Reforming the military up-and-out personnel system, guaranteeing pay and reimbursements for troops and limiting access of younger service members to firearms top a list of recommendations from an independent group of researchers tasked to help reduce suicides in the Department of Defense that were released Friday.
The Suicide Prevention and Response Independent Review Committee released its final report, containing 127 recommendations, of which 23 received high prioritization, for reducing suicide in the military. Among the recommendations are several involving owning firearms and reforms to the military’s promotion system, researchers told reporters on Friday.
While the panel recommended a wide swath of reforms, the researchers keyed on reducing easy access to firearms for those at risk for suicide as the most productive action the military could take in the short term.
“When we look at the science of suicide prevention, there’s arguably only one thing that all researchers agree on,” Craig Bryan, a psychiatry professor at the Ohio State University and an Air Force veteran, told reporters during a press call ahead of the report’s release Friday.
“And that one thing is that taking steps to slow down convenient access to highly lethal methods, like firearms, is the single most effective strategy for saving lives.”
The panel singled out death by firearm in their research as to its level of lethality compared to other methods like a drug overdose.
“And so this was a common refrain in our site visits was that the military personnel wanted to encourage a culture of secure firearm storage and also to reduce convenient access to firearm acquisition, especially for those who are in acutely elevated distress,” Bryan said.
SPRIRC recommended raising the minimum purchase age for firearms and ammunition to 25 on Department of Defense properties.
Looking at military suicide statistics, about half of suicides are among service members who are between 17 and 25 years old, he said. Targeting that age group is one way to reduce suicides. Between the firearms and suicide statistics, 25 was the best age to recommend as the earliest someone could purchase a firearm at an on-base exchange, he said.
“Once we were looking at those data, it was really striking that somewhere around the age of 21 is sort of this turning point where servicemembers start using guns to kill themselves,” Bryan said.
The DOD’s annual suicide report for 2022 found that the highest percentage of suicides in the Navy were among sailors between 21 and 24 years old, with the next highest percentage between those 25 to 29 years old, USNI News previously reported.
In addition to raising the age to buy firearms at on-base exchanges, the report also calls for a seven-day waiting period between when someone buys a gun and when they can pick it up, with a four-day waiting period between purchasing and receiving ammunition.
The report also includes a recommendation that Congress overturn a law put in place by the National Defense Authorization Act that prevents DoD records of gun ownership by military or civilian government employees. Repealing the law would allow leaders to know who might be more at high risk for suicide, Bryan said.
Another recommendation in the report focuses on the up-or-out mentality of the military. Not everyone wants to be a leader, according to the report, which can lead to people who are underqualified or not prepared for leadership roles.
“These norms often cause significant relationship strain, which in 2021 was documented in almost half of military suicides,” according to the report. “Some military personnel also described feeling ‘trapped’ by these decisions, resulting in significant emotional distress.”
The committee recommended three overarching changes: creating a task force to look at promotion, eliminating bureaucracy around hiring and centralizing suicide prevention activities.
“The DoD’s complex and rigid hierarchical structure impedes its ability to implement effective suicide prevention strategies and quickly adapt to ensure readiness,” according to slides the committee provided to reporters Friday.
The committee also called for a better system to handle military payments, such as a backlog of travel expenses. Delays in payment can lead to financial stress, which in turn leads to increased risk of suicide.
The goal with standardizing suicide prevention activities is to make it so everyone in the military receives the same training, whether the person is a soldier or sailor. It would still allow for local innovation, said Jerry Reed, a social worker on the committee.
The training needs to be modernized, said Rajeev Ramchand, co-director of the RAND Epstein Family Veterans Policy Research Institute. Suicide prevention training is typically done in conjunction with other training.
People tend to fall asleep or be on their phones, Ramchand said. While people in the military want more prevention taught, it feels like it is done as a “check the block” approach. It also is too general, he said.
“So for example, a junior enlisted service member may need a training to focus on recognizing their own signs of distress, healthy habits, knowing what resources are available on the installation,” he said. “A more senior leader on the other hand, might need some more education and training as to how to identify those at risk of suicide, how to help them how to communicate with them, how to escort them to the resources that may help.”
The Department of Defense needs more access to mental health services, which includes being able to staff clinical positions, said Rebecca Blais, a professor at Arizona State University.
Service members could go up to six weeks in between appointments, Blais said. To add to the difficulties, it could take up to a year to hire for necessary mental health positions, she added.
Other recommendations include creating a billet for a care manager and better TRICARE reimbursement, which would allow service members to seek mental health services outside of DOD installations.
Suicide has been an ongoing problem for the military as a whole. While 2021 saw the lowest suicide rate in five years, it is still continuing to trend up since 2011, USNI News previously reported.
The Navy’s suicide rate in 2021, the most recent year for data, was 16.7 deaths per 100,000, or 58 deaths.
This does not include three suicides among sailors assigned to USS George Washington (CVN-73), as those deaths happened in 2022. An investigation into the suicides, which all happened in April, found there were no connections between the individual deaths.
However, the report highlighted an overwhelmed mental health system aboard George Washington. A separate report on mental health in the Navy is set to be released later this year.
Suicide Prevention Resources
National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)
Military Crisis Line: 1-800-273-8255
The Navy Suicide Prevention Handbook is a guide designed to be a reference for policy requirements, program guidance, and educational tools for commands. The handbook is organized to support fundamental command Suicide Prevention Program efforts in Training, Intervention, Response, and Reporting.
The 1 Small ACT Toolkit helps sailors foster a command climate that supports psychological health. The toolkit includes suggestions for assisting sailors in staying mission ready, recognizing warning signs of increased suicide risk in oneself or others, and taking action to promote safety.
The Lifelink Monthly Newsletter provides recommendations for sailors and families, including how to help survivors of suicide loss and to practice self-care.
The Navy Operational Stress Control Blog “NavStress” provides sailors with content promoting stress navigation and suicide prevention.