Suicide risk spikes for soldiers at specific moments in their careers

In an attempt to help stem a rise in suicide attempts in the US Army, a new study has pinpointed when soldiers are most likely to try to kill themselves — before, during, and after their deployments.

For those who had not yet deployed, suicide attempts peaked in the second month of service, according to the paper, published Wednesday in JAMA Psychiatry. Deployed soldiers faced the highest risk in the sixth month of their deployment, and soldiers who had returned home after a deployment were most likely to attempt suicide in the fifth month.

Those time periods correspond to key phases of a soldier’s experience, said lead author Dr. Robert Ursano, a psychiatrist at the Uniformed Services University of the Health Sciences.

“The strategy here is to identify targets for intervention,” Ursano said. “The approach is directed toward finding who, when, and where” suicide attempts happen.

For newly enlisted soldiers, two months can mark the end of basic training, when they are wrapping up a period of high stress and suddenly have more free time. Deployed soldiers often return home for a few weeks at the six-month mark and then head back into the battlefield. And after five months, soldiers returning home may hit a wall in their readjustment.

The paper “helps identify vulnerable transitions for men and women serving in the military” and “identifies potentially important points of intervention,” Mark Kaplan, an epidemiologist and suicide expert at the University of California, Los Angeles, wrote in an email. Kaplan was not involved in the research.

For the study, Ursano and his colleagues from the Army Study to Assess Risk and Resilience in Servicemembers — the largest-ever investigation of mental health among military personnel — looked at around 163,000 US soldiers, close to 10,000 of whom attempted suicide between 2004 and 2009.

In the sample as a whole, around 40 percent of the soldiers were still in training and had not yet deployed. But these individuals accounted for a disproportionate number — some 61 percent — of all suicide attempts, echoing what other studies have found: Suicide risk is not necessarily associated with being deployed in a war zone.

The method of the attempted suicide also changed depending on the status of the soldier. “During a war, there’s wide access to firearms,” Ursano said, and so soldiers during and after a deployment were more likely to use guns to try to kill themselves than soldiers in training.

And across deployment status, suicide attempts were more likely among female soldiers — a difference also seen in the general population — and among those with histories of substance abuse problems, depression, and post-traumatic stress disorder.