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Topics: Suicide

Suicide after leaving the UK Armed Forces - a cohort study

Suicide article

David While, Professor Navneet Kapur, Centre for Suicide Prevention, University of Manchester

Our research has shown that the overall rate of suicide for this group is statistically no different than the rate in the general population. However, the risk of suicide in men aged 24 years and younger who had left the Armed Forces is approximately 2 to 3 times higher than the risk for the same age groups in the general population. The risk of suicide for men aged 30-59 is lower than that in the general population.

Suicide risk appeared to be greatest in the first two years following discharge but was to some extent persistent over the first six years.

The following factors appeared to increase the risk of suicide: younger age at discharge, male gender, serving in the Army (compared to the Naval Service or Royal Air Force), a short length of Service, not completing further training, being unmarried and lower rank.

47 of the 224 individuals (21%) had been in contact with services in the year before death, slightly lower than among the general suicide population (28%). The lowest likelihood of contact was in the age groups at greatest risk of suicide (14% for those under 20 years, 20% for those aged 20-24 years). Those in contact were more likely to have a history of alcohol misuse, were rated as at lower long-term risk of suicide by clinicians and were less likely to have had contact with services in the week prior to death.

Although there have been some reports of increased suicide risk in specific groups of veterans this is the first study to have systematically examined suicide risk in individuals once they leave the UK military.

How might we explain the high rate of suicide in younger individuals after they have left the Armed Forces? There are three main possibilities.

The first is that leaving the Armed Forces and the transition to civilian life may be extremely difficult for some individuals. For a minority it may result in social exclusion, homelessness, alcohol misuse, unemployment and poor mental health. Had this been the sole explanation for the increased suicide risk we might have expected to see a very high risk of suicide straight after discharge which tailed off rapidly but this was not the case.

The second explanation relates to in-Service factors - those with the highest risk of suicide after discharge may have had the most troubling experiences while serving. We did not aim to examine the role of adverse in-Service experiences in this study and so cannot draw any firm conclusions.

The third possibility is that high suicide risk is a consequence of longstanding vulnerability - so the individuals who died following discharge were vulnerable even before they joined up. The fact that we found that young, untrained individuals with short lengths of Service were at greatest risk of suicide after discharge is consistent with this possible explanation.

What might prevent suicide after individuals leave the Armed Forces? The current study cannot definitively answer this question, but certainly services need to be aware that those who leave (especially the young) may be at increased risk. Other things that could help include good practical and psychological preparation for discharge and helping people to access Health and other services once they leave.

One possibility we were unable to explore in detail in this study was the protective effect of serving in the Armed Forces. It should be borne in mind that Military Service might prevent suicide in some individuals.

Background reading:

Read the full version of this report by Navneet Kapur, David While, Nick Blatchley, Isabelle Bray, Kate Harrison

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