Subcommittee Chair Rep. Jackie Speier (D-CA)
WASHINGTON, DC — When it comes to suicide prevention, is the DoD putting its time and money in the right place? That was the question asked at a recent House Armed Services Military Personnel Subcommittee hearing.
Legislators told Pentagon officials last month that they weren’t doing enough, and some researchers suggested that the entire prevention process is flawed.
“The military saw active-duty suicides rise for the fourth year in a row with a total of 384 active-duty servicemembers dying by suicide in 2020, up from 350 the year before,” declared Subcommittee Chair Rep. Jackie Speier (D-CA). “Between 2015 and 2020, the suicide rate for active-duty servicemembers increased by 41%. This result makes clear that the military’s suicide prevention efforts are failing, and we must find out why.”
Karen Orvis, PhD, director of DoD’s Defense Suicide Prevention Office, explained that the numbers of suicides in the military were actually no higher than those in the general population.
“We’ve seen a slight decline nationwide in the U.S. population,” Orvis said. “That does not hold up for our young males, and that’s consistent with what we’re seeing in the military.”
That answer apparently was unacceptable to Speier.
“[This] reminds me of the reason the Brass gave me for why we have a sexual assault problem in the military,” she declared. “That it was tracking with what’s going on in colleges and communities. That’s not a good enough answer. It’s different in the military. You have control over your servicemembers. You can query them. You can have them seek services. It’s not a good way to create confidence.”
Orvis also noted that, because there are so many reasons a servicemember will commit suicide, it’s difficult to pinpoint any single cause of the rise in suicides during the past few years.
“There are a number of factors, and they vary across individuals,” she said. “So it may be a lack of connectedness with others. It may be for some financial difficulties. Relationship challenges, we know, both within the military and the U.S. population, are factors associated with individuals who may end up dying by suicide. But those are all different across individuals.”
Many suicide researchers and some DoD officials have pointed to this fact—that the reason people commit suicide frequently has roots in factors outside mental health—as evidence that the government needs to deeply rethink its approach to suicide prevention.
Craig Bryan, PsyD, director of the Suicide Prevention Program at Ohio State University’s Wexner Medical Center, is a clinical psychologist who has conducted suicide prevention research for DoD, and he believes that a too-tight focus on mental health will ultimately fail to address the problem.
“The military has invested heavily in a vast array of programs and initiatives. More awareness and outreach more training, more education, more anti-stigma campaigns, more options for mental healthcare,” Bryan explained. “The vast majority of these programs share two common objectives. Identifying which servicemembers are going to kill themselves and referring those servicemembers to treatment or intervention.”
This identify-and-refer approach, he said, is fundamentally flawed.
“It assumes that suicide risk is a character trait of the individual,” he said. “That suicide is caused by something inside a servicemember. Identify and refer fails because it focuses on the wrong part of the problem. Suicide is not just caused by something inside servicemembers. It’s caused by complex interaction between servicemembers and their environments. Context matters.”
According to Bryan, factors such as organizational culture, institutional practices and community conditions impact suicide as much, if not more, than a servicemember’s internal mental state.
“Resiliency is not a thing that servicemembers either have or do not have inside of them. Resiliency is a characteristic of the environment,” Bryan told legislators. “When we live and work in supportive and rich environments characterized by dignity, support and respect, we are better able to endure stress and bounce back from adversity. Treatment can help, but it cannot change the environment.”
This requires a long, hard look at DoD policies and bureaucracy, he added.
“We’re seeing it with [people with] top secret clearance,” he explained. “If someone goes and gets help, they are required to have that reported to their command. There’s the risk someone could lose clearance. It could have other career impacts. We’re encouraging people to get help but we have policies in place that directly impede our ability to do that.”
Bryan likened the issue to the effort to prevent car crashes.
“We don’t just find unsafe drivers and put them into driver’s ed. What we do is we build safer cars. We build safer roadways. We change the environment so it’s harder for people to die in car crashes,” he said. “I think we need to approach suicide in the same way. We focus on individual servicemembers who might be in these toxic environments and we say, oh they’re depressed. Of course they’re depressed, they’re in a toxic environment. Referring for services certainly might help protect that servicemember, but it doesn’t change the real source of the problem.”