Tuesday, September 11, 2012
A suicide prevention expert at the world-renowned Mayo Clinic has released a list of ways he believes the military can combat the epidemic of suicide within its ranks.
Mayo Clinic psychiatrist Dr. Timothy Lineberry works as a suicide expert for the U.S. Army, where the suicide rate exceeds that of the general public. Lineberry's research found that the number one reason soldiers are admitted to Army hospitals these days is for psychiatric evaluation. Lineberry says:
"Despite the anticipated end of large-scale military operations in Afghanistan and Iraq, the effects on the mental health of active-duty service members, reservists, and veterans is only just beginning to be felt.
"Moreover, the potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses."
Lineberry, in his article published in Mayo Clinic Proceedings, recommends the following four ways as a means to reduce the number of military suicides:
- Reduce access to guns and other means of suicide. Nearly 70 percent of veterans who commit suicide use a gun to do it. Veterans are more likely to own firearms. All veterans with psychiatric illness should be asked about their access to firearms and encouraged to lock up guns, giving someone else the key, or remove them from the home altogether. Just slowing down gun access by a few minutes may be enough to stop the impulse.
- Watch for sleep disturbances. Complaints of insomnia or other sleep disturbances in otherwise healthy soldiers, reservists, or veterans may signal the need for taking a careful history and screening for depression, substance misuse and post-traumatic stress disorder. Sleep disturbances have been previously identified as a risk factor for suicide. These complaints may also serve as opportunities for referring those potentially needing more intensive treatment.
- Prescribe opioid medications carefully and monitor. Unintentional overdose deaths, primarily with opioids, now outnumber traffic fatalities in many states. Individuals with psychiatric illness are overrepresented among those receiving prescriptions for opioids and those taking overdoses. This same trend has been seen in former military personnel. A recent study found that Iraq and Afghanistan veterans with a diagnosis of post-traumatic stress disorder who were prescribed opioids were significantly more likely to have opioid-related accidents and overdoses, alcohol and non-opioid drug-related accidents and overdoses, and self-inflicted and violence-related injuries.
- Improve primary care treatment for depression. Research suggests that patients who die by suicide are more likely to have visited a primary care physician than mental health specialist in the previous month. Programs developed to improve primary care physicians' recognition and treatment of depression could help lower suicide rates.