One of the most important steps in preventing suicide is educating servicemembers in the field, according to Dr. Mark Fisher, chief of Psychological Services in the Behavioral Health Department at Kimbrough Ambulatory Care Center.

Fisher said he hopes more outreach will be done to active-duty Soldiers as the results of phase two of a five-year Army study on suicide and prevention are revealed.

"We need to be on the ground," Fisher said regarding the study, noting that behavioral health professionals need to be in direct contact with Soldiers "in regard to risk and how to be resilient."

This fall the Army, in collaboration with the National Institute of Mental Health (NIMH), will begin surveying about 90,000 active-duty Soldiers to collect data for the Army Study to Assess Risk and Resilience in Servicemembers.

Army Army Study To Assess Risk and Resilience in Servicemembers (STARRS) is the largest study of suicide risk, psychological resilience, suicide-related behaviors and suicide deaths that the military has ever undertaken. According to the NIMH website, the goal of the study is to help the Army develop effective strategies for mitigating suicide risk among Soldiers.

The study is being conducted at a critical time for the Army. In July, the Army released the Health Promotion, Risk Reduction and Suicide Prevention Report, which found that in 2009 there were 160 active-duty suicide deaths, with 239 across the total Army, including the Reserve component. Army suicide rates declined between 1994 and 2001, but they have risen steadily in recent years and are now higher than the age- and sex-adjusted rate for the general public, according to NIMH.

The study's researchers will begin surveying Soldier volunteers at several installations across the country. The researchers will confidentially collect data about Soldiers' psychological and physical health, exposure to adverse events, attitudes, social support, leadership and unit climate, employment and economic status, and family history. Biological samples, such as saliva and blood, will also be collected. The Soldiers will be followed over the course of the five-year study.

In addition to the 90,000 active-duty Soldiers, researchers also will collect data from all new recruits entering the Army - an estimated 80,000 to 120,000 per year. By the end of the study in 2014, about 400,000 Soldiers will have participated.

The typical suicide victim in the Army, according to the Health Promotion, Risk Reduction and Suicide Prevention Report, is a white, junior-enlisted Soldier in his early 20s. The risk for suicide is highest during the first year of service or deployment, compared with other times, the report states.

Lt. Cmdr. Marivic Fields, a behavioral case manager at Kimbrough, said the key to reaching young Soldiers is reducing the stigma associated with behavioral health issues. Fields, who served as a member of a Combat Stress Control Prevention Team when she deployed with the 4th Infantry Division, 2nd Brigade in Iraq in 2003, said she saw firsthand how Soldiers are often unreceptive to behavioral health professionals.

"We had to gain their trust and build a rapport," Fields said, noting that getting the unit's leadership to cooperate was crucial.

Eventually, Soldiers began to utilize the behavioral health team for a wide range of issues.

Fisher said he hopes the study's findings will convince Soldiers that they, and not just the medical establishment, are the best defense in the Army's efforts to prevent suicide.

Although behavioral health professionals can assess a Soldier's risk for suicide, Fisher said it is their fellow service members who must know the risks for suicide and make sure their buddies get the help they need.

"I don't make the saves, they do," he said.

Cmdr. Scott Salvatore, director of Behavioral Health Development at Kimbrough said Army STARRS is a "good first step" in viewing suicide as not only a military concern, but also as a public health problem.

"Suicide is preventable," Salvatore said. "If someone is telling you they want to kill themselves, often they don't want to. They want the pain -- physical, psychological, spiritual -- to end. They're reaching out for help."

For more information on Army STARRS, go to Soldiers with questions about participating in the study should e-mail the research team at

Information for this story was taken in part from, and