It doesn't take much for soldiers to feel cared for

Researchers conduct randomized controlled trial of caring texts

Science Daily/February 14, 2019

University of Washington Health Sciences/UW Medicine

Caring texts sent to active-duty military had important findings in reducing suicide.

A soldier named Jerome Motto received caring letters from home in World War II. They helped boost his spirits and later led to one of the nation's first successful suicide interventions.

Today, with military personnel being more mobile, researchers tested out the effectiveness of caring texts sent to active-duty military.

The study of 658 randomized participants at three military installations was led by Kate Comtois, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. The results were published Feb. 13 in JAMA Psychiatry along with a podcast with the researchers.

Comtois said the most significant finding was that the caring contacts reduced the odds of a suicide attempt. The contacts lowered the risk from 15 percent to 9 percent.

"Caring contacts is an entirely different way to engage and take care of suicidal individuals," she said. "It can both prevent suicidal behavior and provide support over periods of stress and transition."

As for the primary aims -- reducing current suicidal ideation and suicide risk incidents, such as hospitalizations or medical evacuation -- the study was inconclusive. But the study did have impactful findings and secondary outcomes as well as clinical implications.

The study recruited Army and Marine Corps personnel identified as being at risk of suicide at three bases in the United States. The control group was given 11 text messages from a clinician, who engaged with the service members, including calling them on the phone if they were feeling urgent distress.

This simple intervention builds on the work of Jerome Motto, a World War II soldier who became a psychiatrist and researcher. He used caring letters to conduct the first successful clinical trial to reduce suicide deaths.

Military personnel historically have had a lower rate of suicide than the general population, Today, however, veterans have a 50 percent higher incidence of suicide than the general population, according to the Department of Veteran Affairs Suicide Data Report, 2006-2016. In 2018, the U.S. military experienced the highest number of suicides among active-duty personnel in at least six years. A total of 321 active-duty members took their lives during the year (57 Marines, 68 sailors, 58 airmen, and 138 soldiers), according to Military . com.

In this study, just under 14 percent of text responses mentioned difficulty and adversity, but after a few exchanges with a clinician, the service member felt better, said Amanda Kerbrat, a research scientist with the UW Department of Psychiatry and Behavioral Sciences.

"Most people didn't seem to need much to get the message that someone cared and was looking out for them," she said.

During the study, which took place from April 2013 to September 2016, five service members indicated they were suicidal and were called by a clinician immediately, said Kerbrat.

Two accompanying editorials in JAMA Psychiatry addressed the research by Comtois and colleagues.

"Comtois et al have confirmed that is possible to conduct high-value suicide prevention research in the active-duty military," wrote three researchers at University of California, San Diego, Harvard Medical School and the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

Charles Hoge, with the Center for Psychiatry and Neurosciences at the Walter Reed Army Institute of Research in Silver Spring, Maryland, called the study a "hallmark clinical trial from the DoD [Department of Defense] portfolio." Hoge, however, said the study joins other intervention trials in delivering primarily null or inconclusive findings in military and veteran populations. He noted that only 30 percent of veterans are engaged in Veterans Affairs care, and he laid out what needs to be understood and implemented to prevent more suicides.

For the researchers, caring texts is something that can be implemented with some guidelines.

"The intervention is ready for prime time," said Comtois, noting that healthcare systems still need to sort out issues such how as who will be delivering the messages and guidelines for what they will include. She and colleagues are working on a free toolkit for healthcare providers.

https://www.sciencedaily.com/releases/2019/02/190214174237.htm

Younger generations of those in the military more vulnerable to suicide

November 18, 2015

Science Daily/SAGE

While many researchers have largely focused on risk factors among individual soldiers, in a new study, researchers contend that the increase in suicide may also indicate increased vulnerability among more recent generations of young adults.

In the last 10 years, the U.S. military has experienced an unprecedented increase in suicides among personnel. While many researchers have largely focused on risk factors among individual soldiers, in a new study, researchers contend that the increase in suicide may also indicate increased vulnerability among more recent generations of young adults. Evidence supporting this perspective is out today in Armed Services and Society (a SAGE journal).

James Griffith and Craig Bryan from the National Center for Veterans Studies at The University of Utah build on research suggesting that increased young adult suicide rates reflect generational declines in social integration (such as access to predictable, stable, and enduring relationships for support and relief) and behavioral regulation (norms that determine the acceptability of certain behaviors).

Griffith and Bryan noted scientific evidence reflecting increased emotional and behavioral problems among younger generations of high school and college students, as well as generational shifts in their values. Of note, more recent generations of high school and college students report that they value fame and wealth more but value community relations, interest in social problems, and civic engagement less than earlier generations. These changes have been especially pronounced during the transition from Generation Xers to the Millennials.

"The fact that a comparable rise in suicides has not been seen among adolescents and young adults more broadly across the U.S. suggests the possibility that the Army is recruiting individuals with more risk factors," the researchers noted.

Recruitment trends since the elimination of the draft and the inception of the All-Volunteer Force support this possibility. Since the elimination of the military draft, the number of volunteers for military service has diminished. Of this pool of volunteers, nearly half are accepted into military service; a much larger proportion of the full volunteer pool than the 7% acceptance rate that existed during the time of the military draft. Of those recruits accepted into military service, larger proportions have waivers for health conditions or behavior problems, and a larger proportion come from nontraditional family structures.

http://www.sciencedaily.com/releases/2015/11/151118070812.htm