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The rate of suicide of veterans is alarmingly high. In addition, the rate of suicide among active duty military is alarming. While active duty suicide rates were low over the years, they have increased during the last couple of decades at the same time that veteran suicide rates have gone up. Is there a military predisposition to suicide? If so why is that?. If so, what can be done to bring this under control? Because suicide is difficult to prevent, the more we understand the basic causes, the more we can do to bring the rates down.

Increasing Active Duty Suicide Rate

Around 2005 when the US invaded Iraq and stayed, the rates of suicide among soldiers on active duty started going up. For decades active duty suicide rates were significantly lower than for demographically matched civilians. Reasons for this likely included screening of those entering the military and exclusion of those with serious mental health and criminal issues. In prior military conflicts US military suicide rates never went up like they did after involvement in Iraq and Afghanistan.

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Why Are Suicide Rates of Active Duty Military and Veterans Rising?

For as long as there has been war there has been risk of injury and death at the hands of the enemy. Active duty have been screened to an extent that suicide risk should be lower. Within the military individuals are in a well defined social setting with well defined goals. What is different now is that the rates of active duty military and veteran suicide are going up along with higher rates mental health problems while on active duty. Part of this may well be the nature of the conflict or conflicts.

Long Wars With Poorly Defined or Difficult to Obtain Goals

The USA has had its share of wars. Most of these, since The Revolutionary War have been limited to a few years. The Civil War caused the most casualties but lasted four years. The Spanish American War lasted 114 days. The Korean War lasted three years. And American involvement in WWI lasted a year and seven months. By comparison the US fought in Afghanistan for nineteen years and ten months and in Iraq for nearly nine years. US involvement in Vietnam lasted nearly twenty years.

The issues in the Civil War, First World War, Second World War, and Korea were something that the average soldier could understand. It became increasingly difficult for American soldiers to understand what we were doing in Vietnam and later in Afghanistan or Iraq. It is useful to remember that the Germans, French, and Brits fought for four horrific years in WWI trench warfare. The aftermath was the European “lost generation.” Suicide rates were excessive among those veterans. In that sense, we can possibly blame the currently high suicide rates among active duty and veterans on the duration of American involvement in wars where it became increasingly unclear why we were fighting.

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Suicide Risk and Protective Factors for Active Duty Military

The vast majority of those who commit suicide have had a mental illness issue at the time of their death. Depression and PTSD along with substance abuse and impulsive aggressive issues lead the list. It makes sense that these sorts of issues could be made worse during times of stress on active duty. But, if that were the case, we should have seen similar upticks in suicide during every military conflict. Protective factors when applied include attention by health care professionals and intervention by comrades of the affected service personnel.

If we assume that the increase in suicide rates in the military has to do with stresses associated with active duty, then we should expect to see that risk diminish when the service member goes back to civilian life. An exception would be when they have PTSD or a service connected injury that makes transition to civilian life difficult.

What Can Be Done About High Active Duty and Veteran Suicide Rates?

The best evidence so far is that identification of those at risk is paramount. Then it is critical to stay in touch with the individual at risk, get them to someone who can help, and get them effective preventative measures and/or treatment. In this regard it is important the effective new measures such as psychedelic medicines as adjunctive measures with psychotherapy become available as soon as possible for those at risk.

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