EXPERT ANALYSIS AT Institute on Psychiatric Services
WASHINGTON (FRONTLINE MEDICAL NEWS) – Women service personnel face different suicide risks from their civilian counterparts, according to a Department of Defense appointee.
Data are few about suicide among women in the military – in part because not much research has been conducted over the years into service women’s health outcomes – according to Jacqueline Garrick , but insights gleaned from the reports of military women, both active duty and veterans, who survived suicide attempts, shed light on what to look for as risk factors. Ms. Garrick, acting director of the defense suicide prevention office in the Department of Defense, made her comments during a panel discussion at the American Psychiatric Association’s Institute on Psychiatric Services.
One of the most salient of suicide risks can emerge when a service woman’s intimate relationship ends. This loss is compounded by the absence of social support that results from the military’s inherently masculine environment where “fitting in is definitely harder for women,” according to Ms. Garrick, a licensed clinical social worker, U.S. Army veteran, and policy analyst.
Deployment and combat zone traumas, whether physical, mental, or both, are other risk factors. Horrors witnessed in war can have psychological implications for men and women personnel. But for women, who also possibly face additional concerns of sexual assault and lack of social support, the traumas can become debilitating and lead to risk of suicide, Ms. Garrick said.
Women in the military overlap with civilians in their suicide risk factors where mental health history, abuse, and exposure to suicide are concerned, but where the two cohorts particularly diverge, Ms. Garrick said, is access to lethal means, particularly among women veterans. Civilian women who attempt suicide are more likely to cut themselves or overdose on drugs, whereas, “Military women have firearms, and they know how to use them,” Ms. Garrick said. “So, if you’re screening [for suicide in this population], pay close attention to whether there are weapons in the home.”
Traumatic brain injury is another area in which risks for suicide in military women could exist, but not enough is known at this point, Ms. Garrick said.
A suicide risk intervention called “safety planning” is one that Ms. Garrick said she has been developing in her work with the DOD. This includes asking these women what makes them feel “safe” at home, determining what their families know about the whereabouts and the safety features of their firearms, and learning what level of peer support exists for them and how to build it if it is lacking. Building resilience is another area, including finding military women opportunities to use their experiences in positive ways, such as through mentoring others.
For more information on suicide prevention for these women, Ms. Garrick referred clinicians to the suicide risk assessment and prevention clinical guidelines issued by the DOD and the Department of Veterans Affairs.
For patients at acute risk, Ms. Garrick said, “I recommend sitting with them as you watch them put this number into their phone: 800-273-8255. That’s the lifeline number that will connect you directly with the VA if you press 1.”
Because there has been a historic lack of interest on behalf of the military in women’s health outcomes related to their service compared with that of men, there is a need to create a database going forward to better inform DOD health and disability policies for women in the military, Ms. Garrick said. This places the onus on psychiatrists who evaluate this cohort to “tease out any potential psychological stressors that might not be obvious from their personnel file.” Some women have been exposed to the same levels of traumatic combat experiences as their male colleagues, even though it wasn’t until earlier this year that women became eligible for the same combat roles as men.
“If you look in their files, they might not have the same awards and titles as men, but they might have seen the same people being killed or the same number of dead bodies,” she said.
Ms. Garrick’s views are her own and do not represent those of the Department of Defense.
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