Suicide after Leaving the UK Armed Forces —A Cohort Study
Background:
Few studies have examined suicide risk in individuals once they have left the military. We aimed to investigate the rate, timing, and risk factors for suicide in all those who had left the UK Armed Forces (1996–2005).
Methods and Findings:
We carried out a cohort study of ex-Armed Forces personnel by linking national databases of discharged personnel and suicide deaths (which included deaths receiving either a suicide or undetermined verdict). Comparisons were made with both general and serving populations. During the study period 233,803 individuals left the Armed Forces and 224 died by suicide. Although the overall rate of suicide was not greater than that in the general population, the risk of suicide in men aged 24 y and younger who had left the Armed Forces was approximately two to three times higher than the risk for the same age groups in the general and serving populations (age-specific rate ratios ranging from 170 to 290). The risk of suicide for men aged 30–49 y was lower than that in the general population. The risk was persistent but may have been at its highest in the first 2 y following discharge. The risk of suicide was greatest in males, those who had served in the Army, those with a short length of service, and those of lower rank. The rate of contact with specialist mental health was lowest in the age groups at greatest risk of suicide (14% for those aged under 20 y, 20% for those aged 20–24 y).
Conclusions:
Young men who leave the UK Armed Forces were at increased risk of suicide. This may reflect preservice vulnerabilities rather than factors related to service experiences or discharge. Preventive strategies might include practical and psychological preparation for discharge and encouraging appropriate help-seeking behaviour once individuals have left the services.
Vyšlo v časopise:
Suicide after Leaving the UK Armed Forces —A Cohort Study. PLoS Med 6(3): e32767. doi:10.1371/journal.pmed.1000026
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1000026
Souhrn
Background:
Few studies have examined suicide risk in individuals once they have left the military. We aimed to investigate the rate, timing, and risk factors for suicide in all those who had left the UK Armed Forces (1996–2005).
Methods and Findings:
We carried out a cohort study of ex-Armed Forces personnel by linking national databases of discharged personnel and suicide deaths (which included deaths receiving either a suicide or undetermined verdict). Comparisons were made with both general and serving populations. During the study period 233,803 individuals left the Armed Forces and 224 died by suicide. Although the overall rate of suicide was not greater than that in the general population, the risk of suicide in men aged 24 y and younger who had left the Armed Forces was approximately two to three times higher than the risk for the same age groups in the general and serving populations (age-specific rate ratios ranging from 170 to 290). The risk of suicide for men aged 30–49 y was lower than that in the general population. The risk was persistent but may have been at its highest in the first 2 y following discharge. The risk of suicide was greatest in males, those who had served in the Army, those with a short length of service, and those of lower rank. The rate of contact with specialist mental health was lowest in the age groups at greatest risk of suicide (14% for those aged under 20 y, 20% for those aged 20–24 y).
Conclusions:
Young men who leave the UK Armed Forces were at increased risk of suicide. This may reflect preservice vulnerabilities rather than factors related to service experiences or discharge. Preventive strategies might include practical and psychological preparation for discharge and encouraging appropriate help-seeking behaviour once individuals have left the services.
Zdroje
1. TownsendM
2008 February 3
They're back from the front line - so why are these ex-soldiers still fighting their own wars?
Available: http://www.guardian.co.uk/afghanistan/story/0,,2251685,00.html. Accessed 17 December 2008.
2. IversenANikolaouVGreenbergNUnwinCHullL
2005
What happens to British veterans when they leave the armed forces.
Eur J Public Health
15
175
184
3. BallintyneSHanksS
2000
Lest we should forget: ex-servicemen and homelessness.
London
Crisis
4. IversenAWessleyS
2005
The needs of UK veterans with psychological problems: a systematic review of the literature.
London
King's Centre for Military Health Research
5. GunnellDMiddletonN
2003
National suicide rates as an indicator of the effect of suicide on premature mortality.
Lancet
362
961
962
6. SpoonerMH
2002
Suicide claiming more British Falkland veterans than fighting did.
Can Med Assoc J
166
1453
7. Defence Analytical Services Agency (DASA)
2007
Suicide and open verdict deaths in the UK regular armed forces 1984–2006.
Bath (UK)
DASA
8. MacfarlaneGJThomasECherryN
2000
Mortality among UK Gulf War veterans.
Lancet
356
17
21
9. MacfarlaneGJHotopfMMaconochieNBlatchleyNRichardsA
2005
Long-term mortality amongst Gulf War veterans: is there a relationship with experiences during deployment and subsequent morbidity.
Int J Epidemiol
34
1403
1408
10. KangHKBullmanMS
1996
Mortality among U.S. veterans of the Persian Gulf War.
N Engl J Med
335
1498
1504
11. KangHKBullmanMS
2001
Mortality among US veterans of the Persian Gulf War: 7-year follow-up.
Am J Epidemiol
154
399
405
12. ThoresenSMehlumLMollerM
2003
Suicides in peacekeepers: a cohort study of mortality from suicide in 22,275 Norwegian veterans from International peacekeeping operations.
Soc Psychiatry Psychiatr Epidemiol
38
605
610
13. MichelP-OLundinTLarssonG
2007
Suicide rate among former Swedish peacekeeping personnel.
Mil Med
172
278
285
14. KaplanMSHuguentHMcFarlandBHNewsomJT
2007
Suicide among male veterans: a prospective population-based study.
J Epidemiol Community Health
61
619
624
15. IversenADysonCSmithNGreenbergNWalwynR
2005
‘Goodbye and good luck': the mental health needs and treatment experiences of British discharged personnel.
Br J Psychiatry
186
480
486
16. HotopfMHullLFearNTBrowneTHornO
2006
The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study.
Lancet
367
1731
1741
17. LinselyKRSchapiraKKellyTP
2001
Open verdict v. suicide - importance to research.
Br J Psychiatry
178
465
468
18. ApplebyLShawJSherrattJRobinsonJMcDonnellR
2001
Safety first.
London
Department of Health
19. ApplebyLShawJKapurNWindfuhrKAshtonA
2006
Avoidable deaths: five-year report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness.
London
Department of Health
20. CorbetCTannerMBlatchleyN
2008
UK Armed Forces psychiatric morbidity: presenting complaints at MOD Departments of Community Mental Health July-September 2007
Available: http://www.dasa.mod.uk/applications/newWeb/www/index.php?page=67&pubType=0&thiscontent=1320&date=2008-11-04. Accessed 17 December 2008.
21. KangHKBullmanTA
2008
Risk of suicide among US veterans after returning from the Iraq or Afghanistan war zones.
JAMA
300
652
653
22. BullmanTAKangHK
1996
The risk of suicide among wounded Vietnam veterans.
Am J Public Health
86
662
667
23. BullmanTAKangHK
1994
Posttraumatic stress disorder and the risk of traumatic deaths among Vietnam veterans.
J Nerv Ment Dis
182
604
610
24. IversenACFearNTSimonoffEHullLHornO
2007
Influence of childhood adversity on health among male UK military personnel.
Br J Psychiatry
191
506
511
25. ThoresenSMehlumLRoysambETonnessenA
2006
Risk factors for completed suicide in veterans of peacekeeping: repatriation, negative life events and marital status.
Arch Suicide Res
10
353
363
26. JollyR
1996
Changing step: from military to civilian life.
London
Brasseys (UK) Ltd
27. MacLeanAElderGH
2007
Military service in the life course.
Annu Rev Sociol
33
175
196
28. HyamsKC
2006
Mental health screening before troop deployment.
BMJ
333
979
980
29. Ministry of Defence
2008
Conditions of service; resettlement.
Available: http://www.army.mod.uk/1107.aspx. Accessed 17 December 2008.
30. Career Transition Partnership
2008
Non CTP resettlement support.
Available: http://www.ctp.org.uk/ctp/serviceleavers/non-ctp-resettlement-support/. Accessed 17 December 2008.
31. NicholsonD
2007
Access to health services for military veterans. Letter dated 12 December 2007.
Available: http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_081171. Accessed 9 January 2009.
32. Service Personnel and Veterans Agency
2008
What is the community veterans mental health pilot project?
Available: http://www.veterans-uk.info/mental_health/faq.html#vets1. Accessed 17 December 2008.
33. Combat Stress
2008
Combat stress, ex-services mental health welfare society.
Available: http://www.combatstress.org.uk. Accessed 17 December 2008.
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