Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 18;19(1):31.
doi: 10.1186/s12888-018-1978-2.

Suicide attempts among activated soldiers in the U.S. Army reserve components

James A Naifeh  1 , Robert J Ursano  2 , Ronald C Kessler  3 , Oscar I Gonzalez  1 , Carol S Fullerton  1 , Holly B Herberman Mash  1 , Charlotte A Riggs-Donovan  1 , Tsz Hin Hinz Ng  1 , Gary H Wynn  1 , Hieu M Dinh  1 , Tzu-Cheg Kao  4 , Nancy A Sampson  3 , Murray B Stein  5   6
Affiliations

Suicide attempts among activated soldiers in the U.S. Army reserve components

James A Naifeh et al. BMC Psychiatry. .

Abstract

Background: Although the majority of active duty U.S. Army soldiers are full-time personnel in the Active Component (AC), a substantial minority of soldiers on active duty are in the Reserve Components (RCs). These "citizen-soldiers" (Army National Guard and Army Reserve) represent a force available for rapid activation in times of national need. RC soldiers experience many of the same stressors as AC soldiers as well as stressors that are unique to their intermittent service. Despite the important role of RC soldiers, the vast majority of military mental health research focuses on AC soldiers. One important goal of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is to address this gap. Here we examine predictors of suicide attempts among activated RC soldiers.

Methods: This longitudinal, retrospective cohort study used individual-level person-month records from Army and Department of Defense administrative data systems to examine socio-demographic, service-related, and mental health predictors of medically documented suicide attempts among activated RC soldiers during 2004-2009. Data from all 1103 activated RC suicide attempters and an equal-probability sample of 69,867 control person-months were analyzed using a discrete-time survival framework.

Results: Enlisted soldiers comprised 84.3% of activated RC soldiers and accounted for 95.7% of all activated RC suicide attempts (overall rate = 108/100,000 person-years, more than four times the rate among officers). Multivariable predictors of enlisted RC suicide attempts included being female, entering Army service at age ≥ 25, current age < 30, non-Hispanic white, less than high school education, currently married, having 1-2 years of service, being previously deployed (vs. currently deployed), and history of mental health diagnosis (particularly when documented in the previous month). Predictors among RC officers (overall rate = 26/100,000 person-years) included being female and receiving a mental health diagnosis in the previous month. Discrete-time hazard models showed suicide attempt risk among enlisted soldiers was inversely associated with time in service.

Conclusions: Risk factors for suicide attempt in the RCs were similar to those previously observed in the AC, highlighting the importance of research and prevention focused on RC enlisted soldiers in the early phases of Army service and those with a recent mental health diagnosis.

Keywords: Army National Guard; Army reserve; Military; Risk factors; Suicide attempt.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This component of Army STARRS was approved by the Institutional Review Boards of the Uniformed Services University of the Health Sciences for the Henry M. Jackson Foundation (the primary grantee), the University of Michigan Institute for Social Research (site of the Army STARRS Data Enclave), University of California, San Diego, and Harvard Medical School, which determined that the present study did not constitute human participant research because it relies entirely on deidentified secondary data.

Consent for publication

Not applicable.

Competing interests

MBS has been a consultant for Care Management Technologies, received payment for his editorial work from UpToDate and Depression and Anxiety, and had research support for pharmacological imaging studies from Janssen. In the past 3 years, RCK received support for his epidemiological studies from Sanofi Aventis; was a consultant for Johnson & Johnson Wellness and Prevention, Shire, Takeda; and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. RCK is a coowner of DataStat, Inc., a market research firm that carries out healthcare research. The remaining authors report nothing to disclose.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Risk of Suicide Attempt among Activated Reserve Component Enlisted Soldiers by Active Months Since Entering the Army.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Schoenbaum M, Kessler RC, Gilman SE, Colpe LJ, Heeringa SG, Stein MB, Ursano RJ, Cox KL. Predictors of suicide and accident death in the Army study to assess risk and resilience in Servicemembers (Army STARRS) JAMA Psychiatry. 2014;71(5):493–503. - PMC - PubMed
    1. Black SA, Gallaway MS, Bell MR, Ritchie EC. Prevalence and risk factors associated with suicides of army soldiers 2001–2009. Mil Psychol. 2011;23(4):433–451.
    1. Ursano RJ, Kessler RC, Heeringa SG, Cox KL, Naifeh JA, Fullerton CS, Sampson NA, Kao T-C, Aliaga PA, Vegella P, et al. Nonfatal suicidal behaviors in U.S. Army administrative records, 2004–2009: results from the Army study to assess risk and resilience in Servicemembers (Army STARRS) Psychiatry. 2015;78(1):1–21. - PMC - PubMed
    1. Department of Veterans Affairs, Veterans health administration, Office of Mental Health and Suicide Prevention: Veteran Suicide Data Report, 2005–2016; September 2018.
    1. Gibbons RD, Brown CH, Hur K. Is the rate of suicide among veterans elevated? Am J Public Health. 2012;102(Supplement 1):S17–S19. - PMC - PubMed

Publication types