English: Dr. Charles Hoge, Walter Reed Army Institute of research and Brig. Gen. Colleen L. McGuire, director, Army Suicide Prevention Task Force, discussed suicide, post traumatic stress disorder, and the social stigma that prevents Soldiers with PTSD from stepping forward to get treated, during a panel presentation called “Surviving and Thriving in Harm’s Way,” September 25, at the American Enterprise Institute in Washington, D.C. (Photo credit: Wikipedia)

JAMA Psychiatry publishes three articles: Suicide and Mental Health in US Army Personnel

On March 3, 2014, JAMA Psychiatry published on-line first three articles resulting from researchers’ review of the data gathered from the Study to Assess Risk and Resilience in Servicemembers (STARRS) survey. This survey was conducted with 5,500 soldiers with the U.S. Army working with the U.S. National Institute of Mental Health. And according to JAMA Psychiatry, the articles “characterize prevalence of, trends in, and risk factors for suicide and mental health disorders in non-deployed US Army personnel.”

For your convenience we are providing links to the abstracts for each article.

• Predictors of Suicide and Accident Death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)
• Prevalence and Correlates of Suicidal Behavior Among Soldiers
• Thirty-Day Prevalence of DSM-IV Mental Disorders Among Nondeployed Soldiers in the US Army

An overview of the findings…

If you take the time to read a number of the related articles you will find that the researchers uncovered remarkable statistics regarding Army recruits’ pre-existing mental health disorders. Ronald C. Kessler, PhD,  Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts participated in each of the studies and was the lead author on “Thirty-Day Prevalence of DSM-IV Mental Disorders Among Nondeployed Soldiers in the US Army.”  Harvard Medical School released a press release on March 3, 2014, which discusses each article.

CNN reports the following observations from Dr. Kessler regarding the findings:

• The rate of major depression is five times as high among soldiers as civilians, intermittent explosive disorder six times as high, and post-traumatic stress disorder (PTSD) nearly 15 times as high.
• 25% of active-duty, non-deployed Army soldiers surveyed tested positive for a mental disorder of some kind, and 11% within that subgroup also tested positive for more than one illness.
• The STARR survey looked at illnesses that included clinical depression, bipolar disorder, panic disorder, and PTSD. 
• Authors also noted that alcohol and drug use were common.

The Los Angeles Times sums up the statistics:

Most notably, more than 8% of soldiers entered the Army with intermittent explosive disorder, characterized by uncontrolled attacks of anger. It was the most common disorder in the study, with a pre-enlistment prevalence nearly six times the civilian rate.

The researchers found that despite screening, pre-enlistment rates of depression, anxiety, bipolar disorder and substance abuse were on par with civilian rates. Rates of suicidal ideation, planning and attempts were lower than in the general population but still significant, given the military’s practice of excluding recruits with a known suicidal history.

During their military service, the soldiers’ rates of most psychiatric disorders climbed well past civilian levels, several times the rate for some disorders.

A quarter of soldiers were deemed to be suffering from a mental illness — almost 5% with depression, nearly 6% with anxiety disorder and nearly 9% with PTSD. The percentage of soldiers who had attempted suicide rose from 1.1% to 2.4%.

Some final thoughts…

We have often written about US service members and their mental health issues, both while enlisted and as veterans. In that regard, we have discussed post traumatic stress disorder, depression, anxiety disorders, as well as the treatment of addiction. We are hopeful that these studies will guide the military (all branches) to examine their enlistment procedures…to determine the applicants to be physically, emotionally and mentally fit.

While preparing this post, we thought back to the 1965 screenplay for the novel Doctor Zhivago (1965).  At a certain point Yevgraf Zhivago, Doctor Zhivago’s half brother, when speaking of the Russian revolution, sadly recalls…

There were too many volunteers like me. Mostly, it was mere hysteria. But there were men with better motives, who saw the times were critical and wanted a man’s part. Good men, wasted. Unhappy men, too. Unhappy in their jobs. Unhappy with their wives. Doubting themselves. Happy men don’t volunteer. They wait their turn, and thank God if their age or work delays it.