Last month when Samaritans received an award of £3.5million from Libor, it signalled a renewed commitment to prevention of suicide among service personnel and veterans - something we whole-heartedly welcome.
The new funding will enable us to supplement existing services for armed forces and veterans. We will focus on helping servicemen, women and veterans to help each other, as well as developing digital services. As the planning for this work begins, it's the right time to look in more detail at suicide amongst UK armed forces and veterans. In this post I will examine what we already know and what additional information may help us, and the many other organisations and groups providing crucial services, reduce deaths by suicide.
Suicide in the military - what we already know
When examining suicide in the UK military, it's useful to look at the situation on the other side of the Atlantic too. Although there are many differences between the US and UK armed forces, there is little doubt that suicide has a devastating impact and requires concerted action in both countries.
Until eight years ago, it was generally accepted that serving members of the armed forces were at lower risk of suicide than civilian populations. But in 2008, for the first time, suicide rates in serving members of the US army exceeded those of the general US population. This has been true there every year since.
In recent years the US government has shown significant commitment and investment in suicide prevention amongst the military and its veterans. As a result their military and veteran suicide data and research is world-class.
Here in the UK less detailed information about suicide amongst serving personnel is available. Although the existing evidence suggests that serving military personnel in the UK remain at lower risk of suicide than civilians, there is no routinely collected data on suicide deaths amongst veterans.
On top of that, UK research into suicide in serving personnel and veterans remains piecemeal. We urgently need to know more about how to identify those at highest risk of suicide and about the difficulties they may be facing.
There are some important studies though and there appear to be a few emerging themes - including the importance of addressing stigma around suicide and mental health in the military, the role of alcohol abuse in suicide, and the increased risk of suicide and self-harm among young servicemen, women and veterans. All of these areas require further research.
Spotlight on suicide in serving armed forces
In March the Ministry of Defence released its annual figures for suicide in UK regular armed forces. They showed that 332 servicemen and 17 servicewomen serving in the Naval Service, Army, Royal Air Force died by suicide in the last 20 years. This equated to a suicide rate of nine suicide deaths per 100,000 personnel. In 2015 (the most recent year for which data is available) five servicemen died by suicide. All were currently serving in the British Army. No servicewomen died by suicide that year.
In the US, the sheer number of military personnel who die by suicide is shocking. Time Magazine first brought this issue to public attention in 2012 by featuring this poignant cover story:
2012 remains the worst year ever for suicide in the US military. There are many theories about why this might be.
The latest figures from the US show that 269 active service personnel along with 249 reservists and 89 members of the National Guard died by suicide in 2014. The overall suicide rate was highest in the US reserve force (at 21.9 deaths per 100,000). The suicide rate was slightly lower (at 19.9 deaths per 100,000) in all actively serving US troops combined - almost double that of suicide in serving UK military personnel. Although suicide rates in our serving military personnel seem to be lower than rates in US servicemen and women comparing across countries is notoriously difficult. More on this later.
The US picture looks even bleaker when you consider that the Time magazine story is about serving personnel only - it not does not include suicide deaths among veterans. The most recent estimates suggest that 22 veterans die by suicide in the US every day.
More information and research urgently needed
Here in the UK, while we have information about the numbers of serving personnel who die by suicide each year, we do not yet have the same data for military veterans or reservists. The Ministry of Defence annual report on suicides includes deployed reservists, but the majority of reservists are not actively deployed at any one time. For them, and non-reserve veterans, suicide data is not routinely recorded or reported. This is something that we at Samaritans would like to see change.
One of the best research studies in this field examined suicide rates in UK veterans from 1996 - 2005. Unfortunately more recent data about suicide in this group is lacking. Without this information, we cannot know the full scale of suicide in the UK military and veterans and it makes it difficult to provide the best possible tailored support. That's why Samaritans is calling for suicide deaths for veterans and all reservists to be routinely collected and included alongside suicide deaths for personnel in active service.
Comparing suicide in the armed forces with the general population
Recent UK data suggests that the overall suicide rate in currently serving personnel remains lower than that of the general UK population. In 2014, the suicide rate stood at 9 per 100,000, with suggestion of a declining trend since the 1990s. This compares to a suicide rate in the general UK population in the same year of 10.8 per 100,000. (You can read more about the latest suicide statistics in the general UK population in my blog from February and here.
Comparing suicide rates across groups is notoriously difficult though. Groups need to be matched by age, gender and social background to make meaningful comparisons - and this is not always possible. The lower suicide rates in serving UK personnel compared to the general population are likely to be at least partly explained by military selection criteria - people with many physical and mental health conditions are not eligible to serve in the armed forces.
Looking at trends in suicide rates in different groups can give us important extra clues. In 2008 suicide rates in the US army exceeded those in the civilian population. They have stayed like that ever since. Despite recent increases in suicide rates in the general US population, suicide rates were still higher in both reservists and actively serving troops than in civilians in 2014.
Prevention is key
As the scale of suicide in the US military and its veterans became apparent, significant and continued financial commitment has been made to strengthening prevention and support services such as Veterans' Crisis Line.
Here in the UK, there are numerous hard-working charities, individuals and groups - both inside and outside the forces - providing services and support for military personnel and veterans.
At Samaritans we believe that suicide is preventable. We believe that the new funding to Samaritans represents an important opportunity for suicide prevention. By working with others, we hope this will help lead to improved knowledge about suicide in UK armed forces and veterans and the supplementation of support services for those who need them most. Above all, we hope and believe this will help us achieve our vision that fewer people die by suicide.
At Samaritans we offer a listening service to help you find a way though your problems. You don't have to be suicidal to call us. Whatever you're going through, call us free, anytime, from any phone, on 116 123
This blog first appeared on the Samaritans website, and can be read here
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