Let’s talk about military suicide

This is Part 1 of a two part series on the topic.

I write this as a specialist in men’s mental health and organisational wellbeing, who sees many reasons why we’re losing so many serving and veteran personnel to suicide and how we can attempt to reduce it.  I haven’t served, but do come from a serving family and have been supporting men in uniformed services for the last three years, with a total of twenty years experience of working with those with mental health needs.

Though the military had seen declining rates of suicide since the 1990s, with the figure far less than the rates within general population, the figures have sadly been increasing over recent years and is now the same as civilian rates.  Men account for 94% of all military suicides against the 75% male rate in society, but it’s important to recognise that men currently make up 89% of all military personnel.

And whilst military suicide does reflect the civilian trend of middle-aged men most at risk for suicide, it is also seeing an increase in men under 24 years old, with the British Army unfortunately losing more men (of all ages) annually, than the RAF and Royal Navy.  Statistically, several studies have shown that reservists have higher rates of mental health problems than regular personnel, which could be because they don’t come under traditional military support (from financial to health) and therefore slip through bureaucratic parameters of care. It’s also important to acknowledge that part of this recent increase in rates of suicide, similar to general population, could be attributed to the change in recording suicide at inquest which, in 2018, was dropped from a criminal threshold of “beyond reasonable doubt” to a civilian one of “balance of probability.” Despite this, I’d argue that our suicide statistics in the military are still lower than the actual figure, as many men will attempt suicide, and unfortunately die in ways that are not obviously suicide to prevent shame on their families or avoid issues with life insurance etc.

And though the military are wildly perceived to hold the highest suicide rate of any working sector, construction unfortunately has that title, with us statistically losing 3 times the national average of men, equating to approximately 40 men a week. I bring in this point because both sectors have something in common: they’re male dominated. And this isn’t to attack masculinity, because there are a great many traits of it which are to be encouraged and celebrated (many of which I hold myself), but we have to recognise the harmful limitations some aspects of it can place on men, especially in the workplace. This is something known as the “Masculinity Contest”, which can increase risk-taking behaviour and prevent help-seeking. Several military studies have demonstrated that the masculine culture within the military can have negative effects on help-seeking for mental health (Iversen, 2005, Iversen, 2011 and Langston, 2007).

This is why I argue that it isn’t always the trauma of the job (across all uniformed services) that will kill our personnel, but severe life stressors, including organisational issues.  When I presented my men’s work, after invitation, to the Royal Marines at CTC Lympstone, the RSM agreed that whilst they were good at acknowledging and supporting operational trauma, they were losing their men to general life trauma, such as family breakdowns and leaving the service.

One of the biggest issues, as I see it, is that we’re not naming the issue for what it is and therefore can’t work appropriately to tackle it: male suicide. Women attempt suicide at approximately three times the rate to men, but men unfortunately complete it more, predominantly because we socialise them to use more violent methods.

The military are doing some fantastic work around equality, diversity and inclusion but in doing so are not allowing men the focus on suicide, I suspect because they worry it would be considered sexist. But, as I discuss below, men have specific risk factors for their suicides, so it makes sense to specifically acknowledge and support them, just as we already do for our minority groups in service. Just as there is diversity in the personnel we recruit and train, so too is there diversity in mental health i.e. middle-aged men have greater risk of suicide, than women. Not only this, but specifically discussing male mental health in male dominated workplaces can also benefit women, as many take on male personality traits and attitudes to succeed.

Why does it appear that military suicide is so common?

I believe the largest driver of this being that uniformed services are vocational, and therefore act as communities and families where “everyone knows everyone.”  Studies vary but the number of people affected by an individual suicide ranges from up to 135, with each suicide costing the economy approximately £1.7million, due to lost earnings and the need for welfare and health support for those bereaved etc.

Unfortunately, the community mindset allows the potential for something known as “suicide contagion” or “clusters”.  That is to say that one suicide can lead to several others, either in the immediate unit or by those who simply knew the person, as many personnel will share similar risk factors to suicide. Sadly, we have seen this already with The Rifles and those involved in Op Herrick. This is why “post-vention” (a structured “check in” and support) is so important after a military suicide, even for those who are not known to be considered a risk.

It is important to note, however, that the same community mindset can also be seen as a protective factor against suicide for many.  A sense of belonging and purpose, group/peer support and “brotherhood” can act as deterrents, although these protections can quickly be lost when personnel have left their service, which is one of the reasons we lose so many veterans to suicide.

We also have to recognise that suicide is not a huge leap for many of our personnel to reach for, as many who have completed operational tours, or deployed in other ways, will have had to write a “goodbye” letter.  It is not a great shift therefore, when they have mentally prepared to die, that they can go on to kill themselves with apparent, relative ease.

Risk factors for military suicide

A lot of my work with uniformed services is around education of risk factors for men, to encourage those around the individual to recognise potential problems and proactively start having conversations with them around their mental health, and suicide in general.

Some of these risk factors include:

•       Undergoing investigative or disciplinary proceedings
•       Loss of privileges (such as weapon or responsibility)
•       Anything which triggers an identity crisis
•       Sudden change in role
•       Uncharacteristic disciplinary issues (insubordinate)
•       Late to shift/making simple mistakes
•       Personality (i.e. those with have high levels of
perfectionism & narcissism)
•       Family/relationship breakdown
•       Series of traumatic incidents (professionally or personally)
•       Due to resign/retire from service
•       Becoming a parent (men are 47x at risk for suicide post-birth)
•       Childhood trauma (if known)
•       Recent death or suicide of friend/colleague
•       Limited social support

Many of the uniformed men (serving and veterans) I work with also don’t realise how unwell or traumatised they are, as they have internalised, and therefore normalised, their struggles, fearing career or personal consequences for seeking help.

Here is a non-exhaustive list of some of the ways you might be able to recognise you’re struggling:

•       Decrease in risk aversion
•       Increase in apathy & risk-taking behaviour
•       Emotional numbness
•       Self-sabotage
•       Substance misuse including gambling
•       Nightmares/difficulty sleeping
•       Increase in anger/irritability
•       Change in sexual libido/behaviour (including affairs and
increase in use of porn)
•       Physiological symptoms (nondescript aches & pains,
digestive problems etc.)
•       Low self-esteem and self-loathing
•       Problems with appetite/exercising
•       Lethargy/brain fog

The vast majority of what I support men in uniformed services with, including military, has nothing to do with operational trauma but more to do with general life trauma, such as substance misuse and relational breakdowns, and the trauma their services cause them, from change fatigue (poor decisions made against peoples will) and imposter syndrome to poor leadership and difficult colleagues (without fair resolution); something known as “organisational injustice.”

As the infamous saying goes: “Before you diagnose yourself with depression, first make sure you are not, in fact, surrounded by arseholes.”

There is a reticence within uniformed services, especially military, not to sanction and encourage peer support initiatives because they can’t risk mitigate or control and analyse the outcomes. But formal support won’t be as effective, or engaged with at all, if we don’t first educate our personnel on how to become more self-aware and comfortable with having uncomfortable conversations, with themselves and each other.

Peer support is life-changing and saving and something Gen Sanders advocated for in his emotive, open letter to his Fellow Riflemen, which is why I’ll discuss it, in depth, along with other prevention methods in the second part of this series.

Part two can be found here.