Suicidal behaviors among active-duty U.S. service members: data from the 2018 Health Related Behaviors Survey

Background: From 2006–2021, suicide was the second leading cause of death among U.S. active-duty military service members (SMs). This study aimed to determine the prevalence of past-year suicidal ideation (SI) and attempts (SA) among active-duty SMs; to determine whether differences exist by age, sex, and race; and to assess whether prevalence estimates vary by risk profiles of mental health conditions and substance use. Method Data were from the 2018 Health-Related Behaviors Survey (HRBS), a cross-sectional survey of active-duty SMs (n = 17,166). We used the logistic model to identify factors of SI and SA and latent class analysis (LCA) to identify the risk profiles. RESULTS Among active duty SMs, 8.26% had SI and 1.25% had SA in the past year. Among SMs with past-year SI, 14.19% attempted suicide. Mental health conditions were associated with higher odds of SI and SA, as were younger ages; LGB identity; being separated, divorced, or widowed; use of e-cigarettes, dual use of e-cigarettes and cigarettes, or drugs; and history of deployment of less than 12 months. The LCA identified patterns of SI and SA according to illegal drug use, tobacco use, alcohol use, and mental health risk profiles. Conclusions Despite the resources and increased access provided for mental health support, the prevalence of SI among active-duty SMs is greater than in the general population of the same age, likely due to additional military exposures and stressors. This study highlights the need for intensive interventions to detect, mitigate and prevent suicidal behaviors, particularly among those with higher risk profiles.