Leadership and Military Suicides

Abstract

The problem of suicide has become increasingly common among military personnel. The growth has been especially common since the occupation of Iraq. According to studies, combat service increases the chances of committing suicide during the periods of war. On the other hand, army officials are less likely to commit suicide during years of peace compared to civilians. While offering protection to some people, combat service also increases the risk of committing suicide of others. This shows that suicide in the army is a complicated situation and requires proper research to determine the best way to resolve. In this paper, it is determined whether there is a need to engage leaders in seeking sanity to the situation. In essence, should leaders provide an advisory role in to their subordinates to prevent them from committing suicide? Should they encourage individuals who seem suicidal to engage in professional care? It also looks at the various treatments that are offered or should be offered to people who become suicidal in their combat service.

Introduction

Globally, about 1 million people die each year from suicide. In the US, suicide accounts for approximately 11 out of every 100,000 deaths nationwide. Suicide therefore qualifies as one of the major threat to health in the community. In the armed forces, suicide is the second largest cause of death. It accounts for between 9 and 15 for every 100,000 deaths (Alvarez, 2009). While the rate is approximately similar to that of the general population, the suicide rate often becomes much lower among the armed forces during periods of peace and shoots during war. Moreover, there have been studies showing that military service could be a major contributor to the suicide rate in the military and that suicide is the most common type of traumatic death suffered during army training. Leaders today need to be better at identifying soldiers who are at risk of displaying suicidal behaviors, and encouraging them to seek assistance.

The rate of suicide in the military has been rising steadily. According to Alvarez (2009), the suicide rate rose in 2008 for the fourth year in a row. This has led to rising interest in identifying suicidal ideation and treating affected military personnel. Since Operation Iraqi Freedom and Operation Enduring Freedom, the rate of suicide among the military personnel who have been exposed to combat has risen above that of the general population. This observation suggests a relationship between exposure to combat and future death by suicide. At the same time, there is an observation that the military environment discourages death by suicide during periods of peace. The army experiences a death by suicide rate of as low as 5 deaths caused by suicide for every 100,000. There is therefore a complicated relationship between suicidal behavior and military service. To some, it acts as a protective factor while serving as a risk factor to others.

Unluckily, the research regarding this relationship has been sparse. According to Selby et al. (2010), there is a need to employ new theories to the relationship between these factors. There is a need to explore the issue of suicide in the military and provide treatment and effective, economical and efficient assessments for suicide behavior. This way, leaders will be able to identify the right way to approach the issues of suicide among their subordinates and working towards lowering the risk of suicide in their army.

According to CDC (2014), the while suicide can be prevented, it has become of the biggest cause of death in the US military. The major reason why suicide continues to haunt the US army is a major communication breakdown between the culprits and their leaders. This gap further causes a division between the culprits and those people who are likely to offer them support and treatment. If the communication breakdown is resolved, there is a likelihood that military personnel will prefer to share their grievances before going to the extent of committing suicide.

Trust in the army is built by being honest. Leaders must continually display honesty to their subordinates to earn their trust. The issue of trust has been widely studied and reviewed to determine that trust is an important aspect of leadership. According to Allen and Braun (2012), it is not only an important aspect but should be at the heart of the profession. Creating trust between leaders and their subordinates is one aspect that can be used in reducing the number of suicides in the army. By army officers being able to communicate openly with their superiors, they would be likely to share important information that would be used in curbing suicide among the army.

There are various ways in which to look at information sharing in the army. First, army should be willing to share their experiences with their teams. By so doing, they will encourage others to share their experiences as well. By communication, there would be in a position to tell or imply that they have plans regarding taking their own lives. With this information, it would be easy for the leaders to deal with the situation. Secondly, communication provides a platform for counseling. In the course of communication, leaders would often find themselves in a position where they can chip in a work of encouragement. Thirdly, communication with subordinates gives leaders an opportunity to recommend certain personnel to the medical department. Sometimes it may be required that a leader approaches the issue head on and requires that a certain member of his team immediately seek counseling and mental support. If a team member is no longer in the spirit of working, it would be necessary for such a person to be referred to the right department for support. Finally, if the information is shared in confidence, leaders should advise their subordinates to seek the attention that would save them from risky behavior.

According to the Interpersonal-psychological Theory of suicide, individuals become suicidal when they gain the ability to cause self-harm, start perceiving themselves as burdensome and start feeling unaccepted in the society. If leaders are able to identify any of these three factors, they would be better positioned to deal with suicidal behavior within the army (Alvarez, 2009).  The three domains not only show a desire to cause self-harm, but also an increased likelihood that an individual will commit suicide. For one to be diagnosed with extreme suicidal behavior, all the three domains must be present. Low levels of any of the three may eventually distract their intention of taking their own lives. Leaders can participate in causing change of behavior by reducing the impact of the two of three domains. First, they can influence the sense of belongingness by creating a team spirit and promoting a sense of belongingness in their team. Every member will therefore feel valued and not see a need to take their lives. Secondly, with an increased sense of belongingness, such individuals will understand that they are valuable to their team and that their contribution is highly valued. Being so, they would not have the feeling of being burdensome in their team. By working on these two aspects in the team, leaders are likely to largely influence the rate of suicide in their respective team. The capability to cause self-harm is harder to resolve. Moreover, it may not be in the domain of the leaders to offer guidance in this regard. In this regard, it would be more reasonable to refer such individuals to the rightful departments for treatment. Moreover, guidance should be offered in all aspects of suicidal behavior including those that are covered by leaders. Offering further guidance would emphasize the message provided in the team situation. Moreover, the leader may not be able to deal with every individual team member especially during a situation of combat. In such a situation, referring all individuals to the right departments would be the most appropriate decision.

To determine the values of intervening strategies, reliable effective measures are required. Although it has been experienced that the research for veteran and military suicide is faced by so many problems, that is, on the status of the veteran’s surveillance records such as; the manner in which death took place; data being dissimilated from U.S. Department of Defense (DOD), Veteran Affairs department (VA); national death index and population variability subgroups (Hoge & Castro, 2012). Despite all these problems, pressures do exist that lead to rapid implementation of multicomponent prevention programs. Such implementations succeed due to the evidence that arise from the observations that are first conducted, for example, the one that took place in 1990s due to the Air Force efforts. Replications of such interventions that succeeded cannot be put into practice without the knowledge of the components that contributed to the effectiveness.

As war in places such as Afghanistan reduces, caution is advised in causing future reductions in the rates of suicide due to specific programs. Individuals that are in charge of the management of the military should give utmost attention to the intervention programs that tend to curb suicide rate within the military. Such intervention measures can be classified under the following broad categories of education, screening as well as treatment.

Public awareness and education

Suicide awareness in the training of military personnel is a mandatory requirement. However, evidence indicate that implementation of this requirement is not effective. This shows that there are other reasons to be concerned (Alvarez, 2009). Public understanding is influenced a lot by other factors, apart from the education campaigns that include the news media. Studies have indicated that when reports that surround the suicide deaths are reported, that is from films, print and television reports and web content, other cases of suicide usually follow. This indicates that there is a need for research on the relationship of reports and the military suicides. Educational efforts that portray the stories that involve the suicidal behavior should also be studied. The interactive military training videos may be the ones that portray the wrong messages through details that illustrate behaviors which are suicidal. If this is the case, then the leaders are responsible for not giving or heeding to the warnings that come with such videos. Training tools should be validated critically in the military environments to ensure that they are associated with improving the awareness in mental health, seeking of help and change the attitudes that are concerned with suicide.

The leaders should also critically examine the communication strategies in the military environments. Attitudes that are stigmatizing may be reflected unwittingly in clichés such as “a single suicide is too many” or “zero tolerance”, that is, when expressed by military leaders or even well-intentioned VA (Hoge & Castro, 2012). Such messages indicate that suicide is so different from all the other medical conditions, and such a selection is a “bad choice” to any individual. Leaders in the military should be aware that such choices being made by their juniors indicate the leader’s negligence or peer influence. Military training and awareness should indicate that certain types of communications are not used to describe attitudes towards cancer, PTSD or even towards depression.

There are many reasons that cause suicide among individuals apart from being the fault of the individuals or even the persons that are closest to that particular individual. Leaders in the military environments should ensure that all the individuals get the required social support, cohesion of the mission teams as well as improved mental health (Hoge & Castro, 2012). With such provisions, the peers or even the leaders cannot know or tell of any individual who is in need of immediate intervention. Studies have also indicated that no treatment can be given to prevent suicide. Statistics show that most of the individuals who commit suicide had visited professionals for mental health within the last thirty days.

There are individuals who are reported to have committed suicide after making serious attempts. Such individuals believe that suicide presents the best option that brings about relief from the serious sufferings that they may be going through or burdens that they may be placing on the lives of others, for example, in cases of veterans it may be due to the guilt of certain survivors. Even though suicide may seem to be within the control of an individual, the leaders should understand that it is not a decision or a choice that individuals make after exhausting all other available options. Intent for suicide is as a serious condition as any other life threatening condition. Military leaders should understand it that way and should put the necessary measures in place.

Treatment as a way to curb suicide intentions

Evidence is insufficient to conclude that the individual has the intentions of committing suicide. Experience from a clinical officer as well as various trials gives support to a wide range of interventions (Alvarez, 2009). Such interventions are focused to enhance care access, means restrictions as well as psychosocial treatment. Access of care includes interventions such as, crisis call lines and provision of contact information in case of emergencies. In suicide prevention attempts, the main challenge is the stigma that surrounds the negative perceptions of the treatment, mental illness itself as well as other barriers that include the confidentiality concerns in military settings. These are some of the things that result in most of the service members as well as the veterans that fail to access care when it is required or in the case when dropping out prematurely.

In terms of treatment, the leadership should ensure that research efforts lead to prioritization of patient engagement, satisfaction, and screening for any mental disorders for primary care, coordination capacity for appointments, treatment that is effective and to reinforce the protective effects of peer and family connections.

Risk assessment and screening

Screening is a default strategy that is prioritized to ensure mental health during the recruitment of the military. The leaders ensure that every individual that they recruit is mentally well and out of any danger (Alvarez, 2009). Screening is also done particularly for posttraumatic stress disorder (PTSD), depression, and misuse of substances. There are problems that arise from deployment-screening, which includes a predictive value that is low in the cases of validated tools. The only screening that is beneficial is the one that includes lower rates of suicide identification. In these cases, the leaders are supposed to be extra vigilant to ensure that screening is done as required.

Another way to look at the problem of suicidal behavior is that most military personnel commit suicide after they have left the army. At this point, they no longer feel useful to either their society or to the state (Hoge & Castro, 2012). They are also, often, unemployed and no longer have a role to play in the society. At this point, leadership is absurd. The best way to resolve this problem is by involving them in programs that would make them play an integral role in the society. Since individuals are different and would often play different roles with ease, they should be consulted before being allocated a role in the society. Even better, they should be required to join veteran organizations and get follow-up from medical personnel to ensure that the suicidal feelings never take toll of the veterans.

Not everyone believes that the role of recommendation treatment to army personnel who intend to commit suicide. Other people feel that individuals should be charged with the role of self-protection. In this regard, they feel that training programs need to be created such that army personnel are less likely to commit suicide (Hoge & Castro, 2012). Furthermore, they should be in a position to identify suicidal feelings and take appropriate action. It is not possible for leaders to keep close contact with each of the members of their team. For this reason, everyone should be involved in a training program that teaches them to take responsibility and protect their lives from harm at all times rather than taking their lives. Doing this will eliminate the need to involve the leadership in every aspect of each individual’s life. Self-development should also be integrated into the program to ensure that people have a higher regard for themselves.

These methods of dealing with suicide show that some people would want leadership to be separated from care of the team. However, according to the Department of the Army (2012), an army leader is any individual who is any person who assumes or is assigned responsibility and influences the decisions made in pursuit of organizational goals. An army leader influences people both without and within his chain of command to make decisions for the greater good of the organizations. In this regard, if an individual makes the decisions to commit suicide, such a decision would not be in favor of the organization. For this reason, it is necessary for the leader to intervene and promote the decision of seeking intervention from the right organizations and departments.

Conclusion

In conclusion, there is a need for leaders to get involved in the eradication of suicide within the armed forces. They are charged with the role of seeing to influence of their subjects so as to see to decisions that are important to the company. Moreover, these individuals already trust their leaders sufficiently to make it reasonable for them to acquire the information that would imply it if they wanted to commit suicide. Moreover, leaders have a lot of influence over the lives of these individuals. If they choose, the leaders could easily influence people to believe more in themselves and lose the intention of taking their lives. That they may not have sufficient contact with each of the individuals under them does not qualify as a viable reason why they should not play their role. They are moreover required to take advantage of available medical personnel to help members of their teams and eliminate the need to engage in risky behavior.

References

Allen, C., & Braun, W. (2013). Trust: Implications for the Army Profession. Military Review, 73-85. Retrieved from http://usacac.army.mil/CAC2/MilitaryReview/Archives/English/MilitaryReview_20131031_art012.pdf

Alvarez, L. (2009). Suicides of Soldiers Reach High of Nearly 3 Decades – NYTimes.com. New York Times. Retrieved 26 January 2015, from http://www.nytimes.com/2009/01/30/us/30suicide.html?_r=0

CDC,. (2014). Suicide Prevention Investment Needed to Reverse Trend of Increasing Suicide. American Foundation for Suicide Prevention. Retrieved 26 January 2015, from https://www.afsp.org/news-events/in-the-news/suicide-prevention-investment-needed-to-reverse-trend-of-increasing-suicide

Department of the Army,. (2012). Army Leadership. Washington.

Hoge, C., & Castro, C. (2012). Preventing Suicides in US Service Members and Veterans. JAMA,308(7), 671. doi:10.1001/jama.2012.9955

Selby, E., Anestis, M., Bender, T., Ribeiro, J., Nock, M., & Rudd, M. et al. (2010). Overcoming the fear of lethal injury: Evaluating suicidal behavior in the military through the lens of the Interpersonal–Psychological Theory of Suicide. Clinical Psychology Review, 30(3), 298-307. doi:10.1016/j.cpr.2009.12.004