US soldiers who attempt suicide often have no prior mental health diagnosis

Bottom Line: The latest study based on data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) reports that among 9,650 enlisted soldiers with a documented suicide attempt, more than one-third had no prior mental health diagnosis. Risk factors for attempting suicide (sociodemographic, service-related, physical health care-related, injury, being subject to crime, perpetrating crime and family violence) were similar for soldiers with or without a prior mental health diagnosis, although the degree to which they were factors differed. Risk factors most strongly associated with suicide attempt by soldiers with no prior mental health diagnosis included being in their first year of service. Being female, having less than a high school education, delayed promotion and past-year demotion increased the odds of suicide attempt in both groups of soldiers with or without a prior mental health diagnosis but the effect was more so in soldiers without a prior mental health diagnosis. The study is limited by administrative data that reflect only events that came to the Army's attention. Study results suggest administrative records from personnel, medical, legal and family service systems could help to identify soldiers at risk for suicide attempt.

Authors: Robert J. Ursano, M.D., of the Uniformed Services University of the Health Sciences, Bethesda, Maryland, and coauthors

Related Material: The editorial, "Suicide Prevention in the U.S. Army: A Mission for More Than Mental Health Clinicians," by Mark A. Reger, Ph.D., of the Veterans Affairs Puget Sound Health Care System, Seattle, Washington, and coauthors also is available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/ jamapsychiatry.2018.2069)

Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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