"As I mused, the fire burned"

Reflection on life as a person of faith.

Military Suicide

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I’ve written before about the suicide rate in the Canadian Forces. The last formal report from the CF health care side stated there wasn’t a problem because the rate of suicide among soldiers was below that of the general population. These interesting articles from the US suggest that the problem of suicide among combat soldiers is growing, and a concern even though the rate is below that of the general population.

This article talks about the `epidemic of suicide` among US soldiers.

This article offers the startling statistic that more US soldiers died by suicide than in combat.

The report from the CF ‘expert panel’ on suicide is still off the website (ah, I found it at a third party site).  I have trouble believing our experience is that different from the US, except in number of people involved. 

From the expert report panel on suicide prevention in the CF…the conclusion that there is no real problem:

The finding that CF suicide rates are lower than the general Canadian population rates is not surprising as CF personnel are a screened, employed population and would be expected to have lower rates of suicide as well as lower rates of other medical problems. Reporting of CF suicides is probably more complete than those of the Canadian population as the latter derive from death certificate records, which are known to under-report suicides. Reporting of CF suicides is a product of both death certificate data as well as records kept by military police.

As shown in Table 1, no recent trend is apparent in CF suicide rates. However due to low numbers and low statistical power, detecting changes in CF suicide rates over time is limited to finding only very gross changes in suicide rates as the numbers are very small.

Which means exactly what it says, the sample size is so small as to not be significant.  From earlier in the report, they document some of the data shortfall, which is a pretty huge issue.

Surveillance is an essential component of any prevention program. Since 2004, the CF has implemented a suicide surveillance program, which is described in detail in ANNEX I. While this represents a significant advance over the previous system, key information for evaluation of prevention efforts is often missing. For example, documentation available to staff involved in suicide surveillance may not indicate the source of the weapon (personal vs. CF) for firearm suicides.

The CF has no mechanism for capturing information about suicides in Reservists, for whom the CF has much more limited potential for suicide prevention. Class A Reservists (who form the bulk of the CF Primary Reserve personnel) spend only a few hours per week in their military workplace and receive almost all of their healthcare through the provincial system. 

Until recently, there was no ongoing surveillance mechanism within the CF or within Veterans Affairs Canada for suicide in veterans (that is, after separation from military service). This is an important blind spot because of evidence that service members may be at increased risk for suicide only after they release [12;120]; risk appears to be highest in the first few years after release [120;121].

Our mission in the sandbox started around 2002, yet the surveillance program has only been in place since 2004.  There is no way to track info on reservists or retired military personnel.  That means the CF suicide rate only reflects those who have deployed and are still in the CF. 

The conclusions are telling:

The following conclusions are reached with the understanding that a true difference can be missed due to the small sample size (i.e. the power of the study is low):

1. The crude rate of suicide in the Canadian Forces is below those of the general Canadian public, which is not unexpected for a screened, working population. From 1995 to 2008 there has been no clear change in male CF suicide rates.

2. The rate of suicide when standardized for age and sex is lower than that of the general Canadian population.

3. History of deployment is not a risk factor for suicide in the Canadian Forces.

So the study is potentially statistically flawed, but there are still conclusions?  One of which is there is no correlation between deployment and suicide…in a study with too small a sample size…when reservists and released soldiers are not considered.  You don’t have to be a rocket scientist in statistics to raise your eyebrows.

My problem with all this – we spend $ to ensure our soldiers have body armour, and armoured fighting vehicles, and the equipment necessary to fight (new howitzers, GPS shells…), but once they get home our studies suggest they’re all fine, even though our closest neighbour is ringing alarm bells (with a good sample size).  [and this report on sleep problems in active duty soldiers, which won’t help any mental health issues]

What does it mean to support your soldiers?

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Written by sameo416

January 29, 2013 at 8:06 pm

Posted in Uncategorized

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