Army developing method to predict suicide in soldiers

Source: USA Today
Published: Wednesday 12 November, 2014

The Army is developing a way to predict which soldiers might be at higher risk of committing suicide by using a scientist-developed algorithm.

The six-year-long effort could help commanders and health care workers intervene before a suicide occurs, a problem that has plagued the Army since fighting in Iraq and Afghanistan began.

The findings — described in a paper released Wednesday in JAMA Psychiatry — show soldiers with a psychiatric disorder have an unusually elevated risk of committing suicide in the year after being discharged from the hospital, a rate of nearly 264 suicides per 100,000 soldiers. The national suicide rate is about 12 per 100,000.

The Army, which received the findings last year, is developing a data system to generate predictive scores for at-risk soldiers, said Ronald Kessler, a researcher at Harvard Medical School and lead author of the paper.

Lt. Col. Ben Garrett, an Army spokesman, described the science as "an important step forward." He cautioned that much work remains before a program of identifying soldiers at risk of committing suicide can be put into action.

"The Army is working through complex privacy and ethical concerns regarding the use of these types of data, as well as updating the data from today's soldiers," Garrett said. "Use of the risk model will enhance the Army's ability to provide services to soldiers at elevated risk."

Army suicides began rising in 2004, reaching record highs in 2012 and 2013 as the leading cause of death, surpassing war, heart disease, homicide, car accidents and other causes.

The increase in suicides came as the Army was under considerable strain, sending troops to fight in two wars in Iraq and Afghanistan. High rates of depression or post-traumatic stress disorder generated by combat experiences could be behind the increase in suicides, researchers have said.

The study published Wednesday examined the records of nearly 54,000 soldiers hospitalized from 2004 to 2009, less than 1% of the Army. Scientists found 12% of Army suicides occurred within a portion of the 54,000 — those who had been diagnosed with a psychiatric disorder and released from hospital care within the previous 12 months.

When scientists delved even deeper in that group, they identified soldiers who were extremely prone to suicide, with a rate as high as 3,824 per 100,000. These were soldiers who shared other risk factors, such as late-age enlistment, a history of verbal violence, ownership of a firearm, prior suicidal behavior and a record of using antidepressants.

Their analysis showed this group was not only at high risk of suicide, but also for attempted suicide, car accidents or traumatic brain injury.

Researchers said the findings could justify interventions with soldiers predicted to have the highest suicide risk. They cautioned that identifying such individuals could lead to increased scrutiny on those soldiers, adversely affecting their careers.

"There is sort of this flirting-with-death syndrome where sometimes they die, most of the time they don't. But we're tapping into all of that here" with this new algorithm, Kessler said. "This is a group that's at a big enough risk that the Army should focus some attention on them."

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