By Debbie Sheehan, Fort Monmouth Public AffairsOctober 14, 2009
FORT MONMOUTH, N.J. -- It is scary stuff. "How do you deal with a population that has lost hope' How do you work with those who have lost the ability to take themselves away from something; the ability to take yourself out of a 'bad place''" asked Michelle Scott, an assistant professor in the School of Social Work at Monmouth University.
Scott was one of the presenters at a seminar on Suicide Assessment, Prevention and Intervention with Young Adults and Military Families held recently at the New Jersey university. The seminar was partially funded by the Fort Monmouth Officers' Wives Club Welfare Fund.
The seminar helped attendee define the phases often associated with suicide:
Suicide or completed suicide -- a death from injury, poisoning, or suffocation where there is evidence, either explicit or implicit, that the injury was self-inflicted and that the decedents intended to kill themselves.
Suicide attempt -- a potential self-injurious behavior with a non-fatal outcome, for which there is evidence that the persons intended to kill themselves.
Suicide ideation -- any self-reported thoughts of engaging in suicide-related behavior.
According to data gathered by the Center for Disease Control since 2003, of 100,000 teenagers, 5,400 males have attempted suicide; 1 in 465 succeeded and 11,500 females tried to kill themselves, but only 1 in 4,300 succeeded.
Most males who succeed do so because they used a firearm, which affects the military because firearms are readily available.
Since 2005, military suicides have been on the rise, increasing from fewer than 100 in 2005 to nearly 200 in 2008.
There is concern among the medical community that little data exists on suicide attempts or ideation within the military community.
The Army suicide numbers are the highest of the Armed Services at 20.2 per 100,000. The Marines had 19, the Air Force 11 and the Navy 11.3.
In 2006, the Army documented 2,100 attempted suicides; an average of more than five per day. In comparison, there were 350 attempts in 2002, the year before the war in Iraq began.
The method of choice was a firearm. There is no firm data on Soldiers who had thoughts of suicide.
"Stressors" are common in youth and military suicide, but stress itself does not cause suicide.
Some stressors include: disciplinary action, the breakup of relationships and humiliation of some sort.
Ninety percent of those who kill themselves have at least one psychiatric disorder.
Other common factors are depression, conduct disorders, substance abuse and anxiety.
Scott said that for young college students and young members of the military, their age works against them.
"They are at an age when biologically basic psychiatric disorders may be emerging and have not been treated. This includes depression, bi-polar disease and schizophrenia," Scott said.
Young adults may be experimenting with drugs and alcohol, have new independence, but also new responsibilities. They may have poor sleep and eating habits. They are away from home, maybe for the first time, and lack their usual support systems.
Persons away from home a just forming relationships, making it difficult for peers to detect that someone is behaving differently. They do not know new acquaintances well enough to see different patterns.
Other risk factors for Soldiers include: depression caused by long and multiple deployments, breakups in relationships, too much time away from family and post traumatic stress disorder (PTSD).
Those with PTSD were four times more likely to have thoughts of suicide. Young Soldiers, females, the undereducated, unmarried and smokers are at a higher risk for PTSD.
Suicide can be prevented by limiting access to firearms, having a drinking age of 21 and reducing the lethality of prescription drugs, particularity antidepressants.
Currently, the Army is conducting education seminars to focus on suicide prevention. Since 2003, mandatory suicide screenings have been in place for Soldiers who have been deployed.
The Army is expanding its screening process to implement further screenings to 90 to 180 days after deployment, including screening for PTSD and depression.
A process is in place to flag potential at-risk Soldiers. Nineteen percent of those deployed to Iraq, and 11 percent of those deployed to Afghanistan, have reported mental health problems and seven percent have been referred for mental health treatment.
It has been recommended that the military train providers to deliver proven medical care, and that the military provide a consistent approach to encouraging members to seek care and to continue evaluation and research to collect definitive numbers for future analysis.
"Lives are on the line here," said Maureen Underwood, a licensed clinical social worker and the conference presenter. "You are dealing with what for some might be a snowball, but for those in distress, it is an avalanche. You need to find out what is going on in their lives that would make them want to end it."
Underwood said the main thing a caregiver, battle buddy or friend can do is find out what event triggered a suicidal state and to help them find a reason for living.