51˶

What's Behind the Rise in Navy Suicides?

— 'For career servicemen, seeking help can be damaging to careers'

Last Updated December 18, 2019
MedpageToday

A suicide cluster in the U.S. Navy has brought to light a rise in overall Navy suicide rates, according to reports.

Three servicemembers stationed on the USS George H.W. Bush -- currently in dry dock in Norfolk, Virginia, for repairs -- killed themselves within days of each other. Two other suicides among crewmembers occurred since 2017.

While the Navy suicide rate was once well below general population averages, it now stands at 20.7 per 100,000 members -- a doubling since 2006, . That rate is still lower than that of the Army or Marine Corps, but the spike is troubling, experts said.

Charles Van Way III, MD, retired colonel in the U.S. Army Reserve Medical Corps and emeritus professor of surgery at the University of Missouri in Kansas City, answered 51˶'s questions about the increase and military suicide prevention efforts.

51˶: What could be contributing to these sailors' deaths?

Van Way: Three deaths in a short time, or even five deaths over 2 years, in a crew of 5,000 people is a tragedy, not a crisis. But it's a "wake-up" call. Note that the George Bush is in dry dock. Putting sailors "on the beach" is more stressful than the Navy acknowledges. It often removes the sailor from the built-in support systems that come with being on an active ship's crew.

MPT: What's behind recent increases in suicide rates among Navy personnel more generally?

Van Way: The rate has indeed gone up recently. It's still lower than the ground combat services, but it's higher than civilian rates. There are multiple factors. Increased optempo [rate of deployment], with sailors (and soldiers) becoming estranged from their families and friends on shore, is always stressful. As the example of the George Bush illustrates, the stresses come to the fore when sailors come home and have down time.

Then, while the Navy has good healthcare, mental health in the military services is always a problem. Nobody wants to admit that they're hurting, so the pressure builds up. Recognition of depression is difficult, and people don't like to seek help.

MPT: Are military members reluctant to seek help for mental health issues?

Van Way: Yes, there is reluctance to seek mental health services. For career servicemen, seeking help can be damaging to careers. And there is a self-image of toughness, which can stand in the way of admitting depression or suicidal ideas, and can allow them to become worse.

MPT: The Navy has launched efforts to prevent suicide. What else needs to be done?

Van Way: Better availability of mental health services, better screening of sailors at the unit level. Once the sailor is considering suicide, it's late in the process. It's much better to identify and treat depression at an earlier stage.

Unit (i.e., ship) health services should have more emphasis on mental health, and more resources. Mental health enlisted and professional personnel should be available to sailors, both on shore and when deployed.

Confidentiality of mental health services is difficult to maintain in the military environment. Still, efforts should be made to keep these interventions confidential.

Ultimately, this is a command responsibility, with medical personnel assisting the commander to meet the responsibility to keep the crew both physically and mentally healthy. The commander must "own" this issue.