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Study of Military Personnel Who Died By Suicide Finds Primary Care Physicians Key to Detecting Contributing Mental Health Issues
(New York, NY) – A study of the use of primary health care and mental health services by Israeli military personnel found that 38.3 percent of those who committed suicide contacted a primary care physician within the month before death, compared with only 27.6 percent who contacted a mental health provider during their entire military service. The study was published online in The Journal of Clinical Psychiatry on August 26, 2014.
In the past, the suicide rate in the general U.S. population has outpaced that of military personnel; but experts have seen a reverse trend over the past 10 years, with a dramatic increase in suicide rates among American servicemen and women. “The United States has struggled to understand the reason for the major increase in suicides in the Army and Marines over the past almost ten years,” said John Mann, MD, Paul Janssen Professor of Translational Neuroscience (in Psychiatry and Radiology) at Columbia University College of Physicians and Surgeons and Director of the Molecular Imaging and Neuropathology Division at the New York State Psychiatric Institute, one of the study authors and the only American contributor. “The findings from this study in the Israel Defense forces offer some clues that may help the U.S. reduce suicide rates.”
The study—which reviewed data on about 170 active-duty males in the Israel Defense Forces from 2002 to 2012 who went on to die by suicide and 500 active-duty males who did not die by suicide (controls)—evaluated the rates at which military personnel seek services from primary care physicians (PCP) and mental health providers.
While twice as many active-duty males who later died of suicide (28 percent) saw a mental health care professional within the month before death, compared with military controls (14 percent), they were even more likely to see a non-mental health professional. A prevention strategy, Dr. Mann noted, “needs to emphasize education of primary care physicians within the military to detect depressed and suicidal soldiers in order to prevent more suicides.”
Training PCPs to detect major depression and evaluate suicide risk, said Dr. Mann, “should be even more fruitful in terms of suicide prevention in civilians than in the military,” as civilians (45 percent) were more likely than military personnel (38.3 percent) to see a primary care doctor within the month before they died.
The paper is titled, “Primary Health Care Utilization Prior to Suicide: A Retrospective Case-Control Study Among Active-Duty Military Personnel.”
The other contributors are Eldar Hochman, MD, PhD; Leah Shelef, PhD; Shirly Portugese, MD; Amir Krivoy, MD; Gal Shoval, MD; Mark Weiser, MD; and Eyal Fruchter, MD.
The authors report no funding support.
The authors declare no financial or other conflicts of interest.
Columbia University Department of Psychiatry and New York State Psychiatric Institute (Columbia Psychiatry/NYSPI)
New York State Psychiatric Institute (founded in 1896) and the Columbia University Department of Psychiatry have been closely affiliated since 1925. Their co-location in a New York State facility on the NewYork-Presbyterian/Columbia University Medical Center campus provides the setting for a rich and productive collaborative relationship among scientists and physicians in a variety of disciplines. Columbia Psychiatry/NYSPI are ranked among the best departments and psychiatric research facilities in the nation and have contributed greatly to the understanding of and current treatment for psychiatric disorders. The Department and Institute are home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders and childhood psychiatric disorders. Their combined expertise provides state of the art clinical care for patients, and training for the next generation of psychiatrists and psychiatric researchers.