Learning from Tragedy, Part 2: Why, How Suicide Happens

This three-part series describes the Department of Defense Suicide Event Report (DoDSER) system that collects and analyzes data on U.S. military deaths by suicide, as well as data on suicide attempts. The National Center for Telehealth & Technology (T2) compiles these data into an annual report for military leadership that is available to the public. The first blog in the series described how the DoDSER system was established; this blog describes the type of data collected about military suicides and suicide attempts.

The Department of Defense Suicide Event Report (DoDSER) system collects data on military deaths by suicide, as well as any suicide attempt that results in hospitalization or evacuation from a theater of operations, regardless of service or component. This article explains the data-collection process, which collects over 500 pieces of information about a service members including:

  • Demographic background
  • Medical, mental health and substance-use history
  • Military experience
  • Characteristics about the suicide event or attempt
  • Personal and family history
  • Home, work and other stressors present prior to death

In the wake of a death by suicide, or a suicide attempt, behavioral health and command professionals begin the data-collection process at the installation where the event occurred. They review health records and job performance history, and may interview family, friends and peers of the individual (as long as it is determined that doing so will not cause additional suffering to those already grieving). In cases of attempted suicide, the service member is also typically interviewed.

All of the information gathered during this review process is input into the DoDSER system using a standardized form. This form ensures that the same information is captured across the services. Each year, the National Center for Telehealth & Technology analyzes this information and produces a large technical report called the DoDSER Annual Report. This report presents information in a meaningful and useful manner so military leadership can learn from the tragedy of suicide.

Using this report, military leadership can:

  • Review key information to help inform base policy and programming decisions.
  • Monitor the occurrence of suicide-related behavior among the U.S. armed forces annually.
  • Identify important risk factors and profiles associated with suicide.
  • Provide an unbiased source of information related to the effectiveness of Defense Department suicide-prevention priorities, policies and programs.
  • Support research into suicide prevention.
  • Guide local and national suicide-prevention program development.

These annual reports are also available to the public online. When you open a DoDSER Annual Report, you’ll see it is rather technical with lots of data tables. There are some very specific questions that the report can answer, and others that it cannot, so it’s important to understand what the report provides. The following are some of the important considerations to keep in mind.

Case Counts, Rates

The DoDSER provides a count of suicide-related deaths each year and the rates of suicide for the military as a whole, broken down by each component and service. Though the counts provide the total number for a given year, the rates provide more insight because they account for the size of the force (for each service) for that year.

Cause of Death

The report doesn’t determine the official cause of death for individual cases. Following a service member’s death, the office of the Armed Forces Medical Examiner Service conducts the official investigation into the cause of death, and officially records findings.

Risk Factors

The DoDSER provides an analysis of the frequency of certain risk factors present during an individual’s life prior to death. For example, a recent break up or divorce is a risk factor for suicide, thus the DoDSER system tracks known information about relationship problems in the 90 days prior to the individual’s death. It also tracks probable risk factors, such as working too much, ongoing military moves or deployments, transitioning out of the service, etc.

Causes of Suicide

A suicide event often includes several complex factors. It’s unlikely that a case will only have a single factor or event. Usually, complex interactions between an individual’s history, current environment, genetics and biology all contribute to these tragic events. The purpose of the DoDSER system is to monitor risk factors, rates and profiles associated with suicide as closely as possible to address red flags early. However, the system is not designed to identify potential causes of suicide.

In the third and final blog of this series, I’ll highlight more considerations to keep in mind when analyzing suicide data.

If you, or someone you know, have thoughts of suicide, please reach out for help immediately:

  • Dial 9-1-1 or go to your closest emergency room.
  • Call the Military Crisis Line at 800-273-8255. If you are a service member or veteran, Press 1 to talk to someone who has served.
  • Start a confidential online chat session at http://www.VeteransCrisisLine.net/chat.
  • Send a text message to 838255 to connect to a VA responder.
  • If you are deaf or hard of hearing, you can connect through chat, text or TTY.

Larry Pruitt, Ph.D. is a licensed clinical psychologist and the program supervisor for the DoD Suicide Event Report (DoDSER) program at the National Center for Telehealth & Technology (T2)

The views expressed are those of the author and do not reflect the official policy or position of the National Center for Telehealth & Technology, the Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury, the Department of Defense or the U.S. Government.

 

Read other posts by Dr. Larry Pruitt