What predicts self-destructive behavior? This is a key question among researchers concerned by the sharp uptick in United States soldier suicides over the past decade. In some cases, a new study finds, a soldier’s behavior may be predicted by an actuarial risk algorithm. While suicide is generally rare in the military, the data reveal those at highest risk are soldiers during the 12-month period after being hospitalized for a psychiatric disorder.

Overall, “about three percent of the soldiers in the highest risk group die by suicide,” Dr. Ronald C. Kessler, of Harvard Medical School, told Medical Daily in an email.

Grim Statistics

Historically, suicide rates among soldiers in the U.S. army have been lower than that of civilians. However, since 2004, one year after the armed conflict began in Iraq, this changed dramatically. From that time, the Army suicide rate has spiked and it now exceeds the civilian rate. The Veterans Administration estimates there is one suicide each day among active duty soldiers, while among all veterans — this would include Army, Navy, Air Force, and Marines — there are 22 (or more) suicides each day. While veterans contribute only about 10 percent to the total U.S. adult population, according to the Center for Public Integrity, nearly one in every five suicides nationally is a veteran.

For the current study, a team of researchers led by Kessler wanted to develop an actuarial risk algorithm for suicide in order to provide better treatment. They turned to the Historical Administrative Data System (HADS) of the Army Study to Assess Risk and Resilience in Service-members (Army STARRS) and searched among a variety of administrative data. Between January 2004 and December 2009 they discovered a total of 53,769 hospitalizations of active duty soldiers with psychiatric diagnoses.

“The suicide rate is 18.4/100,000 people each year in the entire army,” Kessler told Medical Daily, and “about 14 times that high among soldiers who were hospitalized.”

In fact, the results indicate that 68 soldiers died by suicide within a year of being discharged from the hospital. Researchers found the strongest predictors included being male, late-age of enlistment, criminal offenses, weapons possession, and prior suicidality. Another risk factor? More than half (52.9 percent) of those who committed suicide following hospitalization were in the highest predicted risk group.

There were other sad outcomes in that stratum as well: 7 soldiers died of unintentional injuries, while 830 made suicide attempts. Plus, among the high risk group, there were 3,765 subsequent hospitalizations within a year of discharge. The researchers do not speculate on reasons why the suicide rate increased sharply since 2004, still one interesting fact came to light.

“We showed in previous STARRS papers based on our surveys that soldiers on active duty in 2011-2012, when our surveys were carried out, had higher rates of mental disorders than civilians of the same age, sex, race, and social class background,” Kessler said in an email to Medical Daily.

Source: Kessler RC, Warner CH, Ivany C, et al. Predicting Suicides After Psychiatric Hospitalization in US Army Soldiers The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). JAMA Psychiatry. 2014.