Monday, August 20, 2007

Durkheim, Suicide & The Military

We've been discussing Durkheim's theory of suicide in most of my classes this week. As you'll recall, Durkheim theorized that persons who are less regulated by society (anomie) and less integrated in their social relationships are more likely to commit suicide.

Last week we learned of a large increase in the suicide rate amongst U.S. Army personnel:

"Repeated and ever-longer war-zone tours are putting increasing pressure on military families, the Army said Thursday, helping push soldier suicides to a record rate.

"There were 99 Army suicides last year -- nearly half of them soldiers who hadn't reached their 25th birthdays, about a third of them serving in Iraq or Afghanistan."

In the Army's report released last week, it is noted that, "A majority of suicides in 2006 involved firearms, and the most common contributing factors were failed personal relationships and occupational, legal and financial problems. The report did not find a direct relationship between increased deployments and suicides."

There may be no direct cause and effect relationship established, but it could be argued that increased deployments lead to "failed personal relationships and occupation, legal and financial problems," thus making the correlation somewhat more useful in understanding the numbers.

Using Durkheim's measurements, the military has a culture that is highly regulated and integrated. This is noteworthy because
the Army Suicide Event Report showed that "30 of [the reported 99 suicides] occurred in Iraq or Afghanistan." In other words, most seem to be occurring once the soldier has been released from active duty or is out of the combat-related theater, which leads to lower social regulation and integration, hence a greater chance of committing suicide.

However, there are always issues of population and sampling to consider. According to the report, "the Army’s suicide rate for 2006 was 17.3 suicides per 100,000 soldiers. This compares to the overall U.S. population rate, for the same age and gender group, of roughly 19 suicides per 100,000 people."

Occupationally speaking, the Army and its attendant combat-related hazards may not be any more dangerous (from a suicide standpoint) than civilian life. To use Durkheim again, we might even suggest the heavily integrated and regulated culture of military life acts as a deterrent to suicide.

While the issues of PTSD, major depression, anxiety and other assorted psychological issues are beyond our scope in class, it is worth noting that many returning combat vets are having difficulty obtaining psychological services once state-side.

According to the Frontline documentary "The Soldier's Heart", nearly 17% of returning combat vets from Iraq met the criteria for one or more of the above diagnoses (most prominently PTSD), yet only between 23 to 40 percent actually sought psychological counseling. In the NEJM report cited, reasons for not seeking help range from the "stigma of mental illness" to a more than six month wait at the Veterans Administration for benefits.

Comparing rates of suicide is always tricky, because by implying that "this rate is lower than that rate" we somehow minimize the tragedy and loss of the actual act. For a combat vet to survive the horrors of war, only to return and take his own life, suggests suicide is more than just a "moral crisis". It's a public health epidemic in need of serious attention.

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