By C. Todd Lopez
WASHINGTON (July 06, 2010) -- Vice Chief of Staff of the Army Gen. Peter W. Chiarelli, strongly urges Soldiers to participate in a study that will help the service learn more about the causes of suicide and improve prevention efforts.
The five-year Army Study to Assess Risk and Resilience in Servicemembers -- called "Army STARRS" for short -- kicked off in 2008. The study involves a review of existing historical information the Army has, including the personnel and medical records of Soldiers who have committed suicide.
Those conducting the study now need new information that will come directly from Soldiers. That information will be gathered through questionnaires, online surveys and Soldier interviews.
Suicide is a national issue as well as an issue the Army is facing. The Army asked the National Institute of Mental Health to conduct the Army STARRS study in 2008. To gather the kind of information needed to complete the study, researchers from NIMH will need to follow Soldiers as they move through their Army careers.
Researchers will collect information from as many as 120,000 new Soldiers each year over the course of three years. To gather that information, they will interface with Soldiers in basic combat training locations at Fort Jackson, S.C.; Fort Sill, Okla. and Fort Leonard Wood, Mo., and Fort Benning, Ga.
Researchers will also interface with a representative sample of about 90,000 "combat-seasoned" active-duty Soldiers, including reserve-component Soldiers who have been mobilized.
From that second group of Soldiers, researchers will be looking for, among other things, information to help describe a Soldier's psychological and physical health, as well as history of exposure to adverse events. Those Soldiers may be asked to complete paper and pencil questionnaires, take online surveys, or participate in one-on-one interviews.
Collection of information from Soldiers will begin this summer, and it is expected that as many as 400,000 Soldiers will eventually participate.
Chiarelli said that participation in Army STARRS will be voluntary for all Soldiers. He stressed the importance of Soldiers agreeing to participate, and emphasized that participation is going to be confidential.
"Confidentiality has been a hallmark of everything we have done to put this together," Chiarelli said. "We have put in place all the safeguards you would expect to ensure a Soldier can confidently provide data to NIMH researchers and trust it will be kept in the strictest of confidence. We hope every Soldier who is approached is willing to participate in this study."
The general said results of the study may one day help a Soldier who participates -- but he guaranteed those results will one day "help out one of his buddies."
Chiarelli said the Army has placed emphasis on suicide prevention over the past two years because its suicide rate has risen to a point that now exceeds that of a demographically equivalent selection of the civilian community.
"The Army always used to fall below the Center for Disease Control's average for a population corrected to be the same as the United States Army," Chiarelli said. "But in the last three years, we've seen the numbers go up above that corrected number. And this is of great concern to us."
In recent years, the number of active duty suicides has slowly risen -- though it appears in 2010 the suicide rate has tapered off. In 2007, 115 Soldiers committed suicide; in 2008, that number jumped to 140. In 2009, the number rose again to 162. As of June 10, there have been 62 active duty suicides in the Army -- that number is lower than the 89 suicides the Army experienced at the same time last year.
While the NIMH was asked to conduct the Army STARRS study, Chiarelli said the Army is not going to wait until the study is completed to learn the results. Instead, he said, he is briefed regularly on items of interest the institute has discovered so he can apply those findings now.
Already, he said, what has been learned from the NIMH study is "paying significant dividends" and has been transmitted out to Army leadership around the globe.
"I've learned that from the instance of whatever event causes post-traumatic stress to the time individuals in the United States seek help is 12 years," Chiarelli said. "That 12 years is in itself not a good thing. What is really not a good thing are all the other potentially negative events that happen inside that 12 years, before that person even seeks help."
The general said the kinds of actions that can happen include alcohol abuse, spouse abuse, drug abuse, anger management issues, job loss and divorce.
"These are all negative behaviors that happen because a person has not sought the help they need. That's why we want Soldiers to get help as soon as possible," he said.
The general also said that Soldiers in their first year of service are at higher risk for suicide, as are Soldiers who are in some kind of transition.
"We know Soldiers who are in transition from basic training to their first unit, from their first unit to their second unit, even some senior Soldiers who make a decision to go to a professional military education course, such as the 1st Sergeants Course -- we know that's a particularly dangerous time for Soldiers," Chiarelli said. "These are the kinds of lessons learned and trends I've been able to provide to the field."
Also at risk for suicide are Soldiers on deployment.
According to researchers at the NIMH, the risk to male Soldiers for suicide occurring while deployed appears to be two to three times higher than in male Soldiers who have never deployed. Male Soldiers who have previously deployed, but who are not currently deployed, appear to have a one-and-a-half times higher risk of suicide than those who have never deployed.
The Army is looking for ways to decrease the stress on Soldiers that comes from an increased operations tempo and extended time away from family and loved ones. The Army is aiming now for a 2:1 dwell time for Soldiers. That means two years home for every one year in combat. The service isn't quite there yet, Chiarelli said, and right now the ratio is more like 1:1 for most Soldiers. But the Army is looking to make sure that dwell time is protected.
"Today, commanders have made a decision -- and they are holding out individuals who don't have 12 months of dwell," he said. "When you move from -- let's say 3rd Infantry Division to the 1st Cavalry Division, and the 1st Cav. is deploying before you have been home for a year, commanders are leaving their Soldiers behind and don't force them -- don't require them -- to go on the front end of the deployment until they have had that 12 months of dwell time."
Finally, Chiarelli said that to reduce suicides in the Army, Soldiers and commanders must work to eliminate the stigma associated with seeking help for mental health issues.
"We are starting to reduce the stigma associated with Soldiers seeking help for behavior health issues," Chiarelli said. "People are beginning to understand what traumatic brain injury and post traumatic stress is all about. Like you would for any other injury, with behavioral health issues, you need to seek help."
The Army STARRS study, conducted by the NIMH, is a "longitudinal study" patterned after a study on cardiovascular disease called the Framingham Heart Study that began in Framingham, Mass., in 1948 and continues to today.
"The Framingham study has reduced the incidents of sudden cardiovascular death in this country by over 60 percent," Chiarelli said. "What we are trying to do with Army STARRS is kind of pattern it after Framingham. To be able to come up with an algorithm possibly, that will allow us to ask a Soldier or family member questions -- not unlike your doctor asks you about your heart -- about your mental well-being, and given that information, identify people that may have issues."