After nearly two decades of annual increases, the national suicide rate decreased slightly in both 2019 and 2020. Suicides among U.S. military personnel continued to rise, however, departing markedly from national trends. Reflecting the continued importance of this topic, both the Senate and the House recently held hearings focused on military suicide and the secretary of Defense convened an independent review committee to provide recommendations.
The Department of Defense (DOD), directed by Congress, has also provided an unprecedented level of funding to support research aimed to identifying, developing and testing strategies to prevent military suicides. Over the past decade and a half, our team has received some of these research funds and has published dozens of studies reporting the results of these efforts.
One clear takeaway from this coordinated scientific effort is that little to no progress in suicide prevention will be made until we directly address the central role of firearms.
Nearly 70 percent of military suicides in 2020 were caused by self-inflicted gunshot wounds — and almost all of these were from personally owned firearms. Whereas the vast majority of individuals who attempt suicide by other methods survive their attempt and then never attempt suicide again, 85 to 95 percent of those who attempt suicide with a firearm die. Although firearms may not be the reason whymost service members die by suicide, firearms are certainly howmost service members end their own life.
Decades of research show that limiting or reducing access to lethal methods of suicide, also known as “lethal means safety,” reliably, dramatically and sustainably reduces suicide rates. These approaches work in tandem with efforts to address why people want to die by suicide — things like therapy, medication or other interventions to address risks — in that they first ensure that they are less able to fatally act on those thoughts. Basically, reducing access to firearms during times of risk makes the environment safer, giving people time and space to heal. It’s akin to a designated driver making sure an intoxicated friend can’t get behind the wheel until they’re sober again.
Guided by this research, the DOD has implemented several firearm injury prevention strategies, including distribution of firearm locking devices and revising the Joint Travel Regulations to make it easier for service members to ship gun safes when changing duty stations.
The problem? The ability for DOD leaders and researchers to evaluate the impact of these strategies on suicide and to report accordingly to Congress is profoundly limited by an obscure provision buried in the 2011 National Defense Authorization Act (NDAA). The provision in Sec 1062 — intended to prohibit the unconstitutional infringement of service members’ right to lawfully acquire, possess or use firearms — has been interpreted in a way that even non-military researchers are now restricted from asking service members about firearm access and storage practices as part of DOD-funded research.
Because this prohibition extends even to anonymous survey studies funded and directed by Congress itself, the 2011 NDAA limits Congress’s own oversight capacity. Congress has directed DOD to evaluate the effectiveness of its suicide prevention programs, but it prohibits DOD and other researchers from asking about a method that accounts for the lion’s share of military suicides. This prohibition is as nonsensical as trying to prevent traffic fatalities while forbidding researchers to ask about car ownership, driving behaviors and seatbelt use.
After years of discouragingly limited impact, the DOD’s approach to suicide prevention has recently shifted due in no small part to newer, more innovative thinking and investments. Those investments mean little, however, if Congress prevents researchers and military leaders from asking even the most basic questions related to the method that contributes to nearly three-quarters of military suicides.
So, what to do? We call on Congress to repeal the language in Section 1062 of the 2011 NDAA that has inadvertently prevented researchers and DOD leaders from developing and testing strategies that could save the lives of so many service members. Should a full repeal be impossible, Congress should create exceptions for research studies that have received ethical review and approval by a registered institutional review board.
We cannot solve complicated public health problems by refusing to talk about them. The lives of our servicemembers depend upon Congress creating the space for scientists to identify and test effective solutions. Until then, our ability to prevent military suicide will be unjustifiably obstructed.
Only Congress can fix this.
Michael Anestis, Ph.D., is the executive director of the New Jersey Gun Violence Research Center, an associate professor in the School of Public Health at Rutgers University and the author of “Guns and Suicide: An American Epidemic.”
Craig Bryan, PsyD, ABPP, is an Iraq War veteran, as well as the Stress, Trauma, and Resilience (STAR) professor of psychiatry and behavioral health at The Ohio State University, and the author of “Rethinking Suicide: Why Prevention Fails, and How We Can Do Better.”
Emmy Betz, MD, MPH, is a professor of emergency medicine at the University of Colorado Medical School and the director of the Colorado University Firearm Injury Prevention Initiative.
The opinions expressed herein are those of the authors and not their employers.