Australia, Canada, the UK, and the United States (US). [3] [4] [5] [6] [7] The risk is particularly marked among veterans who joined up at a young age. [3] [5] [8] [6]
Contrary to popular belief, deployment to a war zone has not been associated with an increased risk of suicide overall, according to research in Canada, Denmark, the UK, and the US. [4] [9] [10] [11] [12] Participating in, or witnessing killing and wounding, however, can increase the risk. [12]
A study of the US army found that the career stage carrying the greatest suicide risk was not deployment, but initial military training, [13] as a time of disorientation and stress. [14]
Individuals most at risk of suicide during or after a military career include those who: had a troubled childhood; [10] are of low rank; [3] [4] [1] [15] [16] have close-combat roles in war; [4] [17] and/or leave service soon after joining. [3] [8] [18] Certain other known risk factors for suicide are common in military life, including depression, [19] posttraumatic stress disorder, [20] alcohol misuse, [20] [21] bullying [22] [23] [24] [25] and sexual harassment. [26] [27] [28] [29]
Variations in the suicide rate in military populations may also signify changes in the prevalence of related mental health problems, such as anxiety, depression, and histories of self-harm. [30]
Research from Australia, Canada, the UK, and the US indicates that suicide is a pervasive problem in military life, particularly after personnel leave, and that the youngest are most affected.
In countries where data are collected, the rate of suicide among serving armed forces personnel varies widely. The table below presents rates among serving male personnel in the regular armed forces (i.e. excluding reserve forces) of four countries, with comparisons to the general population.
Date range | Crude rate per 100,000 | Risk relative to general population | |
---|---|---|---|
Australia [3] | 2002–2019 | 11 | -51% |
Canada [4] | 2015–2019 | 25 | +122% |
UK [1] | 2002–2021 | 8 | -57% |
US [15] | 2020 | 32 | ≈0 |
Since most military personnel are male and suicide is a rare event, it is not usually possible to calculate a statistically significant rate among female personnel. The large military of the US is an exception, where the suicide rate among serving female personnel in 2020 was 12 per 100,000. [15]
Typically, former personnel are more likely than serving personnel to end their lives. The table below shows suicide rates among ex-armed forces personnel for three countries.
Date range | Crude rate per 100,000 | Risk relative to general population | |
---|---|---|---|
Australia [3] | 2002–2019 | 30 | +24% |
Canada [4] [5] | 2015–2019 | Not reported | +39% |
US [6] [7] | 2019 | 33 | +52% |
(The UK Ministry of Defence has announced that it will begin collecting and publishing official statistics on suicides in the ex-armed forces population from 2023. [31] )
Research suggests that the period of maximum risk for those leaving the armed forces is in the years shortly following discharge: within two years in the UK and within four years in Canada. [8] [5]
Official statistics from Australia, Canada, the UK, and the US show that younger personnel face increased risks.
In the UK, for example, while the suicide rate among male serving soldiers overall was 57% lower than that in the general population between 2002 and 2021, [1] it was 31% higher among those under 20. [2] The graphs opposite illustrate the elevated risk in this youngest age group.
The risk among young former personnel is markedly higher than that among civilians of the same age and to older veterans. In the UK, for example, those who enlist young have been found to face an increased risk of self-harm [32] and suicide [8] [2] after leaving the armed forces, relative both to older personnel and to their civilian peers. Compared with serving personnel of the same age, the suicide rate among young former personnel in the UK has been between two and three times as high, as is also the case in Australia. [3] [8] In both countries and additionally in Canada, the relative risk of suicide among young former personnel is also consistently well above the rate found among civilians of the same age. [3] [5] [8]
The table below shows the rate of suicide among the youngest age groups for which data are collected in three countries (note varying date ranges).
Date range | Age group | Former personnel in age group: suicide rate per 100,000 | Serving personnel in age group: suicide rate per 100,000 | Former personnel: Suicide risk relative to general population | |
---|---|---|---|---|---|
Australia [3] | 2002–2019 | Under 30 | 34 | 13 | +68% |
Canada [5] | 1976–2014 | Under 25 | Not reported | Not reported | +152% |
UK [8] | 1996–2005 | 16–19 | 30 | 17 | +193% |
US [6] | 2019 | 18–34 | 51 | Not reported | Not reported |
Individuals with experiences of distress are more susceptible to suicide. Certain such experiences are typically more common in the armed forces than in civilian life, according to research in various countries, including:
Similarly, research has found that suicide risk if higher in certain military subgroups than others. In addition to those of young age, higher risk is conferred to serving and former personnel who are:
Contrary to common assumption, deployment to a war zone (unless in a direct combat role) has not been associated with an increased risk of suicide, according to research in Canada, Denmark, the UK, and the US. [4] [9] [10] [11] [12] [37] [16] When considered overall, US veterans of the Vietnam War [37] and Iraq War, [12] [16] for example, and British veterans of the 1982 Falklands War and 1991 Gulf War, [37] have not been more likely to end their lives as a consequence of their deployment.
However, common deployment experiences of certain military groups, such as those with close-combat roles like the infantry, do carry additional suicide risks. For example, research in the US has found that specific types of traumatic war experience add to the risk, including killing and injuring others, or witnessing the same. [12]
Even so, most suicide attempts in the US army are by personnel who have never been to war. [13] According to one large study, US infantry soldiers who had never been deployed were twice as likely to end their lives as those who had. [17]
A study of the US army found the peak period for attempted suicide not to be during or after deployment, but initial training, [13] a time of prolonged psychological coercion, disorientation and stress. [14] It identified three career-stage points when suicide attempts were most likely, namely early in initial training, late in a first operational tour, and a few months after homecoming. Of these, initial training was the period of greatest risk, with a rate of attempted suicide four times as high as that found during a first deployment. [13] The graph below presents the study's results.
Some research further suggests that the childhood background of military personnel may play a role in increasing the average suicide risk during and after military life. [36] In the UK, for example, the army enlists new soldiers disproportionately from economically deprived neighbourhoods, [38] where adverse childhood experiences (ACEs) are more common. [39] Since ACEs bear a strong relationship both to stress-related mental health problems such as anxiety and depression, [36] and to self-harm and suicide, [35] this accounts in part for the additional mental health burden found in military populations recruited largely from economically marginalised communities. [36]
Since adolescents with an adverse childhood background are relatively susceptible to the toxic effects of prolonged stress, [40] [41] [42] [43] some health professionals have argued that the coercive resocialisation involved in initial military training may load a particularly heavy psychological burden on these younger recruits, as may any traumatic war experiences later. [42] [43]
In countries where suicide rates among serving personnel as a whole are lower than among civilians, a frequently proposed explanation is the healthy worker effect. [1] This refers to the relatively strong health of people in employment versus the general population, a portion of whom are not economically active. The healthy worker effect may be particularly pronounced in military populations, which are selected for mental health before enlistment. [44] After enlistment, personnel may further benefit from a relatively active lifestyle, conveying an additional health advantage over the general population.
These protective factors may be lost on leaving the armed forces, however.
Children in the military, including state armed forces, non-state armed groups, and other military organizations, may be trained for combat, assigned to support roles, such as cooks, porters/couriers, or messengers, or used for tactical advantage such as for human shields, or for political advantage in propaganda. Children have been recruited for participation in military operations and campaigns throughout history and in many cultures.
A veteran is a person who has significant experience and expertise in an occupation or field.
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) personnel are able to serve in the armed forces of some countries around the world: the vast majority of industrialized, Western countries including some South American countries such as Argentina and Chile in addition to South Africa, and Israel. The rights concerning intersex people are more vague.
Counter-recruitment refers to activity opposing military recruitment, in some or all of its forms. Among the methods used are research, consciousness-raising, political advocacy and direct action. Most such activity is a response to recruitment by state armed forces, but may also target intelligence agencies, private military companies, and non-state armed groups.
Military recruitment refers to the activity of attracting people to, and selecting them for, military training and employment.
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.
Mental health in China is a growing issue. Experts have estimated that about 130 million adults living in China are suffering from a mental disorder. The desire to seek treatment is largely hindered by China's strict social norms, as well as religious and cultural beliefs regarding personal reputation and social harmony.
Military personnel or military service members are members of the state's armed forces. Their roles, pay, and obligations differ according to their military branch, rank, and their military task when deployed on operations and on exercise.
As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.
Military psychology is a specialization within psychology that applies psychological science to promote the readiness of military members, organizations, and operations. Military psychologists provide support to the military in many ways, including through direct clinical care, consultation to military commanders, teaching others and supporting military training, and through research relevant to military operations and personnel. Military psychology as a field has been growing since the early 20th century, evidence that the demands and needs for psychological clinical and operational application is continuing to grow steadily. There are many stressors associated with military service, including exposure to high-risk training and combat. As such, psychologists are critical support components that assist military leaders in designing appropriate training programs, providing oversight to those programs, and assisting military members as they navigate the challenges of military training and their new lifestyle. Military psychology covers a wide range of fields throughout the military including operational, tactical, and occupational psychology. Gender differences between military-trained personnel who seek mental health assistance have been extensively studied. Specific examples include post traumatic stress disorder (PTSD) associated with combat, or guilt and family/partner difficulties accompanying extended or frequent deployments due to separation. Clinical providers in military psychology are often focused on the treatment of stress, fatigue, and other personal readiness issues. Previous wars such as the Korean war, Vietnam war, and WW 2 provide great insight to the workings and practices of military psychology and how the practices have changed and assisted the military over the years.
Suicide is the act of intentionally causing one's own death. Mental disorders, physical disorders, and substance abuse are risk factors. Some suicides are impulsive acts due to stress, relationship problems, or harassment and bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide such as firearms, drugs, and poisons; treating mental disorders and substance abuse; careful media reporting about suicide; improving economic conditions; and dialectical behaviour therapy (DBT). Although crisis hotlines are common resources, their effectiveness has not been well studied.
Sir Simon Charles Wessely is a British psychiatrist. He is Regius Professor of Psychiatry at the Institute of Psychiatry, King's College London and head of its department of psychological medicine, vice dean for academic psychiatry, teaching and training at the Institute of Psychiatry, as well as Director of the King's Centre for Military Health Research. He is also honorary consultant psychiatrist at King's College Hospital and the Maudsley Hospital, as well as civilian consultant advisor in psychiatry to the British Army. He was knighted in the 2013 New Year Honours for services to military healthcare and to psychological medicine. From 2014 to 2017, he was the elected president of the Royal College of Psychiatrists.
Suicide is a major national public health issue in the United States. The country has one of the highest suicide rates among wealthy nations. In 2020, there were 45,799 recorded suicides, up from 42,773 in 2014, according to the CDC's National Center for Health Statistics (NCHS). On average, adjusted for age, the annual U.S. suicide rate increased 30% between 2000 and 2020, from 10.4 to 13.5 suicides per 100,000 people. In 2018, 14.2 people per 100,000 died by suicide, the highest rate recorded in more than 30 years. Due to the stigma surrounding suicide, it is suspected that suicide is generally underreported. In April 2016, the CDC released data showing that the suicide rate in the United States had hit a 30-year high, and later in June 2018, released further data showing that the rate has continued to increase and has increased in every U.S. state except Nevada since 1999. From 2000 to 2020, more than 800,000 people died by suicide in the United States, with males representing 78.7% of all suicides that happened between 2000 and 2020. In 2022, a record high 49,500 people died by suicide, while the suicide rate in 2022 reached its highest level since 1941 at 14.3 per 100,000 persons. Surging death rates from suicide, drug overdoses and alcoholism, what researchers refer to as "deaths of despair", are largely responsible for a consecutive three year decline of life expectancy in the U.S. This constitutes the first three-year drop in life expectancy in the U.S. since the years 1915–1918.
Smoking in the United States military has been observed in previous wars, but smoking's close association with the United States military started in World War I when tobacco companies began to target military personnel through the distribution of cigarettes to servicemen and the eventual inclusion of cigarettes into rations. Although the military has attempted to implement tobacco control initiatives, the association between smoking and military personnel has persisted to the present day as smoking rates remain high, despite declines in civilian rates. Such high rates have led to questions about the effect of smoking from the apparent health risks to troop readiness and training costs.
A moral injury is an injury to an individual's moral conscience and values resulting from an act of perceived moral transgression on the part of themselves or others. It produces profound feelings of guilt or shame, moral disorientation, and societal alienation. In some cases it may cause a sense of betrayal and anger toward colleagues, commanders, the organization, politics, or society at large.
United States military veteran suicide is an ongoing phenomenon regarding the high rate of suicide among U.S. military veterans in comparison to the general civilian public. A focus on preventing veteran suicide began in 1958 with the opening of the first suicide prevention center in the United States. During the mid-1990s, a paradigm shift in addressing veteran suicide occurred with the development of a national strategy which included several Congressional Resolutions. More advancements were made in 2007, when the Joshua Omvig Veterans Suicide Prevention Act created a comprehensive program including outreach at each Veterans Affairs Office (VA) and the implementation of a 24-hour crisis hotline. PTSD, depression, and combat-related guilt in veterans are often related to suicide as it can be difficult for veterans to transition to civilian life.
Neil Greenberg is an academic psychiatrist, who is a specialist in the understanding and management of psychological trauma, occupational mental ill-health and post traumatic stress disorder. Greenberg works with King's College London and served as the President of the UK Psychological Trauma Society from 2014 to 2017. He also runs the psychological health consultancy March on Stress. During the 2020 COVID pandemic, Greenberg was part of the NHS England and Improvement Wellbeing Team and contributed to the national response to protect the mental health of NHS workers.
Sexual harassment in the military is unwanted sexual behaviour experienced as threatening, offensive, or otherwise upsetting, which occurs in a military setting.
Use of mind-altering substances in warfare has included drugs used for both relaxation and stimulation. Historically, drug use was often sanctioned and encouraged by militaries through including alcohol and tobacco in troop rations. Stimulants like cocaine and amphetamines were widely used in both World Wars to increase alertness and suppress appetite. Drug use can negatively affect combat readiness and reduce the performance of troops. Drug use also poses additional expenses to the health care systems of militaries.
Sexual misconduct in the British military is unwanted sexual behaviour occurring in military organisations of the United Kingdom, including verbal and physical harassment, assault, and rape.