Risk of suicide attempts in army units with history of suicide attempts

Does a previous suicide attempt in a soldier's U.S. Army unit increase the risk of other suicide attempts?

A new study published by JAMA Psychiatry by Robert J. Ursano, M.D., of the Uniformed Services University of the Health Sciences, Bethesda, Md., and coauthors explores that question.

The authors used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) and identified records for all active-duty, regular U.S. Army, enlisted soldiers who attempted suicide from 2004 through 2009. There were 9,512 enlisted soldiers in the final sample who attempted suicide.

Soldiers were more likely to attempt suicide if one or more suicide attempts had occurred in their unit during the past year and those odds increased as the number of suicide attempts in a unit increased, according to the results. Also, soldiers in a unit with five or more suicide attempts in the past year had more than twice the odds of suicide attempt than soldiers in a unit with no previous suicide attempts.

The study acknowledges limitations, including that data are subject to diagnostic or coding errors. Also, the data focus on the 2004 through 2009 period and the findings may not be generalizable to earlier and later periods of the Iraq and Afghanistan wars or to other U.S. military conflicts.

"Our study indicates that risk of SA [suicide attempt] among U.S. Army soldiers is influenced by a history of SAs within a soldier's unit and that higher numbers of unit SAs are related to greater individual suicide risk, particularly in smaller units. ... Early unit-based postvention consisting of coordinated efforts to provide behavioral, psychosocial, spiritual and public health support after SAs may be an essential tool in promoting recovery and suicide prevention in service members," the article concludes.