Pre-Enlistment Mental Disorders, Suicide Rates Among New Soldiers Comparable to Civilians

Newswise — Bethesda, MD – New results from the largest-ever study of mental health risk and resilience in Army personnel show that despite higher rates of current mental disorders and suicidality among U.S. Army soldiers than similarly matched civilians, the rates of most pre-enlistment mental disorders among new soldiers are comparable to those of civilians.

At the same time, some pre-enlistment mental disorders and an increased presence of one or more additional disorders are more common among new soldiers than civilians, showing that a history of these disorders is associated with increased probability of volunteering for Army service. In addition, the rates of pre-enlistment suicidality reported by new soldiers are comparable to those reported by non-deployed active-duty soldiers throughout their Army careers and to those of matched civilians.

The results, described in two reports published online Tuesday, Oct. 21, in Depression & Anxiety, are based on a survey of 38,507 new soldiers carried out as part of the Army Study to Assess Risk and Resilience in Service members, or Army STARRS. The researchers estimated the rates of lifetime pre-enlistment mental disorders and pre-enlistment suicidality from the survey taken of soldiers reporting for Basic Combat Training in 2011 and 2012.

Army STARRS is the largest study of mental health risk and resilience ever conducted among U.S. Army personnel and is led by co-principal investigators Robert J. Ursano, M.D., chairman of the Department of Psychiatry at the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, and Murray B. Stein, M.D., M.P.H., Professor of Psychiatry and Family and Preventive Medicine at the University of California, San Diego. In one of the papers, the lifetime rates of pre-enlistment mental disorders were compared to those of a matched civilian sample. Results showed that new soldiers and civilians do not differ in their probability of having at least one lifetime mental disorder (38.7% of new soldiers; 36.5% of civilians). However, some mental disorders (generalized anxiety disorder, post-traumatic stress disorder and conduct disorder) are more common among new soldiers than civilians. A significantly higher proportion of new soldiers than civilians also have a history of three or more mental disorders (11.3% vs. 6.5%).

The second paper reported that 14.1% of new soldiers had considered suicide at some point in their life before enlisting, that 2.3% of new soldiers had made a suicide plan, and that 1.9% of new soldiers previously attempted suicide. “These results are quite similar to those found in our survey of soldiers who were later in their Army careers and these, in turn, were similar to the rates found among matched civilians,” said Ursano, lead author of the paper. “This means that new soldiers do not come into the Army with higher rates of suicidality than comparable civilians. This, in turn, means that the high rates of suicidality seen later in the Army career are associated with experiences that happen after enlistment rather than before enlistment.”

Matthew Nock, Ph.D., Professor of Psychology at Harvard University and one of the paper’s authors, noted that “Taken together, these results suggest the need for at least two separate kinds of interventions: clinical interventions early in the Army career to help new soldiers reduce chronicity of pre-enlistment mental disorders; and preventive interventions throughout the Army career to reduce onset of post-enlistment suicidality.”

About Army STARRS:Army STARRS is a large-scale epidemiological and neurobiological study of Army suicides and their correlates sponsored by the Department of Army and funded under a cooperative agreement with the U.S. Department of Health and Human Services, National Institutes of Health, and National Institute of Mental Health. In addition to study leaders Ursano and Stein, members include site investigators Steven G. Heeringa, PhD, at the University of Michigan, and Kessler, along with NIMH collaborating scientists Schoenbaum, and Lisa J. Colpe, PhD, MPH. The team brings together international leaders in military health, health and behavior surveys, epidemiology, suicide, and genetic and neurobiological factors involved in psychological health. For more information on Army STARRS, please visit: http://www.armystarrs.org/

About USU:The Uniformed Services University of the Health Sciences, founded by an act of Congress in 1972, is the nation’s federal health sciences university and the academic heart of the Military Health System. USU students are primarily active duty uniformed officers in the Army, Navy, Air Force and Public Health Service who receive specialized education in tropical and infectious diseases, TBI and PTSD, disaster response and humanitarian assistance, global health, and acute trauma care. A large percentage of the university’s more than 5,200 physician and 1,000 advanced practice nursing alumni are supporting operations around the world, offering their leadership and expertise. USU also has graduate programs in biomedical sciences, public health, clinical psychology and oral biology, committed to excellence in research, which have awarded more than 1,500 degrees to date. The University's robust research program covers a wide range of areas important to both the military and public health. For more information about USU and its programs, visit www.usuhs.edu.