NCO Journal logo highlighting the ranks of enlisted officers

Publishing Disclaimer: In all of its publications and products, NCO Journal presents professional information. However, the views expressed therein are those of the authors and are not necessarily those of the Army University, the Department of the US Army, or any other agency of the US Government.

Enhancing the Army Suicide Prevention Program

By Sgt. Maj. Jerald J. Stephens

Directorate of Emergency Services

March 7, 2024

Download the PDF

In a tightly cropped photograph, a Soldier in a uniform and cap places his hand upon the shoulder of a bareheaded Soldier sitting beside him. This second Soldier has his face in his hands, and his head is bare — revealing closely cropped black hair whose curls shine with dampness. Beyond the two Soldiers, what looks to be the wooden rail of a deck is at their back. Because the photograph has been taken from a high angle, concrete and leaf-strewn earth are visible below.

The Army must prioritize Soldiers’ mental well-being and enhance program resources to ensure every Soldier has access to necessary support in times of crisis. The increasing rates of suicide erode the foundation of military readiness. (U.S. Army photo by Jean Graves)

In military service, where honor, duty, and sacrifice are paramount, a profoundly troubling issue demands the Army’s utmost attention. The escalating rates of suicide ideations, attempts, and completions in the Army reflect a severe mental health crisis among Soldiers.

Research in 2021 found that 30,177 active-duty Soldiers and veterans who served after 9/11 died by suicide compared to 7,057 service members killed in combat during the same period (DeSimone, 2023). This trend poses a significant threat to the Army’s mission of maintaining readiness to defend the nation.

The Army must take decisive action to improve program resources, fostering a culture of resilience and mental health awareness. The Army, steeped in tradition, faces a new challenge that defies conventional warfare but is equally threatening. The increasing rates of suicide ideations, attempts, and completions erode the foundation of military readiness.

To address this issue, the Army must prioritize Soldiers’ mental well-being and enhance program resources to ensure every Soldier has access to necessary support in times of crisis. It must implement ways to improve program resources to sustain readiness and decrease suicide ideations, attempts, and completions.

Understanding the Problem

Addressing the issue requires a comprehensive understanding of the problem’s scope. The Army must effectively examine current statistics and trends related to suicide.

Psychosocial factors — including relationship difficulties, administrative or legal problems, and workplace challenges — play a significant role in increasing suicide risk among Soldiers. Certain medical conditions — such as traumatic brain injury (TBI), chronic pain, and sleep disorders — also elevate suicide risk. Notably, firearms are the most frequently employed method in suicide cases, constituting more than 60 percent of all military suicide deaths (Uniformed Services University, n.d.).

A bearded man in a black T-shirt stands among Soldiers in black shirts that read Army. The bearded man addresses the men, his back to the camera and his face in profile. The back of his shirt says, Not every fight is on the battlefield. The yellow text is in capital letters, and a yellow silhouette of a Soldier appears next to the words. Below, in a similar but smaller font, one reads, National Suicide Prevention Lifeline: 988. There is another line below this, but it is difficult to read: The lettering curves around the man's back and is slightly distorted by slight undulations in the fabric.

The Fort Drum Army Suicide Prevention Program coordinator speaks to Soldiers at Nash Gym on Fort Drum, New York, May 21, 2024. Evaluating and enhancing the ASPP is a moral imperative essential for maintaining the Army’s readiness and effectiveness. By prioritizing Soldiers’ mental well-being, senior leaders can work toward reducing suicides and ensuring the Army remains a strong and resilient force. (U.S. Army photo by Sgt. Amber Edwards)

Statistics and Trends Related to Suicide in the Army

The current Army statistics are deeply concerning. Over the past decade, there has been a distressing upward trend in suicide rates among Soldiers, exceeding the national average.

In 2023’s first quarter, there were 75 suicides: 49 in the Regular Army (RA), 18 in the Army National Guard (ARNG), and 8 in the U.S. Army Reserves (USAR) (Department of Defense (DoD), 2023). The suicide rate among Soldiers has reached its highest point in recent years, underlining the urgency for intervention.

One recent study shared these findings:

Suicide is the tenth leading cause of death in America. Particularly at risk, Veterans are 1.5 times more likely to die by suicide than non-Veterans, and the suicide rate among service members has risen over the last decade. (Schafer et al., 2021, p. 1)


The Army’s inability to adequately address the alarming suicide rates affects combat effectiveness and readiness.

Suicide’s Impacts on Combat Effectiveness and Readiness

Suicide rates have profound impacts on the Army’s readiness and effectiveness. Each loss of life deprives the force of valuable experience, skills, and capabilities, while the mental health crisis can erode unit cohesion, trust, and morale.

The number of suicides among active-duty Soldiers and veterans continued to rise over the past decade, highlighting the urgent need for the Army to address this issue (Uniformed Services University, n.d.). To sustain and enhance readiness and combat effectiveness, the Army must prioritize its Soldiers’ mental well-being.

It must improve program resources and foster a culture of resilience and mental health awareness. Only by addressing the underlying causes of suicide and providing comprehensive support can the Army mitigate the impact of this crisis on its readiness and effectiveness.

Evaluating the Suicide Prevention Program

The Army must undertake a comprehensive evaluation of the current Army Suicide Prevention Program (ASPP). This evaluation should thoroughly assess program resources, policies, and practices to identify areas requiring enhancement. Engaging with mental health professionals, service members, and experts in suicide prevention will provide insights into the program’s strengths and weaknesses.

A tightly cropped photograph shows the shoulders and back of a uniformed Soldier, who sits with his head in his hands. The photograph is shot from a high angle, so that one sees beyond the Soldier a gray ground, likely a floor covered with linoleum or carpet.

Suicide rates have profound impacts on the Army’s readiness and effectiveness. Each loss of life deprives the force of valuable experience, skills, and capabilities, while the mental health crisis can erode unit cohesion, trust, and morale. (U.S. Army photo by Jenn DeHaan)

Senior leaders must prioritize allocating additional resources to the ASPP, ensuring it has the necessary funding, personnel, and infrastructure to deliver comprehensive and timely support to Soldiers in need. Evaluating and enhancing the ASPP is a moral imperative essential for maintaining the Army’s readiness and effectiveness.

By prioritizing Soldiers’ mental well-being and improving program resources, senior leaders can work toward reducing suicides, thereby ensuring the Army remains a strong and resilient force ready to defend the nation.

Examining ASPP Strengths and Weaknesses

The ASPP promotes positive behavioral change, strengthens bonds, and builds resilience. However, persistently high suicide rates indicate that the ASPP has not been effective in reducing suicides.

Ongoing high suicide rates among veterans and service members, despite prevention efforts, reveal the complex nature of suicide and the need for more effective strategies to address it comprehensively (U.S. Department of Veterans Affairs & U.S. DoD, n.d.).

There is a significant gap between the demand for mental health support and the available resources. According to the U.S. Department of Veterans Affairs and U.S. DoD, previous research and program assessments suggest mental health care access should be viewed through three key areas:

  • Emergency or same-day care
  • Nonurgent care engagement
  • Follow-up care (U.S. Department of Veterans Affairs & U.S. DoD, n.d.)

Providing evidence-based, high-quality care in these areas has been shown to support recovery and enhance wellness. Therefore, initiatives aimed at expanding capacity, improving accessibility, and optimizing evidence-based care delivery are crucial to effective suicide prevention efforts (U.S. Department of Veterans Affairs & U.S. DoD, n.d.).

The stigma associated with seeking help for mental health issues remains a challenge, deterring Soldiers from reaching out for support. Improved training and awareness campaigns targeting Soldiers and leaders are essential to address this issue.

Efforts to reduce the stigma associated with seeking mental health care are essential, as this stigma continues to prevent service members from accessing necessary support (U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, 2018). The ASPP must intensify efforts to reduce this stigma, as it can deter Soldiers from seeking the assistance needed to maintain a healthy mental state of mind.

Improved training and awareness campaigns are needed. These campaigns should target Soldiers and leaders at all levels. Leaders must be better equipped to recognize signs of distress among their subordinates so they can take appropriate action. To enhance the ASPP, the Army must identify ways to eliminate barriers and the stigma associated with Soldiers seeking help for mental health care.

Barriers and Stigma Create Limitations for the ASPP

The ASPP faces significant limitations due to barriers and the stigma that deters Soldiers from seeking mental health support. Poor leadership creates a hostile and stigmatizing environment for Soldiers in a unit under psychological or emotional duress (Meadows et al., 2018).

In a culture valuing toughness and self-reliance, admitting vulnerability and seeking help can be perceived as a sign of weakness, which discourages Soldiers from seeking the support they need.

A stack of what appear to be refrigerator magnets sit on black cloth, perhaps a sheet draped over a table at a display booth. The objects are rectangular, their height slightly greater than their width. Their fronts are white, with the primary graphic printed on them a teal square, with this text inside: 988 Suicide & Crisis Lifeline. Beside this box, a font that resembles handwriting says, There is hope. Below the box, in the same font, are the words Talk with us. Next to this text, another message appears: If you or someone you know needs support now, call or text 988 or chat 988lifeline.org. Because of the size of the font, the letters for the chat address are difficult to make out, but the viewer may guess what they spell out based on the rest of the text. At the bottom of the rectangle, a scannable QR code appears.

Efforts to reduce the stigma associated with seeking mental health care are essential, as this stigma continues to prevent service members from accessing necessary support. The Army Suicide Prevention Program must intensify efforts to reduce this stigma, as it can deter Soldiers from seeking the assistance needed to maintain a healthy mental state of mind. (U.S. Army photo by Sgt. Eve Moore)

Additionally, the program’s resources may not be sufficient to meet the demand, resulting in delayed or inadequate assistance. Effective training and awareness campaigns for Soldiers and leaders are crucial to addressing these barriers.

One critical barrier is the need for more effective training and awareness campaigns for Soldiers and Army leaders. Leaders at all levels need better training to recognize signs of mental distress among their subordinates so they can respond appropriately. The absence of such training can lead to missed early intervention and support opportunities.

According to the Government Accountability Office (GAO), various DoD policies and guidance cover the general response to suicide attempts but lack specifics on commanders’ roles in these situations.

For instance, while DoD’s suicide prevention policy outlines requirements for reporting suicide attempts among servicemembers, it does not provide guidance for how commanders should respond.

DoD’s suicide prevention strategy includes general approaches to handling suicide attempts, like ensuring continuity of care by clinical providers. Still, it does not offer direct guidance for commanders’ actions in these cases (U.S. Government Accountability Office, 2022).

With the significant ASPP training gaps and lack of leader awareness of the program, the Army needs to enhance Soldier programs and support.

Enhancing ASPP Resources and Support

Enhancing the ASPP requires making mental health services more accessible and available. The Army must expand the number of mental health professionals, reduce appointment wait times, and create a more Soldier-friendly environment for those seeking help.

Integrating advanced technology can enhance access to mental health resources, self-assessment tools, and crisis hotlines. Fostering a sense of camaraderie and emotional support among Soldiers is crucial.

Encouraging peer-to-peer support networks and mentoring programs can create a culture where Soldiers feel comfortable discussing their mental health concerns. Continuous evaluation of the ASPP is essential to ensure its effectiveness.

Resilience and Mental Health Awareness

Cultivating a culture of resilience and mental health awareness in the Army is vital. Establishing a culture of resilience begins with Army leaders at all levels setting the example by openly discussing mental health concerns and seeking help when needed.

Education and training should be continuous, with Soldiers receiving regular briefings on mental health resources and self-care techniques. Encouraging peer support and mentorship programs can help Soldiers feel connected and supported.

Reducing the stigma associated with seeking mental health assistance by promoting confidentiality and emphasizing that mental health issues are treatable medical conditions is crucial.

A Soldier walks down a path and there's a large sign that says Medcom.

A 3rd Infantry Division Soldier exits Marne Embedded Behavioral Health Clinic on Fort Stewart, Georgia, Oct. 7, 2021. The Army must ensure mental health resources are easily accessible and well-publicized to promote transparency and encourage Soldiers to seek help. (U.S. Army photo by Spc. Daniel Thompson)

The Army can enhance its screening and monitoring processes to identify individuals at risk of suicide early on. By regularly assessing Soldiers’ mental health and stress levels, it can proactively intervene and provide necessary support.

It must ensure mental health resources are easily accessible and well-publicized to promote transparency and encourage Soldiers to seek help. Soldiers should know where to turn when they need help, whether through unit chaplains, behavioral health specialists, or crisis hotlines.

Army leaders must create a culture of resilience and mental health awareness. This requires a multifaceted approach that addresses attitudes, education, prevention, and support. It also requires engaged leadership, normalizing seeking help, and providing accessible resources.

By fostering such a culture, the Army can work toward reducing suicides and ensuring its Soldiers’ well-being.

Conclusion

Escalating Army suicide rates represent a profound challenge that demands immediate attention. Suicide statistics and trends are deeply concerning. They directly impact the Army’s readiness and effectiveness.

Evaluating and enhancing the ASPP is essential, including addressing barriers and stigmas that hinder Soldiers from seeking help. Proposing specific improvements — such as increased funding, resources, and personnel dedicated to mental health support — is crucial. Cultivating a culture of resilience and mental health awareness, led by committed leadership, can reduce the stigma associated with seeking help and promote open discussions about mental well-being.

The Army’s commitment to Soldiers’ mental health and well-being is essential for maintaining readiness and fulfilling its core mission to defend the U.S.A.

References

Department of Defense. (2023). Department of Defense (DoD) quarterly suicide report (QSR) 1st quarter, cy 2023. Defense Suicide Prevention Office. https://www.dspo.mil/Portals/113/Documents/QSR/2023/TAB%20A_20230623_QSR%20Rpt_Q1%20CY23_vf.pdf

DeSimone, D. (2023, September 6). Concerns rise over military suicide rates; here’s how the uso is trying to help. https://www.uso.org/stories/2664-military-suicide-rates-are-at-an-all-time-high-heres-how-were-trying-to-help

Meadows, S. O., Engel, C. C., Collins, R. L., Beckman, R. L., Breslau, J., Bloom, E. L., Dunbar, M. S., Gilbert, M., Grant, D., Hawes-Dawson, J., Holliday, S.B., Maccarthy, S., Pederson, E. R., Robbins, M. W., Rose, A. J., Ryan, J., Schell, T. L., & Simmons, M. M. (2018). 2018 Department of Defense health-related behaviors survey (HRBS). RAND Corporation. https://www.rand.org/pubs/research_reports/RR4222.html

Schafer, K.M., Duffy, M., Kennedy, G., Stentz, L., Leon, J., Herrerias, G., Fulcher, S. & Joiner, T.E. (2021). Suicidal ideation, suicide attempts, and suicide death among veterans and service members: a comprehensive meta-analysis of risk factors. Military Psychology, 34(2), 129-146. https://doi.org/10.1080/08995605.2021.1976544

Uniformed Services University. (n.d.). Suicide in the military. https://deploymentpsych.org/disorders/suicide-main

U.S. Department of Veterans Affairs & U.S. Department of Defense, (n.d.). Reducing military and veteran suicide: Advancing a comprehensive, cross-sector, evidence-informed public health strategy. Retrieved from https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-Prevention-Strategy.pdf

U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention. (2018). National strategy for preventing veteran suicide: 2018–2028. https://www.mentalhealth.va.gov/suicide_prevention/docs/Office-of-Mental-Health-and-Suicide-Prevention-National-Strategy-for-Preventing-Veterans-Suicide.pdf

U.S. Government Accountability Office. (2022). Suicide prevention: DOD should enhance oversight, staffing, guidance, and training affecting certain remote installations. U.S. Government Printing Office. https://www.gao.gov/products/GAO-22-105108

 

Sgt. Maj. Jerald J. Stephens is the Directorate of Emergency Services (DES) sergeant major at Fort Irwin, California. He has served in a variety of leadership assignments and positions over the last 22 years, ranging from team leader to first sergeant. He holds a bachelor’s in human resources management from the University of Maryland Global Campus and is pursuing a master’s degree in organizational leadership from Excelsior University.

Back to Top