Every death by suicide is an unnerving tragedy. This is why the U.S. Department of Defense (DOD) is taking a comprehensive public health approach to save lives through widespread education and evidence-based prevention practices in the face of one of the military's—and the nation's—most vexing public health crises.
There is no simple reason why anyone, including a Service member, takes their own life. As with civilians, military personnel and their families are not immune from life's daily challenges. Also, there is no single solution to preventing suicide in our U.S. population or across the military. We recognize the complex interplay of risk and protective factors and take a bundled approach to prevention that focuses on reducing suicide risk for Service members and their families. We agree that service-related challenges can play a role in Service members' and their families' circumstances—exposure to the battlefield may result in traumatic injuries compounding stressors, for example. But this doesn't tell the whole story. The complexity extends to social and environmental factors: relationship and financial challenges, substance abuse, or legal issues, can also contribute to a downward spiral and thoughts of suicide.
A focus on lethal means safety is one centerpiece in DOD's suicide prevention efforts. Lethal means are objects (e.g., firearms, medications, sharp objects) that can be used to engage in suicidal behavior. Adding safety measures to lethal means includes the use of safe storage options such as cable locks, locked safes, and other protective measures such as readily available medication lock boxes. Lethal means safe storage is an evidence-based part of a comprehensive suicide prevention strategy; it also includes safe medication prescribing practices and safety counseling to reduce the risk of suicide by limiting access to all lethal means.
The DOD Calendar Year 2020 Annual Suicide Report showed that firearms were the primary method of suicide death for Service members (approximately 70% across DOD) and for more than half of our military family members. Research tells us that while owning a firearm does not cause someone to be suicidal, storing a loaded firearm at home increases risk for dying by suicide for everyone in that household. Likewise, our data shows us that medications are the leading method for suicide attempts. This is a primary reason why our education and communications put a spotlight on the vital details of safe storage, personally-owned firearms, and medications.
Prolonged stress, coupled with the stigma of seeking help and support, can also characterize aspects of military family life. At the same time, DOD and national research clearly indicates that protective factors such as social connectedness and feelings of belongingness are buffers against suicide risk.
Traditional military culture and the premium it places on self-reliance also plays a role; prevailing attitudes often work against those in the military and their families in getting help for mental health conditions or other life challenges. And though receding, stigma can still reinforce Service members going it alone, with fear of negative career impacts as a concern.
In 2020, suicide was among the top ten leading causes of death in the country among Americans 10-64 years old, and the second leading cause of death for people ages 10 to 34, according to the Centers for Disease Control and Prevention. And according to key findings from the DOD 2020 Annual Suicide Report, the suicide rate statistically increased from CY 2015 to CY 2020 (i.e., 20.3 to 28.7 suicides per 100,000 Service members) among Active Component Service members.
Statistics tell a story, no doubt. But research also confirms the potent and mitigating effects of lethal means safety. This safety precaution shows that adding safe storage practices to lethal means such as firearms and medications are one of the most effective ways to reduce suicide and protect people.
Research also shows it can take less than 10 minutes between thinking about suicide to acting on it. Here too, broader context is vital. For many people, thoughts of suicide and the desire to take steps to end one's life come on quickly and intensely. But, like a wave, these thoughts also tend to subside and reduce in intensity just as quickly. Safe storage practices increase the time it takes for a person experiencing suicidal thoughts to access a lethal item. And in this precious time the desire to die may wane, the person may be reminded of reasons to live, or someone else may be able to intervene, resulting in a life saved. Nonetheless, adding measures that build in additional safeguards between someone who may be at risk for suicide, and a method for suicide such as firearms or medications, is the DOD's aim.
Safe storage for firearms requires a locking device that creates a barrier to unauthorized access or use, separation of firearms and ammunition when not in use, or storage in a secure, locked box. Cable locks, for instance, prevent a firearm from being loaded and fired; a gun case enables secure and concealed firearm storage. Equally useful are full-size gun safes for reliable protection. The same is true for medications. To prevent overdose, medications such as opioids should be stored under lock and key, with medication lockboxes available at most pharmacies. Given that every second counts in suicide prevention, safely storing personally-owned firearms and medications can give someone an extra moment to have a change of heart about suicide.
To prevent firearm-related suicide, DOD takes a multi-pronged approach, working with military leaders at all levels, military communities, military/veteran serving organizations, and firearm retailers, to raise awareness about safe storage options to promote safety in the home. Our efforts also extend to align with the U.S. Department of Veterans Affairs (VA) on lethal means safety for both veterans and Service members: Safe storage options are effective in preventing suicides and protecting others from accidents in the home. If not for yourself, then practice safe storage so others cannot readily access your firearm without your knowledge. Unload it, lock it, and/or store it away. Bottom line – Stop, Lock, and Live.
There are actions every individual can take to assist, especially during a crisis: if someone you know is feeling overwhelmed or have thoughts about suicide, check on them and don't be afraid to ask if they own or have access to lethal means, such as firearms or medications. If so, ask if they would allow you to safely store those lethal means (e.g., a firearm or medications) for them during a challenging time. As indicated, one of the most effective ways to save a life is to put time and distance between someone who is feeling overwhelmed and a method of suicide. Someone at risk may not ask for help, but reaching out to them and offering support can make a world of difference. We all can take small steps to help by checking in on people to offer assistance.
Through education, initiatives such as our new suite of lethal means safety suite of tools and Leaders Suicide Prevention Safe Messaging Guide, and programs tailored for various needs, DOD has expanded support services to military members and their families. For example, Military OneSource, provides resources and support at no cost to our Active Component, Reserve, and National Guard Service members, and their families anywhere in the world, including non-medical counseling such as relationship and family therapy, youth programs, financial or legal assistance, and connects Service members and family to Chaplains in their local area. Military OneSource is available 24 hours a day, seven days a week. Connecting with resources such as Military OneSource can help lift burdens and prevent challenges from becoming overwhelming.
It would be difficult to overstate the priority placed by DOD on suicide prevention for our Service members, veterans, and families. The aim is to positively impact individual beliefs and behaviors as we continue to reduce stigma and instill systemic cultural change that encourages hope and seeking help. Collaborations, strong agency interconnections, as well as community are keys to prevention. We cannot do this alone. We need your help because suicide is preventable and simple actions such as safely storing your firearm or medication can save lives. We encourage our military and veteran communities to stay attuned to important signs both in person and online. Our website's social media links are inclusive of our "Simple Things Save Lives" video that details how to approach and talk with people who are vulnerable and, where appropriate, guide them to resources and assistance—because it can make a difference. Every death by suicide is a devastating loss, which is generally preventable with simple actions.
Service members and veterans who are in crisis or having thoughts of suicide, and those who know a Service member or veteran in crisis, can call the Veterans/Military Crisis Line for confidential support available 24 hours a day, seven days a week, 365 days a year. Call 1-800-273-8255 and Press 1, text to 838255, or chat online at VeteransCrisisLine.net/Chat.
Because suicide is a public health issue and scientific research indicates that certain types of reporting can negatively impact vulnerable individuals, reporters covering this topic can visit ReportingOnSuicide.org for important resources on communicating about suicide.
