Predicting U.S. Army suicides after hospital discharge

November 12, 2014

Science Daily/Harvard Medical School

Some Army suicides can be predicted with enough accuracy to justify implementing preventive interventions in patients at high risk, experts say. The study looked at 53,769 regular Army soldiers during the 12-month period following their discharge from a psychiatric facility during 2004 to 2009. Hundreds of potential predictors of post-hospital suicide were abstracted from the extensive Army and Department of Defense administrative files that contain data on all soldiers.

"The high concentration of suicide risk in the 5 percent of highest-risk hospitalizations is striking," said lead author Ronald Kessler, McNeil Family Professor of Health Care Policy at Harvard Medical School. "The fact that nearly half of all highest-risk hospitalizations were followed by at least one adverse outcome -- either suicide, unintentional injury death, suicide attempt or rehospitalization -- argues strongly for developing expanded post-hospital preventive intervention services for these highest-risk soldiers."

http://www.sciencedaily.com/releases/2014/11/141112203216.htm

Soldiers at increased risk for suicide within a year of psychiatric in-patient treatment

November 12, 2014

Uniformed Services University of the Health Sciences (USU)

Soldiers hospitalized with a psychiatric disorder have a significantly elevated risk for suicide in the year following hospital discharge, according to research. Although this has long been known in the civilian sector, it has never before been studied in the military population.

The study used data from the Army Study to Assess Risk and Resilience in Service members (Army STARRS), the largest study of mental health risk and resilience ever conducted among U.S. Army personnel. Robert J. Ursano, MD, chair of the Department of Psychiatry at the Uniformed Services University, Murray B. Stein, MD, MPH, professor of Psychiatry and Family and Preventive Medicine at the University of California, San Diego, both co-principal investigators for Army STARRS, and a team of Army STARRS researchers looked at data from the 12 months following a hospital discharge for more than 40,000 regular Army soldiers (excluding National Guard and Reserve) who served on active duty from 2004 through 2009.

The Army's suicide rate began increasing in 2004, exceeded the rate among U.S. civilians (adjusted to match the sex and age distribution of the Army), in 2009, and has remained high through 2014. This study of administrative data shows that 40,820 soldiers (0.8% of all regular Army soldiers who served from 2004-2009) were hospitalized with a psychiatric disorder. Suicides occurring in this group during the year after a hospital discharge accounted for 12% of all Army suicides during this period.

Researchers also found that it was possible to identify smaller, higher-risk groups within this at-risk population. Analyzing soldiers' characteristics and experiences prior to and during hospitalization, researchers identified the 5% of soldiers with the highest predicted risk of suicide after leaving the hospital. This top 5% accounted for 52.9% of the post-hospital suicides. Soldiers in this top 5% also accounted for a greater proportion of accident deaths, suicide attempts, and re-hospitalizations, compared to other previously hospitalized soldiers.

http://www.sciencedaily.com/releases/2014/11/141112161040.htm