We Can Still Do More for Veterans

Army suicide prevention programs can be implemented to reduce the rising rates

(RxWiki News) As the suicide rate in the military climbs, the Veterans Administration is looking for ways to improve suicide prevention for veterans. An expert from the Mayo Clinic points out more ways to improve prevention of military suicides.

Timothy Lineberry, MD, a psychiatrist at the Mayo Clinic and an expert in suicides in the U.S. Army, and co-author Stephen S. O'Connor, PhD, offered four primary ways that suicide prevention efforts could be taken up a notch.

Calling army suicides a major public health concern, Dr. Lineberry points out that the winding down of the wars in Iraq and Afghanistan are just the start of mental health concerns for our veterans.

"Watch for signs of suicide intentions."

"The potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses," he wrote.

He points out that between 2004 and 2008, the suicide rate in the army has jumped 80 percent over historical levels since 1977.

About half of the 301 soldiers who committed suicide in 2010 were active duty, and half were inactive reservists.

The increase does not appear to be slowing down. The 154 suicides between January and June of 2012 represent an 18 percent increase over the same months in 2011.

The military also reported in June that there have been more suicides than deaths during combat since the start of 2012.

But hope should not be lost.

There is still a great deal more that can be done to meet the needs of veterans contemplating suicide.

First, Dr. Lineberry emphasizes the need to limit the means of suicide to active duty and reservist soldiers — especially guns, since almost 70 percent of the vets who commit suicide use a gun.

He suggests that veterans with mental illnesses be asked about their access to guns. The veterans should consider taking firearms out of their home for a while or locking them up and giving the key to someone else.

Next, he points out that insomnia and other sleep problems are a risk factor for suicide because they indicate possible depression, substance abuse or post traumatic stress disorder (PTSD)

Both doctors and family members can ask veterans about their sleep quality or watch for problems related to sleeping.

Third, Dr. Lineberry suggests that opioid medications are well-monitored when prescribed to veterans since they offer another avenue for suicide.

He said research finds a higher risk of overdose, violence and mixing opioids with alcohol or other drugs associated with opioid prescriptions to veterans with PTSD.

Finally, Dr. Lineberry suggests that primary care for depression be improved so that primary care physicians are more on the lookout for symptoms of a depressed or potentially suicidal soldier.

It's more likely that a veteran saw his family doctor instead of a mental health doctor in the month before committing suicide, according to research cited by Dr. Lineberry.

Dr. Lineberry does not claim that these four steps will prevent suicides altogether, but they are important in addressing the rising trends.

"The enormity of a person’s death by suicide is not something defined abstractly by rates per 100,000, psychiatric diagnoses, or concepts such as impulsivity or aggression," he wrote.

"Prevention of suicide in the military will require multiple interventions using a comprehensive public health framework that includes ongoing monitoring and research to better identify, understand, and modify the complex contributory risk factors," he wrote.

The article was published in the September issue of Mayo Clinic Proceedings. The only competing interests mentioned were that Dr. Lineberry is a suicide prevention expert for the army and Dr. O'Connor is a research consultant for a study comparing the effectiveness of treatments for suicidal military personnel.

Review Date: 
September 11, 2012