When mental health diagnosis isn't enough: The need for comprehensive data to understand suicide risk in the military

Military populations present unique mental health challenges, including deployment and combat, which often compound traditional marital, financial, and career stressors. Despite suicide surveillance through the Department of Defense Suicide Event Report (DoDSER), gaps and limitations exist that require a more comprehensive tool like the psychological autopsy (PA) for suicide investigation. Currently the DoDSER lacks the depth of data collection with PA in areas such as recent and risk-taking behaviors, certain stressors, and recent symptoms. Given that more than half of 2011 military suicides were among service members with no mental health diagnosis¹, thorough knowledge of recent symptoms including irritability, memory problems, and vision changes is essential to identifying persons acutely at risk to refer for intervention and to ultimately strengthen suicide prevention initiatives. The researchers propose augmenting the DoDSER to follow the PA by adding data elements, as well as standardizing the conduct of the enhanced DoDSER interview through best practices and recommendations for the type of interviewer, preferred interviewee (e.g., spouse versus friend), training across the service branches, and other methodological aspects. Expanding the breadth and depth of knowledge of individual suicides may reveal potential risk factors independent of traditional behavioral health diagnoses, to further describe the proportion of military suicides that occur without these diagnoses. Capitalizing on additional data could inform suicide prevention programs utilizing both individual- and population-level methods.  

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[1] Department of Defense Suicide Event Report. (2011). National Center for Telehealth & Technology (T2), Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury (DCoE).