A new study links the U.S. Air Force’s extensive suicide prevention program to a major drop in the military branch’s suicide rate since the mid-1990s.

The report, a follow-up to a 2003 study, reveals that a decline of about 21 percent held up from 1998 through 2008 with the exception of one year.

The findings show that “it’s possible to reduce deaths from suicide and to do it over a period of years,” said study lead author Kerry Knox, an associate professor of at the University of Rochester.

The Air Force began putting its suicide prevention program into place in 1996 amid concern about a rising suicide rate. Among other things, the program aims to remove the stigma from those who seek help for .

The message, Knox said, is that “getting help is a sign of strength,” and “it’s not going to hurt your career if you get help early.”

The study appears in the August issue of the .The researchers found that for every 100,000 service members, the suicide rate dropped from 17 suicides per year before the program to a rate of 5.6 suicides during the program.

The actual number of suicides fell from a high of 68 suicides a year in 1994 before the program to a low of 20 suicides per year in 1999 following the program. The Air Force has about 335,000 service members currently.

In 2004, the suicide rate did spike to a level beyond 13.1 per 100,000 service members, or 49 suicides. However, the rate dipped after that year to levels similar to those seen following the initial implementation of the program.

It is hard to know how to explain the brief increase in suicide, Knox said, but it might have something to do with the pressures of two wars (Iraq and Afghanistan) at the time and “implementation ” that could have disrupted the suicide prevention program. However, Knox said the later reinforced the program.

The study does not prove that the prevention program is responsible for a lower rate. Still, there is plenty to suggest that it did and made a “significant” difference, Knox said.

David Segal, a director of the University of Maryland’s Center for Research on Military Organization, said the study findings are “very convincing” and suggest that the Air Force's prevention program is indeed having a significant influence.

“They’ve made significant efforts to destigmatize seeking mental health help,” Segal said. “That has been a big problem in the military culture. In that culture, seeking the help of a psychiatrist or psychologist has been a sign of weakness, and if you want a successful career you don’t do that.”

More information: Knox KL, et al. The US Air Force Suicide Prevention Program: implications for public health policy. Am J Public Health 100(7), 2010.