From Time Magazine: New Study: U.S. Military Suicide Rate Now Likely Double or Triple Civil War’s
ditor’s note: we spent a lot of time trying to dig up
historical data on suicide in the U.S. military for our recent story on
the current epidemic. The Army itself has only been keeping accurate
suicide statistics for about 30 years, making historical comparisons
difficult. A pair of scholars in the field has just released a paper focused on suicides in the U.S. Civil War that might be of interest to Battleland readers. They summarize their findings in the following Q&A:
Can medical data from the U.S. Civil War help us better understand military suicides?
Your recent Time cover story in
the July 23 issue detailed the tragic facts that suicide rates among
active-duty U.S. military personnel rose dramatically over the past
decade. Military suicide rates doubled between 2001 and 2006, while
remaining flat in the general population, with more military fatalities
attributed to suicide than to actual combat in Afghanistan during that
period.
To make matters worse, we do not
understand why. Stressors related to military training, overseas
deployment, transition back to civilian life, and combat are widely
believed to be major driving factors. However, 31% of soldiers who
committed suicide had never been deployed to a war zone. Furthermore,
suicide rates in British military forces have also increased recently,
though to a lesser degree, and do not exceed the rate of the general
population.
Is there a lack of historical context?
Compounding our inability to understand this current phenomenon is
the lack of adequate historical data to provide context on whether high
suicide rates were typical of prior wars. Review of archival records
from past wars might help shed some light on the current military
suicide epidemic.
In a recent study
(Frueh & Smith, 2012) we reviewed historical medical records on
suicide deaths among Union forces during the U.S. Civil War (1861-1865),
a brutal war that many consider the first modern one, and for the year
immediately after the war to estimate the suicide rate among its Union
combatants. We also reviewed these same historical records for data on
rates of alcohol abuse and other probable psychiatric illnesses.
White active-duty Union military personnel suicide rates ranged from
8.74 – 14.54 per 100,000 during the Civil War, and surged to 30.4 the
year after the war. For black Union troops, rates ranged from 17.7 in
the first year of their entry into the war (1863), to 0 in their second
year, and 1.8 in the year after the war.
For comparison, the current rate of U.S. military suicides is just
over 20 per 100,000 troops. To further put these figures into current
context, there were more military suicides in 2010 (total suicides =
295), than during the entire four years of the Civil War, for which we
found 278 documented Union suicides, and forces were of comparable size.
Thus, current suicide rates in the U.S. military are probably two to
three times higher than those documented during the Civil War. Rates for
other available psychological domains, including chronic alcoholism,
“nostalgia,” and insanity, were extremely low (< 1.0%) by modern day
standards during the Civil War.
Of course, we should interpret data from the U.S. Civil War
cautiously, not simply because of its age, but because medicine and
society in the 1860s were psychologically naïve. There was almost no
awareness or understanding of mental illness then. Posttraumatic stress
disorder (PTSD), now understood to be a common post-combat reaction did
not exist in the medical literature at the time. Moreover, it is
possible (but by no means certain) that the stigma of suicide and
psychological problems may have biased against reporting.
What about combat intensity?
As noted
by preeminent Harvard psychologist, Richard J. McNally (2012), these
Civil War findings occurred within the context of extremely intense
combat operations. In reviewing historical data on rates of killed in
action, he notes that the death rate for Union forces during the Civil
War was 48 times higher than for modern U.S. troops serving in Iraq and
Afghanistan. And yet, emotional problems and disability (from many
different causes) has risen dramatically among U.S. military personnel
and veterans, even since the Vietnam war.
Are there other explanations?
These Civil War data raise more questions than they answer because
they remind U.S. that combat intensity by itself is not necessarily a
good predictor of suicide rates. Thus, we still do not know why military
suicides have soared in the modern era. The “true” explanation is
probably multifactorial: a combination of general military stressors,
combat trauma, economic stressors, societal stressors, and changes in
recruitment standards. We also need to examine whether recent increases
are related to changes in military esprit de corps, aggressive use of
prescription medications military physicians that may deregulate
emotions and cognitive functioning, and even reduced psychological
hardiness in society in general. These are all factors worthy of
additional study.
Is there a sociopolitical element?
There is another sociopolitical element to the story of this
publication. Six scientific journals declined to publish our military
suicide paper (Frueh & Smith, 2012) because peer-reviewers were
reluctant to accept the accuracy of the data. Devoid of empirical or
archival evidence to critique our paper, most reviewers from these other
journals rejected our findings out of hand purely because they could
not accept them to be true – they thought the numbers were impossibly
low.
Some of these reviewers may have been motivated by a perceived need
to protect current troops or the Department of Defense. Although a
popular narrative currently, our data suggest that simply attributing
the recent surge in military suicides entirely to combat stressors or
multiple deployments is insufficient to understand the phenomenon. We
need to start asking other questions and looking for other possible
explanations – which may lead U.S. to possible solutions.
Historically speaking, the medical data from the U.S. Civil War show
that more is at play in the recent spike in military suicides. Perhaps
incorporating a historical perspective can help U.S. begin to tame this
tragic epidemic of military suicides.
B. Christopher Frueh, Ph.D. is a clinical psychologist, and is
professor of psychology at the University of Hawaii, Hilo, Hawaii, and
McNair Scholar and director of research at The Menninger Clinic,
Houston, Texas. Jeffrey A. Smith, Ph.D. is an American historian, and
assistant professor of history at the University of Hawaii, Hilo,
Hawaii.
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