Demographic and Occupational Risk Factors Associated With Suicide-Related Aeromedical Evacuation Among Deployed US Military Service Members

被引:5
作者
Straud, Casey L. [1 ,2 ]
Moore, Brian A. [1 ]
Hale, Willie J. [1 ,2 ]
Baker, Monty [3 ]
Gardner, Cubby L. [3 ]
Shinn, Antoinette M. [3 ]
Cigrang, Jeffrey A. [4 ]
Litz, Brett T. [5 ,6 ,7 ]
Mintz, Jim [1 ]
Lara-Ruiz, Jose M. [1 ]
Young-McCaughan, Stacey [1 ]
Peterson, Alan L. [1 ,2 ,8 ]
机构
[1] Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat & Behav Sci, 7550 Interstate Highway 10 West,Suite 1325, San Antonio, TX 78229 USA
[2] Univ Texas San Antonio, Dept Psychol, One UTSA Circle, San Antonio, TX 78249 USA
[3] Wilford Hall Ambulatory Surg Ctr, JBSA Lackland, 2200 Bergquist Dr, San Antonio, TX 78236 USA
[4] Wright State Univ, Sch Profess Psychol, 3640 Colonel Glenn Hwy, Dayton, OH 45435 USA
[5] VA Boston Healthcare Syst, Massachusetts Vet Epidemiol Res & Informat Ctr, 150 South Huntington Ave, Boston, MA 02130 USA
[6] Boston Univ, Dept Psychiat, Sch Med, 720 Harrison Ave, Boston, MA 02118 USA
[7] Boston Univ, Dept Psychol & Brain Sci, 64 Cummington Mall, Boston, MA 02215 USA
[8] South Texas Vet Hlth Care Syst, Off Res & Dev, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA
关键词
OPERATION-IRAQI-FREEDOM; MENTAL-HEALTH PROBLEMS; ENDURING FREEDOM; COMBAT; ARMY; DUTY; AFGHANISTAN; DIAGNOSES; PERSONNEL; IDEATION;
D O I
10.1093/milmed/usaa201
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Suicide is a significant problem in the U.S. military, with rates surpassing the U.S. general population as of 2008. Although there have been significant advances regarding suicide risk factors among U.S. military service members and veterans, there is little research about risk factors associated with suicide that could be potentially identified in theater. One salient study group consists of service members who receive a psychiatric aeromedical evacuation out of theater. The primary aims of this study were as follows: (1) determine the incidence of suicide-related aeromedical evacuation in deployed service members, (2) identify demographic and military characteristics associated with suiciderelated aeromedical evacuation, and (3) evaluate the relationship between suicide-related aeromedical evacuation from a deployed setting and military separation. Materials and Methods Thiswas an archival analysis of U.S. Transportation Command Regulating and Command and Control Evacuation System and Defense Manpower Data Center electronic records of U.S. military service members (N = 7023) who were deployed to Iraq or Afghanistan and received a psychiatric aeromedical evacuation out of theater between 2001 and 2013. chi(2) tests of independence and standardized residuals were used to identify cells with observed frequencies and proportions, respectively, that significantly differed from what would be expected by chance. In addition, odds ratios were calculated to provide context about the nature of any significant relationships. Results For every 1000 psychiatric aeromedical evacuations that occurred between 2001 and 2013, 34.4 were suicide related. Gender, ethnicity, branch of service, occupation classification, and deployment theater were associated with suiciderelated aeromedical evacuation (odds ratios ranged from 1.37 to 3.02). Overall, 53% of all service members who received an aeromedical evacuation for any psychiatric condition had been separated from the military for a variety of reasons (both voluntary and involuntary) upon record review in 2015. Suicide-related aeromedical evacuation was associated with a 37% increased risk of military separation compared to evacuation for another psychiatric condition (P < 0.02). Conclusions Findings provide novel information on risk factors associated with suicide-related aeromedical evacuation as well as military separation following a suicide-related aeromedical evacuation. In many cases, the psychiatric aeromedical evacuation of a service member for suicidal ideations and their subsequent separation from active duty is in the best interest of the individual and the military. However, the evacuation and eventual military separation can be costly for the military and the service member. Consequently, the military should focus on indicated prevention interventions for individuals who show sufficient early signs of crisis and functional problems so that specialized interventions can be used in theater to prevent evacuation. Indicated prevention interventions should start with leaders' awareness and mitigation of risk and, when feasible, evidence-based interventions for suicide risk provided by behavioral health (eg, brief cognitive behavioral therapy for suicide). Future research should evaluate the feasibility, safety, and efficacy of delivering suiciderelated interventions in theater.
引用
收藏
页码:E1968 / E1976
页数:9
相关论文
共 43 条
[1]   Association of Child Abuse Exposure With Suicidal Ideation, Suicide Plans, and Suicide Attempts in Military Personnel and the General Population in Canada [J].
Afifi, Tracie O. ;
Taillieu, Tamara ;
Zamorski, Mark A. ;
Turner, Sarah ;
Cheung, Kristene ;
Sareen, Jitender .
JAMA PSYCHIATRY, 2016, 73 (03) :229-238
[2]   Means and capacity for suicidal behavior: A comparison of the ratio of suicide attempts and deaths by suicide in the US military and general population [J].
Anestis, Michael D. ;
Bryan, Craig J. .
JOURNAL OF AFFECTIVE DISORDERS, 2013, 148 (01) :42-47
[3]   Prevalence and Risk Factors Associated With Suicides of Army Soldiers 2001-2009 [J].
Black, Sandra A. ;
Gallaway, M. Shayne ;
Bell, Michael R. ;
Ritchie, Elspeth C. .
MILITARY PSYCHOLOGY, 2011, 23 (04) :433-451
[4]  
Bryan A.O., 2014, TRAUMATOLOGY, V20, P154, DOI [10.1037/h0099852, DOI 10.1037/H0099852]
[5]   Suicides and Suicide Attempts in the US Military, 2008-2010 [J].
Bush, Nigel E. ;
Reger, Mark A. ;
Luxton, David D. ;
Skopp, Nancy A. ;
Kinn, Julie ;
Smolenski, Derek ;
Gahm, Gregory A. .
SUICIDE AND LIFE-THREATENING BEHAVIOR, 2013, 43 (03) :262-273
[6]  
Centers for Disease Control and Prevention
[7]  
National Center for Injury Prevention and Control, 2019, WEB BAS INJ STAT QUE
[8]   Predictors of Suicidal Ideation Across Deployment: A Prospective Study [J].
Cigrang, Jeffrey A. ;
Balderrama-Durbin, Christina ;
Snyder, Douglas K. ;
Talcott, G. Wayne ;
Tatum, JoLyn ;
Baker, Monty ;
Cassidy, Daniel ;
Sonnek, Scott ;
Slep, Amy M. Smith ;
Heyman, Richard E. .
JOURNAL OF CLINICAL PSYCHOLOGY, 2015, 71 (09) :828-842
[9]   Diagnoses and factors associated with medical evacuation and return to duty for service members participating in Operation Iraqi Freedom or Operation Enduring Freedom: a prospective cohort study [J].
Cohen, Steven P. ;
Brown, Charlie ;
Kurihara, Connie ;
Plunkett, Anthony ;
Nguyen, Conner ;
Strassels, Scott A. .
LANCET, 2010, 375 (9711) :301-309
[10]   Association of Firearm Ownership, Use, Accessibility, and Storage Practices With Suicide Risk Among US Army Soldiers [J].
Dempsey, Catherine L. ;
Benedek, David M. ;
Zuromski, Kelly L. ;
Riggs-Donovan, Charlotte ;
Ng, Tsz Hin H. ;
Nock, Matthew K. ;
Kessler, Ronald C. ;
Ursano, Robert J. .
JAMA NETWORK OPEN, 2019, 2 (06) :e195383