The estimated cost of this report or study for the Department of Defense is approximately 

$51,000 for the 2017 Fiscal Year. This includes $1,000 in expenses and $50,000 in DoD labor. 

Generated on 2017Jun27 RefID: 0-A2345E0 

 

 

 

 

Calendar Year 2016 Annual Report

Acknowledgements 

The Department of Defense Suicide Event Report (DoDSER) system collects and reports data on 

every case of suicide and every medically identified suicide attempt among members of the 

United States Armed Forces worldwide. A project of this scope is not possible without the 

cooperation and collaborative efforts of many partner agencies.

We would like to offer our sincere gratitude to the Services’ Suicide Prevention Program

Managers, the Services’ DoDSER Program Managers, the Armed Forces Medical Examiner 

System), the Defense Manpower Data Center, and the Sexual Assault Prevention and Response 

Office for their collaborative efforts, time, and understanding of the important goals of the 

DoDSER mission. 

We would also like to recognize the efforts of the Department of Defense’s Suicide Prevention 

and Risk Reduction Committee, chaired by the Defense Suicide Prevention Office, who actively 

works toward translating the information contained within this annual report into suicide 

prevention programs and strategies. 

This year, in particular, we would like to thank all of the medical, behavioral health, and 

command contacts at Military Treatment Facilities, field operations, and installations for their 

ongoing efforts to collect and input accurate data for the DoDSER system. The data quality 

contributions from these individuals made this report possible.

ii 
 

 

 

 

Calendar Year 2016 Annual Report

Table of Contents 

ACKNOWLEDGEMENTS......................................................................................... ii 

EXECUTIVE SUMMARY.......................................................................................... iv 

PREFACE......................................................................................................... 1

CHAPTER 1: MISSION AND METHODOLOGY................................................................ 4

CHAPTER 2: MILITARY SUICIDE RATES..................................................................... 19 

CHAPTER 3: JOINT RESULTS SUMMARY.................................................................... 47 

CHAPTER 4: FINDINGS – U.S. AIR FORCE.................................................................. 63 

CHAPTER 5: FINDINGS – U.S. ARMY........................................................................ 78 

CHAPTER 6: FINDINGS – U.S. MARINE CORPS............................................................ 93 

CHAPTER 7: FINDINGS – U.S. NAVY......................................................................... 108 

CHAPTER 8: FINDINGS – SELECTED RESERVE............................................................ 123 

APPENDIX A: PROPORTIONATE MORTALITY ANALYSIS................................................... 126 

APPENDIX B: GLOSSARY....................................................................................... 135 

APPENDIX C: ACRONYMS...................................................................................... 140 

APPENDIX D: LIST OF TABLES AND FIGURES............................................................... 142 

APPENDIX E: FEEDBACK....................................................................................... 150 

If you, a family member, friend, peer, subordinate, or others are experiencing thoughts of 

suicide, please reach out for help immediately.

Dial 1-800-273-8255. 

If you are a Service member or veteran, then press 1 to talk to a qualified VA responder.

 Start a confidential online chat session at www.VeteransCrisisLine.net/chat 

 Send a text message to 838255 to connect to a VA responder

 If you are deaf or hard of hearing, you can connect through chat, text, or TTY 

Call or text 844-357-PEER (7337) to contact 

DoD BeThere Peer Support Call and Outreach Center.

We've been there. Now, we're here for you. 

iii
 

Calendar Year 2016 Annual Report

Executive Summary 

This report presents data from the United States (U.S.) Armed Forces on suicide mortality and on 

the incidence of attempted suicide between January 1, 2016 and December 31, 2016 (CY 2016). 

Each year the U.S. Air Force, Army, Marine Corps, and Navy must conduct an extensive datacollection effort—known as the Department of Defense Suicide Event Report (DoDSER)—

following all suicide-related deaths and identified suicide attempts. This requirement applies to 

both the Active and Reserve Components, including the National Guard. For CY 2016, only 

data from members of the Reserve Component who were in a duty status at the time of the event 

were required to be submitted via the DoDSER survey.

The DoDSER annual report presents the information collected by the Services, provides official 

suicide rates, and describes the risk and contextual factors associated with instances of suiciderelated behavior for its given calendar year. Each report serves as an independent and 

quantitative summary and review upon which DoD leadership can base policy, programming 

strategy, and decisions. 

Suicide Mortality Rates

The CY 2016 suicide mortality rate for the Active Component, combined across all Services, was 

21.1 deaths per every 100,000 Active Duty Service members. This rate was consistent with 

the three-year average suicide mortality rate for CY 2013–2015. Overall, there was no 

evidence of a change in this combined suicide mortality rate since CY 2011, the first year 

with comparable data available for trend analysis. 

The CY 2016 suicide mortality rates for the Active Component of each Service were consistent 

with the expected rates from the three-year average suicide-mortality rates for CY 2013–2015. 

The data for the suicide mortality rate for the Active Component Army, Marine Corps, and Navy 

did not show evidence of a change since CY 2011; in contrast, the Active Component Air Force 

suicide-mortality rate has increased incrementally since CY 2011. 

The CY 2016 suicide mortality rate for the Reserve Component, combined across all Services 

and regardless of duty status, was 22.0 deaths per 100,000 reservists. The CY 2016 suicide 

mortality rate for the National Guard Component, combined across the Air and Army Guard and 

regardless of duty status, was 27.3 deaths per 100,000 members of the Guard population. Both 

rates (each calculated separately) were consistent with the three-year average suicide 

mortality rates for CY 2013–2015. There was no evidence of an incremental change in the 

suicide mortality rate for either group since CY 2011. 

Comparison to the U.S. General Population 

The CY 2015 suicide mortality rate for the U.S. general population, aged 17–59, provides a 

guide for the mortality rate expected in the military population. As of the writing of this report, 

the U.S. rate was 17.3 per 100,000 members of the general population. After accounting for 

iv
Executive Summary Calendar Year 2016 Annual Report

differences in the age and sex distributions between the U.S. general population and the military 

populations, the adjusted suicide mortality rate for the Active Component, all Services—

17.0 deaths per 100,000 population members—was consistent with the rate for the U.S 

general population. The adjusted suicide mortality rate for the Reserve Component, all 

Services—17.6 deaths per 100,000 population members—was also consistent with the rate for

the U.S. general population. However, the adjusted suicide-mortality rate for the Guard 

Component, combined across the Air and Army Guard—21.8 deaths per 100,000 population 

members—was higher than the rate for the U.S. general population. 

Contextual Factors

The contextual data collected in the DoDSER system revealed that firearms were the most 

common method of injury among suicide decedents in CY 2016 and that the majority of suicide 

decedents had no known behavioral health history. Overall, the proportion of decedents in CY

2016 with behavioral health risk factors or stressors observed prior to death was consistent 

with the three-year average for CY 2013–2015. 

This contextual data also revealed that drug and/or alcohol overdose was the most common 

method of injury among suicide attempt cases and that the majority of cases had a known 

behavioral health history. Overall, the proportion of cases with behavioral health risk 

factors or stressors prior to death was consistent with the three-year average of CY 2013 – 

2015. 

Conclusion 

The rates and risk factors associated with suicide in CY 2016 were consistent with those 

identified in previous years: this report reveals no change in the DoD’s rate of suicide. The 

characteristics and risk factors associated with those deaths have remained stable.

Important Note 

Staff assigned to the National Center for Telehealth and Technology (T2) initially prepared this 

document and began coordinating a draft for public release on July 27, 2017. While the 

document in coordination, the staff and responsibilities associated with the DoDSER program

transitioned to the Psychological Health Center for Excellence (PHCoE) under the Research 

Directorate (J-9) of the Defense Health Agency (DHA). PHCoE now has responsibility for 

oversight of the DoDSER program as well as the content of this report. 

v
 

1 

Preface 
Preface Calendar Year 2016 Annual Report

Preface

The Department of Defense Suicide Event Report 

The Department of Defense Suicide Event Report (DoDSER) has three primary components: 

 A web-based system for collecting case-level data about suicide-related behavior among 

members of the Armed Forces, accessible at https://dodser.t2.health.mil/ 

 A data-collection survey instrument that guides contacts on military installations about 

which data elements to collect, assess, and enter into the system

 An annual report of findings generated from the data-collection effort 

To distinguish among these components, “system,” “survey,” or “annual report” appears after the 

DoDSER acronym as appropriate throughout this report. 

Guiding Questions 

Each year, two important questions guide the development of the DoDSER Annual Report: 

 What is the rate of suicide among Service members? 

 How common are various known or suspected determinants of suicide among those 

Service members who engaged in suicide-related behavior during the past year? 

To answer the first question, the DoDSER team uses all suicide cases determined by the Armed 

Forces Medical Examiner System (AFMES)—with input from the four Service branches for the 

Active Component and the Selected Reserve (SELRES) populations—to determine suicide rates 

for the total military population, regardless of duty status at the time of death. To answer the 

second question, the DoDSER team uses data on specific risk factors reported directly to the 

DoDSER system to describe their prevalence in the cases. 

CY 2016 required DoDSER submissions on all Active Component Service members who died 

by suicide and all members of the SELRES who died by suicide while in a duty status. This 

combination precludes direct comparison between the total number of deaths described in the 

DoDSER-specific data and the number of Active Component suicides in the rate calculation. 

The mission of suicide prevention within the Department of Defense (DoD) falls to the Defense 

Suicide Prevention Office (DSPO) and the Psychological Health Center of Excellence (PHCoE). 

The DoDSER Annual Report is a product of PHCoE and the Defense Health Agency. 

The National Center for Telehealth and Technology completed and submitted the report draft for 

external review on July 27, 2017. The final draft of the report was approved for public release 

on July 2, 2018. 

2 
Preface Calendar Year 2016 Annual Report

Prepared by 

Larry D. Pruitt, Ph.D. 

Psychological Health Center of Excellence 

Defense Health Agency, Research and Development 

Derek J. Smolenski, Ph.D., M.P.H. 

Psychological Health Center of Excellence 

Defense Health Agency, Research and Development 

Nigel E. Bush, Ph.D. 

Psychological Health Center of Excellence 

Defense Health Agency, Research and Development 

Nancy A. Skopp, Ph.D. 

Psychological Health Center of Excellence 

Defense Health Agency, Research and Development 

Amanda Edwards-Stewart, Ph.D., ABPP 

Psychological Health Center of Excellence 

Defense Health Agency, Research and Development 

Timothy V. Hoyt, Ph.D. 

Psychological Health Center of Excellence 

Defense Health Agency, Healthcare Operations 

3 
 

CHAPTER 1 

Mission 

and 

Methodology 

4 
Methodology Calendar Year 2016 Annual Report

Introduction 

Before its disestablishment in 2017, the National Center for Telehealth and Technology, a branch 

of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, was 

responsible for developing, maintaining, and improving the DoDSER system, in addition to 

compiling and reporting the data contained in this and previous DoDSER annual reports. The 

responsibility for the DoDSER system and its annual reports transitioned on October 1, 2017, to 

the Psychological Health Center of Excellence (PHCoE), which operates under the governance 

of the Defense Health Agency (DHA). DHA—a joint, integrated Combat Support Agency—

enables the Army, Navy, and Air Force medical services to provide a medically ready force and 

ready medical force to Combatant Commands in peacetime and wartime. DHA also supports the 

delivery of integrated, affordable, and high-quality health services to Military Health System

(MHS) beneficiaries and is responsible for driving greater integration of clinical and business 

processes across the MHS. 

The DoDSER system represents a collaborative effort among PHCoE, the Suicide Prevention 

Program Offices of the Air Force, Army, Marine Corps, and Navy, and the Defense Suicide 

Prevention Office (DSPO). Its objective is to operate and refine a system for collecting and 

reporting a set of standardized data for every Service member who dies by, or attempts, suicide, 

regardless of branch, component, or duty status. 

The result is a comprehensive annual report characterizing suicide-related behavior in a 

standardized manner across the Air Force, Army, Marine Corps, and Navy. This year’s report 

presents data from the United States Armed Forces on the incidence of suicide and suicide 

attempts that occurred between January 1, 2016 and December 31, 2016. Active and Reserve 

Components of the Services participate in suicide data surveillance, including the Army National 

Guard and Air National Guard. 

The DoDSER annual report provides decision-making authorities with a tool for the following: 

 Monitoring the occurrence of suicide-related behavior among the United States Armed 

Forces 

 Identifying key risk factors and profiles associated with the occurrence of suicide-related 

behavior

 Compiling objective information that informs the evaluation of the DoD’s suicideprevention priorities, policies, and strategies

Calendar year (CY) 2016 was the DoDSER system’s ninth year of operation. All nine annual 

reports are available online via the National Center for Telehealth & Technology website at 

http://www.t2health.dcoe.mil/programs/dodser. 

Data Collection 

Trained behavioral health providers or command officials on military installations and at MHS 

hospitals collect and input data directly into the DoDSER system’s web-based data-collection 

5 
 

 

Methodology Calendar Year 2016 Annual Report

survey. Primary data sources in cases of suicide include the following: 

 Medical records 

 Behavioral health records 

 Personnel records 

 Legal and/or investigative records 

 Interviews with command officials 

 Interviews with spouse, extended family, friends, and peers (if authorized) 

Primary data sources in cases of attempted suicide include the following: 

 Direct interview of the individual who was the subject of the report 

 Medical records 

 Behavioral health records 

 Personnel records 

 Legal and/or investigative records 

 Interviews with command officials 

 Interviews with spouse, extended family, friends, and peers (if authorized) 

Data from each case that required a DoDSER submission is then augmented with information 

from the following: 

 Armed Forces Medical Examiner System (AFMES)—for Active Duty suicide decedents 

 Defense Manpower Data Center (DMDC)—for suicide and suicide attempt reports 

The CY 2016 DoDSER survey form contained more than 500 data elements to provide 

comprehensive information about the Service members, the psychosocial and emotional context 

of their lives, military history, legal and/or disciplinary actions, and the specific characteristics of 

the suicide-related events. DMDC provided additional data related to demographic 

characteristics and deployment histories to cross-reference and to augment what the DoDSER 

system collected.

Only CY 2016 cases in which AFMES confirmed suicide as the manner of death on or before 

January 31, 2017 are guaranteed to have a DoDSER submission included in this report. In order 

to meet the DoD timeline for calculating suicide rates, the DoDSER team excluded CY 2016 

cases in which the cause of death investigation had not been completed by 1 February 2017. Data 

from previous years have been updated to include any cases that were not part of a previous 

year’s DoDSER Annual Report due to pending investigations. 

Cases in which DMDC records classified the Service member as either Absent Without Leave 

(AWOL) or in a Deserter status when the event occurred continue to be excluded from this report 

to conform to the definition of end-strength used in the suicide rate calculations.1

To protect and maintain the privacy of the individuals whose information was collected by the 

DoDSER system in CY 2016, all identifiable information in this report was redacted. It presents 

no singular case-level data presented; rather, it presents aggregated data for DoD as a whole 

6 
Methodology Calendar Year 2016 Annual Report

(Chapter 3) as well as for each individual branch of Service (Chapters 4–7). It presents data for 

the SELRES separately (Chapter 8), regardless of the individual’s duty status at the time of the 

suicide or suicide attempt. 

Changes to the DoDSER in CY 2016 

Prior to this year, revisions to the DoDSER system occurred annually. These changes typically 

included minor system and database improvements, operating software updates, and revisions to 

the data collection survey’s content. Such revisions have been particularly important, as they 

have a direct effect on the completeness and accuracy of the DoDSER data. 

In CY 2014, the DoD Inspector General’s office completed an assessment of DoDSER program

data quality and determined that the system fell under the provisions of the United States 

Paperwork Reduction Act (Pub. L. No. 96-511, 94 Stat. 2812, codified at 44 U.S.C. §§ 3501-

3521). In order to comply with this act, the DoDSER survey form was submitted to the Office of

Management and Budget (OMB) for review and approval. Full findings of this assessment are 

publically available at https://media.defense.gov/2014/Nov/14/2001713434/-1/-1/1/DODIG2015-016.pdf. 

As a result, the DoDSER survey received an OMB Control Number (0720-0058) and expiration 

date (03/31/2018) in March 2015. The expiration date provides the next normally scheduled 

opportunity for revision of the survey instrument. The DoDSER survey was therefore not 

revised for CY 2016; rather, the CY 2015 form was carried forward. 

This new process will change the way the DoDSER survey is revised and assessed. DoDSER 

Program Managers and Suicide Prevention Program Managers (SPPMs) at each of the Services 

will now collect suggested revisions during each period between OMB approval and expiration. 

After reviewing and discussing these suggestions, DoDSER Program Managers, the Services, 

and DSPO will determine the revisions to be made on the first day of a new data collection 

cycle—typically the first working day of a new CY following the next cycle of OMB review and 

approval. 

Processes and Procedures 

Submission Process and Timeline 

The DoDSER system uses a web-based survey tool, available via a secure website 

(https://dodser.t2.health.mil/), to collect and compile data. A DoD Information Assurance 

Certification and Accreditation Process-approved facility at Fort Detrick, MD houses the servers 

on which the DoDSER system operates. Basic data-entry users do not have access to any 

DoDSER data other than those that they collect and submit themselves. 

7 
Methodology Calendar Year 2016 Annual Report

All Services must complete DoDSER surveys for suicides among Service members in the Active 

Component, suicides among members of the SELRES in a duty status at the time of the event, 

and suicide attempts that resulted in hospitalization or evacuation from a theater of operations. 

The Army also requires DoDSER surveys for other non-fatal events, such as self-harm and 

suicidal ideation. These surveys are essential to each annual report, as the descriptive DoDSER 

data are compiled from them. 

All Services track suicides via the offices of each Service’s SPPM in order to meet reporting 

timelines, and the AFMES maintains an official list of confirmed suicides. However, the data 

collection processes can vary slightly between Services. Such variations include the following: 

 Air Force: The Office of Special Investigations is the primary data-collection agency 

that receives the AFMES notification and completes the DoDSER survey within 60 days. 

 Army: The Army Institute of Public Health DoDSER Program Manager receives the 

AFMES notification, contacts the behavioral health point of contact (POC) at the Service 

member’s assigned Medical Treatment Facility, and requests that a behavioral health 

clinician complete a DoDSER survey within 60 days. 

 Navy: Following confirmation from the AFMES, the SPPMs’ office contacts the local 

command and requests an appropriate POC to meet the requirement within 60 days. 

 Marine Corps: The DoDSER Program Manager, located within the Marine Corps 

Headquarters’ Behavioral Health Data Surveillance section, contacts the local command 

and requests an appropriate POC to meet the requirement within 15 working days. 

In cases involving non-fatal events, such as suicide attempts, the Services must complete a 

DoDSER suicide attempt survey within 30 days of the hospitalization or evacuation from a 

theater of operations. 

DoD policy states that a CY suicide rate can be calculated no sooner than 90 days after the end 

of the CY to allow for resolution of case determinations.1

 March 31 typically serves as the final 

reporting date for cases used in the previous CY’s annual rate calculations and for the previous 

CY’s aggregate data from the DoDSER system. 

For CY 2016, the final reporting date—the deadline for the Services to submit DoDSER surveys 

for all CY 2016 deaths AMFES confirmed as suicides on or before January 31, 2017—was 

March 31, 2017. The Services did not have to submit DoDSER surveys for cases of suicide 

confirmed after January 31, 2017 by this deadline; they did, however, have to submit such 

surveys in compliance with their own reporting timelines. 

When evaluating DoDSER submission compliance for each of the Services, the CY 2016 report 

uses the number of confirmed suicides as of January 31, 2017. However, when calculating 

counts and rates, the CY 2016 report uses the most complete data available as of March 31, 

2017. 

8 
Methodology Calendar Year 2016 Annual Report

DoDSER Items

The DoDSER survey requires collection of a broad range of information about the individual 

who is the subject of the report, including demographic information, military history, medical 

history, and current life stressors. The content of the DoDSER survey resulted from a 

collaborative process including the following steps: 

 Structured reviews of each Service’s historical suicide surveillance systems/procedures 

 Workgroup deliberations with representation from all four Services 

 A systematic review of suicide literature 

 Feedback from nationally recognized civilian and military experts

 Feedback from senior military leaders and key stakeholders 

Periodically, a workgroup comprising DoDSER program staff, the SPPM for each Service, and 

representatives from DSPO meets to revise the DoDSER survey items based on the evolving 

needs and patterns relevant to each Service. Table 1 displays the DoDSER survey’s content 

areas.

Table 1. DoDSER survey content areas

Content area Example items 

Personal Information Age, sex, ethnicity, education, marital status

Military Information Job code, duty status, permanent duty station

Event Information Access to firearms, event method, event setting 

Medical History Behavioral health and medical history

Military History Deployment history, disciplinary action 

Personal History Developmental and family history, current stressors

Narrative Summary Information on data-collection strategy

Data Sources 

Following official notification of a suicide or non-fatal suicide attempt, Service personnel begin 

the DoDSER data collection process by reviewing records related to the individual’s suicide 

behavior. Necessary data comes from various sources, including medical records, personnel 

records, investigative records, and, if possible, interviews with the individual’s command, 

investigative agency officer(s), other professionals, and, among some Services, family members 

who are willing to participate and unlikely to be caused additional stress. In cases where the 

suicidal behavior did not result in death, Service personnel also attempt to interview the 

individual. They then use the information collected from these sources to complete the webbased DoDSER survey. 

After the DoDSER report is submitted, additional information is obtained from enterprise 

sources in an effort to improve overall data completeness and accuracy. Data sources include: 

 AFMES, which provides data on the official manner and cause of death for suicides 

among Service members. These data come from military or civilian autopsy reports, 

death certificates, written reports from military investigative agencies, or a verbal report 

from a civilian death investigator or coroner. 

9 
Methodology Calendar Year 2016 Annual Report

 DMDC, which provides data from the Defense Enrollment Eligibility Reporting System 

to deliver demographic information for all events submitted to the DoDSER system. 

DMDC also provides data from the Contingency Tracking System, the repository of 

official deployment-related information. 

 The DoD Sexual Assault Prevention and Response Office (SAPRO), which provides 

analytics in which DoDSER cases are matched against unrestricted, sexual assault 

reporting data. SAPRO analysts examine the relationship between sexual assault and 

suicide-related behavior and provide an aggregated report to DoDSER staff.

In the case of missing or unavailable data in these three sources, data from the DoDSER surveys 

are used to generate the final variable set used in the annual report. Discrepancies are resolved 

with the Service’s SPPMs to the extent feasible given the timeline. 

Data Quality 

It is of the utmost importance that the data entered into the DoDSER system are as accurate and 

complete as possible. The DoDSER system uses several types of controls to improve the overall 

quality of its data. Some of these controls have been in use since the DoDSER system’s 

inception; others are recent additions: 

 System login and data submission require a DoDSER account associated with Common 

Access Card (CAC) credentials. Basic users can only access the active reports assigned 

to them. This assures that the system is private and gives the users confidence that they 

are entering information for the correct individual. 

 The data-submission website design minimizes the possibility of data entry errors. 

 Form-field validation requires users to adjudicate responses that are not logically possible 

(e.g., date of birth must be at least 18 years in the past). 

 Reports are flagged as having ‘low data quality’ when a high degree of missing data is 

detected on the survey form (i.e., reports that are less than 80 percent complete). Should 

a report be flagged, the system warns the user that submitting it will count against the 

Service’s overall level of compliance. 

 Corroboration of suicide event reports against data from the AFMES ensures that a 

suicide event is valid and present in both independent systems. A case present in the 

DoDSER system without a corresponding AFMES report is not included in the analytics 

of the DoDSER annual report. 

 Reviewing all DoDSER surveys ensures that multiple reports are not submitted for the 

same event. The DoDSER system identifies potential duplicates ahead of the analysis, 

and the Services’ DoDSER Program Managers select the submission that represents the 

10
Methodology Calendar Year 2016 Annual Report

most accurate and complete data record. 

 Reviewing open-ended text fields or the selection of the “Other” response option allows 

a) the identification of text responses that should have been coded using the existing-item

coding structure or b) the generation of new response categories based on multiple 

responses with similar text. 

 Data from AFMES and DMDC improve the accuracy of DoDSER data. The AFMES 

data inform the manner and cause of death for suicide reports, and the DMDC data 

provide information on deployment history and demographic characteristics. Priority is 

given to data provided by these external sources when developing the analytic variables 

in this report.

 Standardized Help text informs users about the definitions and parameters relevant to

each question—including relevant diagnostic codes, identification of data sources 

relevant to a given item, and improved readability of the text. This Help text is available 

as a separate ‘pop-up’ window accessible for each item within the DoDSER system, and 

the user does not have to navigate away from the survey page to use the Help text. 

 Data-quality assessments of 10 percent of the DoDSER surveys submitted each month 

examine variables where users chose the “Cannot Determine” and “Data Unavailable” 

response options. These assessments also evaluate the submission timeline and the 

correlation between the survey’s qualitative and quantitative elements. 

Suicide Rate Calculations 

For each DoDSER annual report, AFMES determines an official case list of suicides among 

Service members in the Active Component and in the SELRES. Duty status determination (i.e., 

whether a Service member was in or out of an official duty status at the time of the event) relies 

on information entered into the Defense Casualty Information Processing System as well as on 

consultations with the appropriate Service’s SPPM. Cadets and midshipmen at the designated 

military academies—the U. S. Military Academy in West Point, NY; the U.S. Naval Academy in 

Annapolis, MD; and the U.S. Air Force Academy in Colorado Springs, CO—are determined to 

be in a duty status. This determination is relevant to validating case submission in the DoDSER 

system. 

AFMES collates data on suicides among members of the SELRES not in a duty status from the 

Service-specific SPPM reports for the Air Force, Army, Marine Corps, and Navy. The SELRES 

suicide case numbers presented in the CY 2016 report were verified as of May 31, 2017. 

11
Methodology Calendar Year 2016 Annual Report

Rate Calculation

Collaboration with stakeholders yielded the DoDSER staff’s process for determining the rates of

various suicide-related characteristics. All included parties must reach consensus on decisions 

about those characteristics. Crude and stratified rates are calculated separately for the following: 

 The Active Component (in aggregate and individually for each Service) 

 The Reserve Component of the SELRES (regardless of duty status; in aggregate and 

individually for each Service) 

 The National Guard Component of the SELRES (regardless of duty status; in aggregate 

and individually for the Air Force and Army) 

Stratified rates are calculated for sex, race, ethnicity, education, marital status, age, and 

rank/grade within these components. AFMES collaborates with DMDC to identify the number 

of Service members in each combination of Service, component, and demographic characteristic 

at the end of each month; this total is the “monthly end-strength.” The average of the monthly 

end-strength totals for the CY is the denominator for the rate calculations. 

DoD data standards prohibit reporting rates associated with fewer than 20 instances of suicide, 

because a high degree of statistical instability occurs in rates calculated from small numerators.1 2

Mathematical Formula 

The following formula provides a mathematical expression of the rate calculation. 

ݏ ௚ܴܽݐ݁ ൌ ൈ 100,000 1 ଵଶ

௚௠ܵܧ ୀଵ ∑௠12

In this formula, Sg represents the number of suicides in a particular population group and ESmg 

represents the end-strength of a particular month for the same population group. The mutually 

exclusive populations (g) used in each rate calculation were the following: 

1. Active Component 

a. All Services

b. Air Force

c. Army

d. Marine Corps 

e. Navy 

2. SELRES 

a. All Services

i. Air Force Reserve

12
Methodology Calendar Year 2016 Annual Report

ii. Army Reserve 

iii. Marine Corps Reserve 

iv. Navy Reserve 

3. National Guard

a. Air Force and Army combined 

i. Air National Guard 

ii. Army National Guard 

Rate Standardization

Rate standardizations for each DoDSER Annual Report are implemented using population data 

from the Centers for Disease Control and Prevention (CDC) Web-based Injury Statistics Query 

and Reporting System3

 (WISQARS). The CDC maintains WISQARS and provides aggregate 

data on fatal and non-fatal injuries. 

CY 2015 data were the most current population data available from CDC WISQARS for the CY 

2016 DoDSER Annual Report. For CY 2016, rates of suicide were jointly stratified by age 

group (17–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59) and sex (male, 

female) for each calendar year. 

Indirect standardization is used to calculate the number of expected cases in each age- and sexspecific stratum of the component and Service subpopulations. Indirect, as opposed to direct, 

standardization has been selected because of the small case numbers observed for several 

combinations of age and sex within the DoD population subgroups. 

This technique calculates the number of expected suicides given the overall U.S. population ageand sex-specific stratum rates. Division of the observed number of suicides by the total number 

of expected suicides yields the standardized mortality ratio (SMR). The mathematical formula 

for the SMR is this:4

௔௜݊௔௜݌ ∑ ൌ ܴܯܵ ௜

௔௜݊௦௜݌ ௜∑

 pia —Represents the stratum-specific rate for the study population (i.e., the specific 

 component or Service under consideration) 

 nia —Represents the number of Service members in that stratum 

 pis —Represents the stratum-specific rate from the standard population (in this instance, 

the U.S. population) 

The product of pia and nia gives the observed number of suicides within each stratum. The sum

of the observed numbers across the strata yields the numerator for the formula. The product of 

pis and nia yields the number of expected suicides for that stratum. The sum across the strata is 

13
Methodology Calendar Year 2016 Annual Report

the total number of expected suicides. Multiplication of the SMR by the crude rate of the 

standard population produces the adjusted rate for the population of interest. 

Practical Example of Indirect Rate Standardization 

Table 2 provides a practical example of this indirect method of rate adjustment. The data used in 

Table 2 are for the Active Component suicide rates from all Services combined for CY 2012. 

They do not represent the data for the current calendar year, which are provided in Chapter 2. 

The sum of the expected deaths column (the denominator of the SMR formula) is 289.782. The 

numerator of the SMR formula yields the same value as the total number of observed suicides for 

the time-period: 321. Division of 321 by 289.782 yields the SMR of 1.11. Multiplication of the 

SMR by the unadjusted rate for the standard population (.000165) gives the adjusted rate of 

.000183. This value is then multiplied by 100,000 to convert it into the more easily interpretable 

value of 18.3 suicides per 100,000 members of the population of interest. 

Table 2. Demonstration of the Calculation of the Age- and Sex-adjusted Suicide Rate Using the Indirect 

Method for the Active Component, All Services, CY 2012

Stratum

Male, 17–19

Male, 20–24

Male, 25–29

Male, 30–34

Male, 35–39

Male, 40–44

Male, 45–49

Male, 50–54

Male, 55–59

Female, 17–19

Female, 20–24

Female, 25–29

Female, 30–34

Female, 35–39

Female, 40–44

Female, 45–49

Female, 50–54

Female, 55–59

CY 2012 Serviceaggregated denominator 

(nia) 

67726 

375972 

296051 

188920 

137064 

87498 

33105 

8912 

2082 

13382 

67558 

52184 

32318 

20794 

12161 

4869 

1603 

513 

CY 2012 U.S. 

population rate (pis) 

.000153 

.000221 

.000240 

.000228 

.000248 

.000266 

.000288 

.000315 

.000309 

.000039 

.000049 

.000056 

.000062 

.000072 

.000082 

.000100 

.000104 

.000091 

Expected deaths (niapis) 

10.362 

83.090 

71.052 

43.074 

33.992 

23.274 

9.534 

2.807

0.643 

0.522

3.310 

2.922

2.004 

1.497

0.997 

0.487

0.167 

0.047

The adjusted rate allows for comparisons between the military rate and the general U.S. 

population after accounting for known differences in the distribution of age and sex between the 

two populations. The 95 percent confidence intervals (CI) associated with the adjusted rates 

were calculated using the Poisson distribution. These intervals provide the range of plausible 

values for the adjusted rate: values that are consistent with the data and account for the 

uncertainty involved in estimation. These CI show, with 95 percent accuracy, the true value of 

the rate. If the span of the CI does not overlap with the U.S. population rate, then one can 

14
 

 

Methodology Calendar Year 2016 Annual Report

conclude that there is a statistically significant difference between the population of interest and 

the general U.S. population. In doing so, a 5 percent margin of error is accepted. 

The use of indirect standardization limits the comparisons to just those of the populations of 

interest and against expected rates in the total U.S. population. Within a particular year, it is not 

possible to directly compare the SMRs or associated adjusted rates between components or 

Services because the age and sex distributions may still differ between the subpopulations. 

A separate set of analyses was conducted using a Poisson regression model5

 to compare the rates 

of suicide between years or between components and Services within a single year while 

accounting for different age and sex distributions. This model is appropriate for use with count 

data, such as the number of deaths in a particular group. Model estimates were used to produce 

adjusted rates for temporal comparisons and statistical inference. 

DoDSER Data Analysis 

The majority of the content within the CY 2016 DoDSER Annual Report describes the 

prevalence of suspected risk factors associated with the occurrence of suicide-related behavior 

within DoD. Several statistical comparisons of a defined set of determinants have also been 

included to examine change over time within DoDSER suicide and suicide-attempt surveys. 

These comparisons examine the stability of determinant distributions over time. Logistic 

regression models were used to compare CY 2016 suicide and suicide-attempt DoDSER findings 

to findings from CY 2013 - CY 2015. Data from the three previous calendar years were used to 

provide a stable base of comparison in determining whether the data observed for CY 2016 

reflected a departure from what would be expected. 

Specific to CY 2016, latent class analysis6

 was used to identify subgroups of suicide and suicideattempt cases based on the patterns of the presence or absence of the risk or protective factors 

described in the text. This analysis provides context to the reported case counts and allows for 

an assessment of the following questions: 

 What factors are more likely to co-occur? 

 Does the risk profile for suicides and suicide attempts qualitatively differ? 

 How common are co-occurring risk factors in the population? 

 What proportions of cases in the report are defined more by the absence of risk factors as 

opposed to the presence of those factors? 

Factors present in fewer than 10 percent of cases overall were not included in the models. These 

models were estimated using robust maximum likelihood. Final models were selected based on 

information criteria values, entropy (classification quality; higher is better), and interpretability 

of the identified classes. The distribution of the classes for both suicide and suicide attempt 

cases and the prevalence of each determinant within each class are reported. 

Neither these comparisons nor the descriptive reports related to specific risk factors and/or 

correlates should be interpreted as underlying causes of suicide. Causal relationships between 

variables cannot be identified by the methodology employed for the DoDSER system.

15
Methodology Calendar Year 2016 Annual Report

Identifying such relationships would require an experimental approach involving the systematic 

and concurrent collection of data on control cases, and such an approach is outside the 

epidemiological purview of the DoDSER system. 

The specific determinants included in the comparative and latent class analyses were these: 

 Mechanism of injury (e.g., firearm use, asphyxiation, drug or alcohol overdose— 

comparative analysis only) 

 Mood disorder (as defined by the Diagnostic and Statistical Manual of Mental Disorders, 

Fourth Edition–Text Revision7 (DSM-IV)) 

 Anxiety disorder (as defined by DSM-IV) 

 Adjustment disorder (as defined by DSM-IV) 

 Substance-abuse history 

 History of prior self-injury 

 Use of psychotropic medications in the 90 days prior to the event 

 Relationship problems in the 90 days prior to the event 

 Legal/administrative problems in the 90 days prior to the event

 Workplace difficulties in the 90 days prior to the event 

 Financial difficulties/excessive debt in the 90 days prior to the event 

 History of friend or family member suicide 

 Severe family member illness in the 90 days prior to the event 

These variables were selected for the current report because of their prominence in the suicide 

research literature as major determinants of suicide and suicide attempts. Each model was 

adjusted for age, sex, Service, and component. A full-information maximum-likelihood estimate 

was used to account for missing data on the determinants and demographic variables included in 

the models8. Only the most recent report was retained for analysis from individuals with 

multiple suicide attempts or with both an attempt and a suicide death to satisfy the assumption of 

independent observations in the regression model. 

Interpretive Considerations

The primary goal of the DoDSER annual report and of the DoDSER system overall is the 

collection, organization, and presentation of data relevant to the occurrence of suicide and 

suicide-related behavior in the military community. The DoDSER is not a research study but 

rather a surveillance system. The data collected by the DoDSER system are used to do the 

following: 

 Monitor the occurrence of suicide-related behavior among the U.S. Armed Forces on an 

annual cycle 

 Offer an independent and objective source of information about data related to suicide 

and suicide attempts 

 Provide leaders with key information on which to base policy and programming decisions 

16
 

 

 

Methodology Calendar Year 2016 Annual Report

 Monitor important risk factors and profiles associated with suicide 

 Support research toward suicide prevention 

 Inform local and national suicide prevention program development 

While it is natural to speculate about the relative contributions of specific risk and protective 

factors related to suicide, it is not possible to determine analytically whether any particular 

variable is a risk or protective factor for suicide solely from the data presented in this report. 

Data on the distribution of any particular variable among the broader population are required 

before any statistical inferences or causal statements can be made. The DoDSER system does 

not systematically collect concurrent data on non-cases (i.e., control participants), as this exceeds 

the surveillance mandate of this program. Independently planned and executed research is 

required before inferring any causal roles for specific risk or protective factors.

During CY 2016, many DoDSER items offered the user a “data unavailable” response option to 

indicate that not enough information could be gathered to provide either an affirmative or 

negative response. While use of this response option is discouraged, some information for some 

individuals, inevitably, was unknown or unavailable. For example, information about an 

individual’s family history of mental illness may have been available for Service members who 

had engaged with the military’s behavioral health system, but such behavioral health information 

may have been difficult to assess or ascertain for Service members who had not. The reader 

should weigh the impact of missing information on interpretive considerations against what 

information was not available. Percentages for many DoDSER items were calculated using the 

total number of reports for a given outcome as the denominator.

The reader should also take into account the content area of any given DoDSER item when 

interpreting results. While this report reflects the best data available, some DoDSER items are 

objective (e.g., a Service member’s rank/grade), whereas others are highly subjective (e.g., was 

the patient/decedent involved in community support systems?). Standardized coding guidance 

was available to all designated DoDSER respondents, along with technical definitions of terms

and item-by-item Help text designed to aid in accurate reporting. Nonetheless, idiosyncratic 

interpretation of subjective items may increase variability in the measurement of these factors. 

Figures and Tables 

This report includes graphical displays of data to represent the prevalence of specific variables in 

CY 2013 -CY 2016. The observed prevalence estimates for each year (percent) represent the 

proportion of “yes” responses to a particular item relative to the total number of events with a 

completed case for that year. These figures also display an error bar for proportions where 

practicable. This error bar is the half-width of the 95% confidence interval. It presents the 

amount of error above or below the top of the bar and can be interpreted in the same way as the 

error for a survey or opinion poll. For example, a bar that extends to 50 percent with an error bar 

that extends to 55 percent means that the best estimate of the percent is 50, +/- 5 percentage 

points. The reader is encouraged to note that separate tables may present separate types of 

information such as counts, rates, and statistical comparisons, which cannot be directly compared 

with one another. 

17
Methodology Calendar Year 2016 Annual Report

References 

1. Under Secretary of Defense for Personnel and Readiness Memorandum. (2014). 

Standardized DoD Suicide Data and Reporting. Washington, DC: Government Printing 

Office. 

2. Arias, E., Anderson, R. N., Hsiang-Ching, K., Murphy, S. L., & Kochanek, K.D. (2003). 

Deaths: Final Data for 2001. National Vital Statistics Reports, 52(3). Hyattsville, Maryland: 

National Center for Health Statistics.

3. Centers for Disease Control and Prevention, National Center for Injury Prevention and 

Control. (2005). Web-Based Injury Statistics Query and Reporting System (WISQARS). 

Retrieved from www.cdc.gov/injury/wisqars 

4. Kahn, H. A., & Sempos, C. T. (1989). Statistical Methods in Epidemiology. New York: 

Oxford University Press. 

5. Hilbe, J. M. (2011). Negative Binomial Regression (2nd ed.). New York: Cambridge 

University Press. 

6. Collins L. M., & Lanza, S. T. (2010). Latent Class and Latent Transition Analysis: With 

Applications in the Social, Behavioral, and Health Sciences. Hoboken, NJ: John Wiley & 

Sons, Inc. 

7. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental 

Disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

8. Enders, C. K. (2010). Applied Missing Data Analysis. New York: Guilford Press. 

18
 

CHAPTER 2 

Military Suicide Rates

19
Figure 1. Illustration of the scale of suicide in the military. The figure contains 1,000 gray squares. Each square contains 100 small dots.

Thus, there is a total of 100,000 individual dots in the whole figure, each one representing a Service member. The small red box in the 

bottom corner encapsulates 21 of those dots, which represent 21 cases observed in a population of 100,000 (i.e., a rate of 21 per 100,000).

While suicide is an important problem to address, death due to suicide is a rare outcome requiring sophisticated analytics for tracking,

measurement, and determination of change.

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rates 

Background Information 

What are rates? 

Death by suicide is a statistically rare event (see Figure 1). In many instances, it is so rare that 

often only the number of events recorded is reported (e.g., 10 suicides in the last year). This 

information is necessary to understand the burden, or overall occurrence, of suicide in a

population. Unfortunately, this information is not sufficient to describe the scope of the

problem. A key piece of information that is missing when only reporting the number of

observations is the overall size of the population of interest. If two populations each have 10 

suicide deaths in one year, then we could say that the populations had the same number of 

events. However, is the risk of suicide the same in the two populations? If one population has 

5,000 people and the other has 50,000 people, then the proportion of people who died by suicide 

differs substantially between the two populations (.002 vs. .0002). Since these proportions tend 

to be extremely small numbers, it is customary to rescale them to make interpretation easier. 

They are called ‘rates’ at this point. If we rescale the two aforementioned proportions by 

multiplying each by 100,000, we produce suicide-mortality rates per 100,000 persons. Clearly,

20
 

 

Figure 2. Illustration of population differences (in the age and sex makeup) of the U.S. general population compared to the Service member

population of the Armed Forces. These demographic differences are controlled for by the indirect adjustment of the rates. 

Suicide Rates Calendar Year 2016 Annual Report

even though the number of cases between the two populations is identical, the mortality rate is 

vastly different (200 per 100,000 vs. 20 per 100,000). As such, any presentation of only case 

numbers is inadequate in understanding the overall occurrence of suicide in a population. 

Furthermore, any comparisons or qualifying statements using only case numbers are 

inappropriate and potentially misleading. 

What are expected deaths? 

Mortality rates provide a description of the occurrence of death in a population. They are also 

useful in providing a number of expected deaths in a similar population or in the same population 

at a future time point. For example, if it is known that the annual suicide-mortality rate for a 

population is 15 per 100,000 persons, then it would be expected to observe 30 suicide deaths per 

year in that population if it was made up of 200,000 people. 

What are the statistical considerations? 

There are three primary statistical concerns about rates: volatility, uncertainty, and 

comparability. The first two issues are especially important for events that are statistically rare. 

Volatility means that rates from one year to the next may move up and down dramatically, but 

not meaningfully. Comparisons of an individual year against an average value of several years 

together help provide a more stable comparison by reducing overall variance observed between 

years. 

Uncertainty means that the true underlying mortality rate with the available data can only be 

approximated. As a result, attempts are made to quantify uncertainty by providing a range of 

plausible rate values given the available data. This range is represented by the upper and lower 

bounds of what is called a confidence interval. 

Comparability means the extent to which two populations can be compared directly. Specific to 

suicide mortality in the Services, the population is very young and predominantly male. Figure 2 

shows that the general population of the United States, in contrast, has a more even distribution 

of age (i.e., there is about the same proportion of the U.S. population that are in their 20s as there 

are in their 50s) and an approximately equal distribution of men and women. Any comparison 

21
 

Suicide Rates Calendar Year 2016 Annual Report

between the military Services and the general U.S. population requires accounting for these 

differences in order for it to be valid. Furthermore, any comparison between two or more 

populations using mortality rates should be adjusted for basic demographic variables (often, age 

and sex). If they are not (which is not recommended), the comparison is likely to be biased by 

underlying differences in the composition of the two populations. 

When is a difference not a difference? 

At this point, rates and some of the statistical issues associated with rate construction and 

comparison have been reviewed. Before presenting the suicide-mortality-rate data, it is

important to restate some key points: 

1. Observed rates (which are estimates) can vary from year to year because of volatility, 

uncertainty, and actual changes in the underlying (true) rate. 

2. Our analysis attempts to account for the effects of volatility (using three-year average 

rates for temporal comparison) and uncertainty (confidence intervals) to determine if an 

observed change does or does not represent an actual change in the rates.

3. Any arithmetic difference in rates between populations or between years (e.g., 20.2–18.5 

= 1.7) that does not account for uncertainty and issues of comparability (primarily age 

and sex) is not defensible. 

4. Any difference in observed rates that does not go beyond expected values (i.e., does not 

exceed the confidence interval) is not a statistically significant difference. In other words, 

the evidence is insufficient to argue that the observed difference is real.

5. Unless a rate difference exceeds the expected values, the only defensible inference is that 

there is no evidence of a difference. 

Findings 

Table 3 details the frequency and rate of suicide mortality for the Active, Reserve, and National 

Guard Components of the four Services included in this report. The CY 2016 suicide-mortality 

rates for the three components, all Services, were not statistically different from the three-year 

average suicide-mortality rates for CY 2013–2015 (Figures 3–5). Similarly, there were no 

statistically significant differences detected between CY 2016 and the CY 2013–2015 three-year 

average rates for the Active Components of each of the Services (Figures 6–9). 

In addition to the comparison against the three-year average, a linear increase was identified in 

the suicide-mortality rate, since CY 2011, for the Active Component of the Air Force. No stable 

increase or decrease in the suicide rate for the Active Components of any other Service or in the 

overall analysis of the components was observed. 

22
 

 - 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 3. Frequency and unadjusted rate1

 of suicide, by Component and Service, for CY 2014 CY 2016.

Component and Service

20143 20154 2016 

Count Rate Count Rate Count Rate

Active, all Services 276 20.4 266 20.2 275 21.1

Air Force 62 19.1 64 20.5 61 19.4 

Army 126 24.6 120 24.4 127 26.7

Marine Corps 34 17.9 39 21.2 37 20.1 

Navy 54 16.6 43 13.1 50 15.3

Reserve,2

 all Services 79 21.6 90 24.7 80 22.0 

Air Force 10 --- 10 --- 10 --- 

Army 42 21.4 55 27.7 41 20.6 

Marine Corps 12 --- 11 --- 19 --- 

Navy 15 --- 14 --- 10 --- 

Guard,2

 Air Force and Army 91 19.8 125 27.5 123 27.3

Air Guard 14 --- 21 19.9 14 --- 

Army Guard 77 21.8 104 29.8 109 31.6 1

Unadjusted rate per 100,000 Service members. Rates for subgroups with fewer than 20 suicides are not reported because of statistical 

instability.

2

Rates for the Reserve and National Guard Components of the SELRES include all Service members irrespective of duty status. 3

Pruitt, L.D., Smolenski, D., Reger, M., Bush, N., Skopp, N., & Campise, R.L. (2016). Department of defense suicide event report – calendar year 

2014 (Publication No. 6-9C3997A). Retrieved from: http://www.t2health.dcoe.mil/programs/dodser 4

Pruitt, L.D., Smolenski, Bush, N., Skopp, N., Hoyt, T., & Grady, B. (2017). Department of defense suicide event report – calendar year 2015 

(Publication No. E-6A4ED71). Retrieved from: http://www.t2health.dcoe.mil/programs/dodser. doi: 10.13140/RG.2.2.12110.05448

23
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Active Component, All Services, CY 2011 - CY 2016 

Figure 3. Adjusted annual rates of suicide in the Active Component, all Services, CY 2011 - CY 2016

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year and 

the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

24
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Reserve Component, all Services, CY 2011 - CY 2016 

Figure 4. Adjusted annual rates of suicide in the Reserve Component, all Services, CY 2011 - CY 2016 

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year and 

the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

25
 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the National Guard Component, Air Force and Army, 

CY 2011 -CY 2016

Figure 5. Adjusted annual rates of suicide in the National Guard Component, Air Force and Army, CY 2011 - CY 2016 

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year

and the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

26
 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Active Component, Air Force, CY 2011 - CY 2016

Figure 6. Adjusted annual rates of suicide in the Active Component, Air Force, CY 2011 - CY 2016

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year

and the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

27
 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Active Component, Army, CY 2011 -CY 2016

Figure 7. Adjusted annual rates of suicide in the Active Component, Army, CY 2011 - CY 2016

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year and 

the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

28
 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Active Component, Marine Corps, CY 2011 -CY 2016 

Figure 8. Adjusted annual rates of suicide in the Active Component, Marine Corps, CY 2011 - CY 2016

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013–2015 is the average rate for that year

and the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

29
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Adjusted Annual Rates of Suicide in the Active Component, Navy, CY 2011 -CY 2016

Figure 9. Adjusted annual rates of suicide in the Active Component, Navy, CY 2011–CY 2016

Note: All rates are adjusted for age and sex. The three-year moving average for CY 2013 - 2015 is the average rate for that year 

and the two years previous. The three-year moving average for calendar year CY 2016 is the three-year average for CY 2013–2015 

carried forward to show expected values of the rate for CY 2016. Figure does not contain CY 2016 WISQARS data as they were 

not available at the time of this writing.

30
 

 

Suicide Rates Calendar Year 2016 Annual Report

Thresholds Required to Identify Rate Changes 

Another way to understand the data is to think about the number of cases needed to have a 

statistically significant change in the suicide-mortality rate. For CY 2016, 275 suicide deaths in 

the Active Component, all Services, were observed. In order to reach the threshold to conclude 

that the suicide-mortality rate for CY 2016 was greater than the three-year average suicidemortality rate for CY 2013–2015, there would have to be at least 293 suicide deaths recorded. 

To conclude that the suicide-mortality rate for CY 2016 was lower than the three-year average 

suicide-mortality rate for CY 2013–2015, there would have to be 222 or fewer deaths recorded. 

Table 4 shows the observed number of suicide deaths and the number of deaths needed to 

provide evidence of a change for each Component and for the Active Components of each of the 

Services.

Table 4. Observed number of suicide deaths and number of suicide deaths required to increase or decrease the CY 

2016 suicide-mortality rate relative to the three-year average suicide-mortality rate of CY 2013 – 2015

Component Observed in CY 2016 Maximum number of cases 

allowed to identify a rate 

decrease

Minimum number of cases 

needed to identify a rate 

increase

Active 275 222 293 

Reserve 80 65 109 

National Guard 123 92 140 

Service

Active Component only

Air Force 61 42 76 

Army 127 92 139 

Marine Corps 37 26 56 

Navy 50 33 65 

The CY 2015 suicide-mortality rate for the U.S. population, age 17–59, was 17.3 deaths per 

100,000. These are the most recent population data available. Note that this rate value is higher 

than the one often cited in other reports age range (17–59 years) has been restricted to make it 

comparable to the age range of the U.S. military populations.

Comparison to U.S. General Population

After adjustment for age and sex, the CY 2016 suicide-mortality rate for the Active and Reserve 

Components was no different from expected given the age-restricted, U.S. total-population rate 

for CY 2015 (Figures 10 and 11). 

The National Guard Component had a higher suicide-mortality rate than expected based on the 

U.S. population data for CY 2015 (Figure 12). 

Among the Services in the Active Component in CY 2016, the Army had a higher suicide 

mortality rate than expected, while the Navy had a lower suicide mortality rate than expected 

given the age-restricted, U.S. total-population population data (Figures 14 and 16, respectively). 

There was no detectable difference in the suicide mortality rate for the Air Force or the Marine 

Corps from their expected values given the age-restricted, U.S. total-population data (Figures 13 

and 15, respectively). 

31
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the Active Component, All Services, CY 2011–2016

Figure 10. Suicide-mortality rate for the Active Component, all Services, CY 2011–2016, after indirect adjustment for age and 

sex to the U.S. total population, age 17–59.

32
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the Reserve Component, All Services, CY 2011–2016

Figure 11. Suicide-mortality rate for the Reserve Component, all Services, CY 2011–2016, after indirect adjustment for age and 

sex to the U.S. total population, age 17–59.

33
 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the National Guard Component, Air Force and Army, CY 2011–2016

Figure 12. Suicide mortality rate for the National Guard Component, Air Force and Army, CY 2011–2016, after indirect 

adjustment for age and sex to the U.S. total population, age 17–59.

34
 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the Active Component, Air Force, CY 2011–2016

Figure 13. Suicide mortality rate for the Active Component, Air Force, CY 2011–2016, after indirect adjustment for age and sex 

to the U.S. total population, age 17–59 

35
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the Active Component, Army, CY 2011–2016

Figure 14. Suicide mortality rate for the Active Component, Army, CY 2011–2016, after indirect adjustment for age and sex to 

the U.S. total population, age 17–59

36
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Suicide Rate for the Active Component, Marine Corps, CY 2011–2016

Figure 15. Suicide mortality rate for the Active Component, Marine Corps, CY 2011–2016, after indirect adjustment for age and 

sex to the U.S. total population, age 17–59

37
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Rate for the Active Component, Navy, CY 2011–2016

Figure 16. Suicide mortality rate for the Active Component, Navy, CY 2011–2016, after indirect adjustment for age and sex to 

the U.S. total population, age 17–59

38
 

Suicide Rates Calendar Year 2016 Annual Report

Tables 5 – 11 provide a demographic breakdown of the suicide deaths identified in each 

component and each Service. Where possible, an unadjusted rate is provided. Formal 

comparisons of suicide rates between demographic groups were not made. As such, no formal 

comparisons or conclusions are provided. 

39
 

 - 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 5. Rates of suicide among Service members in the Active Component, all Services, CY 2014 CY 2016, 

overall and by demographic characteristics

2014 2015 2016 

Group Count Rate1 Count Rate1 Count Rate1 

Total 276 20.4 266 20.2 275 21.1

Sex 

Male 256 22.3 252 22.7 255 23.3

Female 20 9.8 14 --- 20 9.7

Race 

American Indian/Alaska Native 3 --- 4 --- 6 ---

Asian/Pacific Islander 8 --- 12 --- 9 ---

Black/African American 42 18.2 44 19.4 32 14.2

White/Caucasian 199 21.5 186 20.7 212 23.9

Other/Unknown 24 22.3 20 19.1 16 ---

Ethnicity 

Hispanic 34 21.4 29 18.2 27 14.6

Non-Hispanic 240 20.8 231 20.7 242 22.8

Unknown 2 --- 6 --- 6 ---

Age 

17–19 7 --- 13 --- 14 ---

20–24 95 22.2 94 22.4 113 27.1

25–29 72 22.4 62 20.0 65 21.5

30–34 53 24.2 45 21.1 35 16.6

35–39 30 19.8 32 21.7 26 17.6

40–44 15 --- 15 --- 12 ---

45–49 1 --- 4 --- 8 ---

50–54 3 --- 1 --- 1 ---

55–59 0 --- 0 --- 1 ---

Unknown 0 --- 0 --- 0 ---

Rank/Grade 

Cadet/midshipman 0 --- 2 --- 0 ---

E1–E4 122 21.2 127 22.5 135 24.0

E5–E9 120 22.8 114 22.5 105 21.1

Officer 31 14.3 18 --- 32 15.3

Warrant officer 3 --- 5 --- 3 ---

Education 

Some high school 1 --- 1 --- 0 ---

Alternative high school certification 20 49.3 18 --- 20 55.9

High school graduate 177 21.4 179 22.4 186 23.7

Some college, no degree 20 32.6 19 --- 17 ---

Associate's degree or technical certification 19 --- 21 19.9 8 ---

Four-year college degree 28 16.8 17 --- 24 14.0

Master's degree or greater 7 --- 6 --- 19 ---

Unknown 4 --- 5 --- 1 ---

Marital Status

Never married 105 19.0 116 21.1 118 21.2

Married 145 19.5 132 18.6 133 19.2

Legally separated 0 --- 0 --- 2 ---

Divorced 25 44.8 17 --- 21 42.1

Widowed 1 --- 1 --- 1 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

40
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 6. Rates of suicide among Service members in the Reserve Component of the Selected Reserve 

irrespective of duty status, all Services, CY 2014 - CY 2016, overall and by demographic characteristics

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1 

Total 79 21.6 90 24.7 80 22.0 

Sex 

Male 72 25.1 78 27.3 76 26.7 

Female 7 --- 12 --- 4 ---

Race

American Indian/Alaska Native 2 --- 0 --- 1 ---

Asian/Pacific Islander 4 --- 6 --- 5 ---

Black/African American 9 --- 10 --- 7 ---

White/Caucasian 59 23.6 72 29.0 63 25.7 

Other/Unknown 5 --- 2 --- 4 ---

Ethnicity

Hispanic 9 --- 14 --- 7 ---

Non-Hispanic 67 21.7 75 24.5 73 24.0 

Unknown 3 --- 1 --- 0 ---

Age

17–19 3 --- 2 --- 5 ---

20–24 30 38.0 25 33.0 25 34.0 

25–29 13 --- 25 33.7 26 34.5 

30–34 9 --- 21 34.7 9 ---

35–39 10 --- 4 --- 5 ---

40–44 3 --- 7 --- 4 ---

45–49 8 --- 3 --- 2 ---

50–54 1 --- 3 --- 1 ---

55–59 2 --- 0 --- 3 ---

Rank/Grade 

Cadet/midshipman 0 --- 0 --- 0 ---

E1–E4 46 29.7 47 31.2 46 31.6 

E5–E9 24 16.8 33 22.9 29 19.5 

Officer 9 --- 8 --- 5 ---

Warrant officer 0 --- 2 --- 0 ---

Education

Some high school 1 --- 4 --- 1 ---

Alternative high school certification 6 --- 5 --- 6 ---

High school graduate 54 26.0 60 29.4 60 30.0 

Some college, no degree 2 --- 3 --- 2 ---

Associate's degree or technical certification 4 --- 5 --- 4 ---

Four-year college degree 8 --- 7 --- 5 ---

Master's degree or greater 4 --- 5 --- 2 ---

Unknown 0 --- 1 --- 0 ---

Marital Status 

Never married 45 27.3 49 29.6 48 28.8 

Married 28 16.3 32 18.8 28 16.5 

Legally separated 0 --- 0 --- 0 ---

Divorced 6 --- 8 --- 4 ---

Widowed 0 --- 1 --- 0 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

41
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 7. Rates of suicide among Service members in the Guard Component of the SELRES, Air Force and 

Army, CY 2014 - CY 2016, overall and by demographic characteristics 

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1 

Total 91 19.8 125 27.5 123 27.3 

Sex

Male 87 22.7 118 31.3 117 31.4 

Female 4 --- 7 --- 6 ---

Race

American Indian/Alaska Native 2 --- 1 --- 4 ---

Asian/Pacific Islander 5 --- 4 --- 6 ---

Black/African American 11 --- 10 --- 9 ---

White/Caucasian 73 20.0 105 29.3 99 27.8 

Other/Unknown 0 --- 5 --- 5 ---

Ethnicity

Hispanic 5 --- 9 --- 4 ---

Non-Hispanic 86 20.4 116 27.9 119 29.0 

Unknown 0 --- 0 --- 0 ---

Age

17–19 8 --- 9 --- 11 ---

20–24 35 31.3 44 39.6 43 39.0 

25–29 19 --- 24 26.0 36 38.6 

30–34 13 --- 23 32.6 12 ---

35–39 8 --- 12 --- 6 ---

40–44 3 --- 4 --- 8 ---

45–49 2 --- 6 --- 4 ---

50–54 2 --- 2 --- 3 ---

55–59 1 --- 1 --- 0 ---

Rank/grade 

Cadet/midshipman 0 --- 0 --- 0 ---

E1–E4 51 25.1 70 35.0 74 37.4 

E5–E9 34 17.3 46 23.7 40 20.8 

Officer 6 --- 9 --- 8 ---

Warrant officer 0 --- 0 --- 1 ---

Education

Some high school 4 --- 2 --- 5 ---

Alternative high school certification 5 --- 12 --- 13 ---

High school graduate 48 25.9 67 36.4 66 35.9 

Some college, no degree 15 --- 25 22.6 19 ---

Associate's degree or technical certification 3 --- 5 --- 2 ---

Four-year college degree 7 --- 12 --- 15 ---

Master's degree or greater 2 --- 2 --- 1 ---

Unknown 7 --- 0 --- 2 ---

Marital status 

Never married 58 25.5 68 29.5 81 35.1 

Married 26 12.9 51 26.2 37 19.4 

Legally separated 0 --- 0 --- 0 ---

Divorced 7 --- 6 --- 5 ---

Widowed 0 --- 0 --- 0 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

42
 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 8. Rates of suicide among Service members in the Active Component, Air Force, CY 2014 - CY 2016, 

overall and by demographic characteristics

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1

Total 62 19.1 64 20.5 61 19.4 

Sex 

Male 53 20.2 62 24.6 56 22.0 

Female 9 --- 2 --- 5 ---

Race

American Indian/Alaska Native 0 --- 0 --- 0 ---

Asian/Pacific Islander 1 --- 5 --- 0 ---

Black/African American 9 --- 7 --- 6 ---

White/Caucasian 45 19.3 48 21.5 52 23.2 

Other/Unknown 7 --- 4 --- 3 ---

Ethnicity

Hispanic 4 --- 2 --- 5 ---

Non-Hispanic 58 19.2 60 20.7 55 20.7 

Unknown 0 --- 2 --- 1 ---

Age

17–19 3 --- 1 --- 4 ---

20–24 27 30.1 25 29.1 14 ---

25–29 11 --- 16 --- 17 ---

30–34 11 --- 10 --- 10 ---

35–39 8 --- 5 --- 9 ---

40–44 2 --- 5 --- 4 ---

45–49 0 --- 2 --- 3 ---

50–54 0 --- 0 --- 0 ---

55–59 0 --- 0 --- 0 ---

Rank/grade 

Cadet/midshipman 0 --- 1 --- 0 ---

E1–E4 29 24.7 30 25.9 22 18.4 

E5–E9 28 20.1 29 22.2 27 20.6 

Officer 5 --- 4 --- 12 ---

Warrant officer 0 --- 0 --- 0 ---

Education

Some high school 0 --- 0 --- 0 ---

Alternative high school certification 0 --- 0 --- 0 ---

High school graduate 50 28.7 43 26.6 40 24.9 

Some college, no degree 0 --- 0 --- 0 ---

Associate's degree or technical certification 6 --- 16 --- 6 ---

Four-year college degree 5 --- 2 --- 5 ---

Master's degree or greater 1 --- 1 --- 9 ---

Unknown 0 --- 2 --- 1 ---

Marital status 

Never married 26 22.4 37 32.6 27 22.7 

Married 29 15.5 22 12.4 25 14.2 

Legally separated 0 --- 0 --- 0 ---

Divorced 6 --- 5 --- 8 ---

Widowed 1 --- 0 --- 1 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

43
 

 

 

 

 

 

 

 

 

 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 9. Rates of suicide among Service members in the Active Component, Army, CY 2014 - CY 2016, 

overall and by demographic characteristics 

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1 

Total 126 24.6 120 24.4 127 26.7 

Sex 

Male 118 26.7 113 26.8 117 28.8 

Female 8 --- 7 --- 10 ---

Race

American Indian/Alaska Native 1 --- 3 --- 3 ---

Asian/Pacific Islander 4 --- 4 --- 5 ---

Black/African American 27 24.6 26 24.3 17 ---

White/Caucasian 88 25.3 78 23.6 97 30.6 

Other/Unknown 6 --- 9 --- 5 ---

Ethnicity

Hispanic 18 --- 14 --- 15 ---

Non-Hispanic 108 24.4 105 24.9 112 27.7 

Unknown 0 --- 1 --- 0 ---

Age

17–19 2 --- 4 --- 3 ---

20–24 37 24.8 31 21.6 50 35.5 

25–29 36 30.2 30 27.0 32 30.2 

30–34 24 27.5 30 36.3 19 ---

35–39 13 --- 19 --- 11 ---

40–44 11 --- 4 --- 7 ---

45–49 1 --- 2 --- 4 ---

50–54 2 --- 0 --- 0 ---

55–59 0 --- 0 --- 1 ---

Rank/grade 

Cadet/midshipman 0 --- 1 --- 0 ---

E1–E4 56 25.6 45 21.4 60 28.8 

E5–E9 56 29.2 59 32.5 46 27.0 

Officer 12 --- 10 --- 18 ---

Warrant officer 2 --- 5 --- 3 ---

Education

Some high school 1 --- 1 --- 0 ---

Alternative high school certification 14 --- 15 --- 13 ---

High school graduate 68 24.1 68 25.4 75 29.3 

Some college, no degree 18 --- 17 --- 15 ---

Associate's degree or technical certification 8 --- 4 --- 1 ---

Four-year college degree 12 --- 9 --- 13 ---

Master's degree or greater 4 --- 4 --- 10 ---

Unknown 1 --- 2 --- 0 ---

Marital status 

Never married 35 19.2 39 21.8 47 26.3 

Married 73 24.2 71 24.9 65 24.0 

Legally separated 0 --- 0 --- 2 ---

Divorced 18 --- 9 --- 13 ---

Widowed 0 --- 1 --- 0 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

44
 

 

 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 10. Rates of suicide among Service members in the Active Component, Marine Corps, CY 2014 - CY 

2016, overall and by demographic characteristics 

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1 

Total 34 17.9 39 21.2 37 20.1 

Sex 

Male 32 18.3 37 21.8 36 21.3 

Female 2 --- 2 --- 1 ---

Race

American Indian/Alaska Native 0 --- 1 --- 3 ---

Asian/Pacific Islander 0 --- 1 --- 2 ---

Black/African American 1 --- 3 --- 4 ---

White/Caucasian 28 18.6 34 23.3 26 17.8 

Other/Unknown 5 --- 0 --- 2 ---

Ethnicity

Hispanic 2 --- 5 --- 1 ---

Non-Hispanic 32 20.3 34 22.6 36 24.3 

Unknown 0 --- 0 --- 0 ---

Age

17–19 2 --- 5 --- 4 ---

20–24 13 --- 22 25.5 24 27.5 

25–29 11 --- 5 --- 4 ---

30–34 8 --- 2 --- 1 ---

35–39 0 --- 4 --- 2 ---

40–44 0 --- 1 --- 1 ---

45–49 0 --- 0 --- 1 ---

50–54 0 --- 0 --- 0 ---

55–59 0 --- 0 --- 0 ---

Rank/grade 

Cadet/midshipman 0 --- 0 --- 0 ---

E1–E4 17 --- 28 25.8 23 21.2 

E5–E9 13 --- 9 --- 13 ---

Officer 4 --- 2 --- 1 ---

Warrant officer 0 --- 0 --- 0 ---

Education

Some high school 0 --- 0 --- 0 ---

Alternative high school certification 1 --- 0 --- 3 ---

High school graduate 25 16.1 36 23.8 32 21.2 

Some college, no degree 2 --- 0 --- 1 ---

Associate's degree or technical certification 2 --- 1 --- 0 ---

Four-year college degree 4 --- 2 --- 1 ---

Master's degree or greater 0 --- 0 --- 0 ---

Unknown 0 --- 0 --- 0 ---

Marital status 

Never married 14 --- 19 --- 19 ---

Married 19 --- 17 --- 18 ---

Legally separated 0 --- 0 --- 0 ---

Divorced 1 --- 3 --- 0 ---

Widowed 0 --- 0 --- 0 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

45
 

 

Suicide Rates Calendar Year 2016 Annual Report

Table 11. Rates of suicide among Service members in the Active Component, Navy, CY 2014 - CY 2016, 

overall and by demographic characteristics

2014 2015 2016

Group Count Rate1 Count Rate1 Count Rate1

Total 54 16.6 43 13.1 50 15.3 

Sex 

Male 53 19.8 40 14.9 46 17.3 

Female 1 --- 3 --- 4 ---

Race

American Indian/Alaska Native 2 --- 0 --- 0 ---

Asian/Pacific Islander 3 --- 2 --- 2 ---

Black/African American 5 --- 8 --- 5 ---

White/Caucasian 38 19.4 26 13.1 37 18.6 

Other/Unknown 6 --- 7 --- 6 ---

Ethnicity

Hispanic 10 --- 8 --- 6 ---

Non-Hispanic 42 16.5 32 12.7 39 16.0 

Unknown 2 --- 3 --- 5 ---

Age

17–19 0 --- 3 --- 3 ---

20–24 18 --- 16 --- 25 24.4 

25–29 14 --- 11 --- 12 ---

30–34 10 --- 3 --- 5 ---

35–39 9 --- 4 --- 4 ---

40–44 2 --- 5 --- 0 ---

45–49 0 --- 0 --- 0 ---

50–54 1 --- 1 --- 1 ---

55–59 0 --- 0 --- 0 ---

Rank/grade 

Cadet/midshipman 0 --- 0 --- 0 ---

E1–E4 20 15.6 24 18.6 30 23.7 

E5–E9 23 16.6 17 --- 19 ---

Officer 10 --- 2 --- 1 ---

Warrant officer 1 --- 0 --- 0 ---

Education

Some high school 0 --- 0 --- 0 ---

Alternative high school certification 5 --- 3 --- 4 ---

High school graduate 34 15.7 32 14.7 39 18.1 

Some college, no degree 0 --- 2 --- 1 ---

Associate's degree or technical certification 3 --- 0 --- 1 ---

Four-year college degree 7 --- 4 --- 5 ---

Master's degree or greater 2 --- 1 --- 0 ---

Unknown 3 --- 1 --- 0 ---

Marital status 

Never married 30 19.0 21 13.1 25 15.6 

Married 24 14.5 22 13.2 25 15.0 

Legally separated 0 --- 0 --- 0 ---

Divorced 0 --- 0 --- 0 ---

Widowed 0 --- 0 --- 0 --- 1

Rate per 100,000 Service members. Rates for strata with fewer than 20 suicides were not reported because of statistical instability.

46
 

CHAPTER 3 

Joint Results Summary 

47
 

Joint Results Summary Calendar Year 2016 Annual Report

Joint Results Summary: All Services 

This chapter presents a joint, aggregated overview of the combined Air Force, Army, Marine 

Corps, and Navy data. An examination of each of these Services, individually, follows in 

Chapters 4–7. The DoDSER system collects data on demographic, contextual, behavioral health, 

historical, and risk-related factors for all incidences of suicide and all suicide attempts that result 

in hospitalization or evacuation from a military theater of operations. Cases involving both 

Active Component Service members and SELRES Service members who were in a duty status at 

the time of the event are subject to this reporting requirement. Particular variables of interest are 

presented in the following text; however, the reader is encouraged to review the DoDSER data 

tables that follow each chapter’s text for the full data, presented separately by event type. 

Suicide Mortality

As of March 31, 2017, the AFMES had identified 300 confirmed or pending cases of suicide that 

occurred during CY 2016. A total of 275 of these deaths occurred among members of the Active 

Component. The remaining 25 deaths occurred among SELRES Service members who were in a 

duty status at the time of their death. A DoDSER survey was submitted for 299 deaths. These 

299 DoDSER surveys were used to populate the tables included in this chapter.

A total of 10 deaths were associated with one or more reported suicide attempts that occurred 

between CY 2010 (CY 2008 for Army) and CY 2016. The median number of days between the 

most recent suicide attempt and the date of death was 159. 

Incidence of Attempted Suicide 

Over the course of CY 2016, 1,263 non-fatal suicide attempts were identified. The associated 

DoDSER reports provided data on suicide attempts for 1,218 unique individuals. A total 1,182 

had a single suicide-attempt reported; 36 had two or more suicide attempts reported, dating back 

to 2010. The median number of days between the most recent suicide attempt and the 

penultimate attempt was 82 days. 

Event Information 

It is important to examine whether the Service members who died by suicide had made an effort 

to communicate their suicidal thoughts or feelings to their family, social, and peer networks prior 

to engaging in suicidal behavior. Data from CY 2016 suggest that 23.4 percent of those who 

died by suicide had communicated their desire to die prior to engaging in the behavior that would 

ultimately cause their death. Most frequently, these communications involved verbal 

communications about their thoughts and feelings (14.4%) or sending electronic (10.4%) 

messages. Most commonly, spouses (8.7%) and friends (9.0%) were the recipients of these 

messages. Communication of suicidal thoughts and feelings were either not made or recognized 

in 64.9 percent of suicide cases. Separately, suicide notes were left in 26.1 percent of deaths. 

48
 

 

 

 

 

 

Joint Results Summary Calendar Year 2016 Annual Report

Firearms were the method of injury 

most often identified in suicide cases 

(62.2%). The majority (94.6%) of the 

firearms used were personal 

possessions, with only 3.8 percent of 

firearm deaths resulting from selfdirected use of a military-issued 

weapon. Regardless of the method of 

injury, firearms were present in the 

immediate environment of 58.5 

percent of those who died by suicide. 

Figure 17 identifies the two most 

common methods of injury and the 

proportion of deaths that are due to 

those methods. These findings, 

related to the methods of injury, are 

consistent with the data from CY 2013 

- CY 2015.

Figure 17. Proportion of CY 2016 DoDSER suicide cases’ method of injury

compared to the three-year average of CY 2013 - CY 2015

With regard to suicide attempts, drug 

and/or alcohol overdose was the most

frequently reported (56.8%) 

mechanism of injury among 

DoDSER suicide-attempt cases. As 

seen in Figure 18, the other common 

methods of attempting suicide 

involved the self-directed use of a 

sharp or blunt object (19%) and 

hanging/asphyxiation (14.2%). The 

prevalence of these mechanisms of 

injury for CY 2016 were consistent 

with the data from CY 2013 - CY 

2015. 

The Service member’s primary 

residence, including military 

barracks, was the most common 

setting in which suicidal behavior occurred (67.5%), with a few cases occurring in other settings, 

for example, their work environment (4%), a vehicle (8.4%), or a hotel room (4.3%). Table 14 

provides a descriptive overview of the settings and circumstances involved in these cases of 

suicide and attempted suicide. 

Figure 18. Proportion of CY 2016 DoDSER suicide-attempt cases’ method of 

injury compared to the three-year average of CY 2013 - CY 2015

Demographic Characteristics

The most common characteristics associated with suicide among Service members closely 

resembled the makeup of the Services overall. The most common demographic profile was non49
 

 

Joint Results Summary Calendar Year 2016 Annual Report

Hispanic, white males, age 20–24, rank/grade of E1-E4, and a high school education. This 

represented 18.7% of all suicide DoDSER cases. 

The occurrence of suicide among female Service members rarely accounts for more than 20 

cases a year; however, for CY 2016, 21 cases were observed, which allowed a rate of suicide to 

be calculated for this specific demographic group. Similar to previous years, the proportion of 

male and female Service members identified in each event type produced a demographic 

distinction between cases of suicide and cases of suicide attempt. Females accounted for 7.0 

percent of DoDSER suicide cases and 30.8 percent of DoDSER suicide-attempt cases. 

Demographic and military service characteristics for all DoDSER suicide and suicide-attempt 

cases are detailed in Tables 12 and 13. 

Behavioral Health History 

Of those individuals who died by suicide in CY 2016, 44.1 percent had met criteria for at least 

one current or past behavioral health diagnosis. Substance use (20.7%), adjustment (21.4%), and 

anxiety (18.7%) disorders were common. However, the most frequent diagnosis was related to a 

mood disorder (21.7%). Conversely, 52.8 percent of individuals who died by suicide had no 

known history of a behavioral health diagnosis. 

Among those who attempted to die by suicide, 61.8 percent had at least one current or past 

behavioral health diagnosis present in their medical record. Again, substance use (22.5%), 

adjustment (27.7%), and anxiety (23.0%) disorders were common. However, the most frequent 

diagnosis in this group pertained to a mood disorder (31.0%). Among those who attempted 

suicide, 38.0 percent of individuals had no known behavioral health history. 

Table 15 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Figure 19 displays the prevalence of various diagnoses, prior self-harm, 

and the use of psychotropic medication in the 90 days prior to a suicide-related death. Risk 

indicators for CY 2016 were consistent with the data from the previous three calendar years. 

Figure 19. Proportions of behavioral health risk factors in CY 2016 

DoDSER suicide cases compared to the three-year average of CY 

2013 - CY 2015 

Figure 20. Proportions of behavioral health risk factors in CY 2016 

DoDSER suicide attempt cases compared to the three-year average of

CY 2013 - CY 2015 

50
 

Joint Results Summary Calendar Year 2016 Annual Report

Figure 20 displays the prevalence of the same factors among DoDSER suicide-attempt cases. 

Amongst reports of attempted suicide, there was a significant decrease in the prevalence of 

anxiety and substance-abuse disorders in CY 2016 compared to the three-year average for CY 

2013-CY 2015. 

Substance Use 

Alcohol use, during the time period immediately preceding death, was identified in 23.4 percent 

of suicide cases, though the “unknown” response for this item was endorsed for a substantial 

proportion of cases (47.5%; Table 14). Drug use (including illicit, prescription, and over-thecounter substances) was identified in 7.0 percent of suicides. Proportionally, few deaths resulted 

from drug/alcohol overdose (3.3%). 

Alcohol use immediately prior to the suicidal behavior was present in 29.3 percent of suicideattempt cases, and 48.6 percent of cases were positive for drug use immediately prior to the 

suicidal behavior. Prescription drugs had the highest overall frequency of overdose (25.7%). 

Health Care Utilization

Regardless of whether or not an individual voluntarily disclosed—or was assessed for—suicidal 

thoughts, feelings, and behavior, 58.5 percent of the Service members who died by suicide in CY 

2016 had been in contact with the MHS in the 90 days prior to their death (Table 15). In total, 

29.1% of cases had received either inpatient (6.4%) or outpatient (28.1%) behavioral health 

services. Substance abuse services and family assistance programs were utilized less at 10.4 and 

3.7 percent, respectively. The proportion of Service members who had made contact with the 

MHS in the 90 days preceding their death was consistent with the three previous years. 

A similar pattern was observed for suicide-attempt case reports. In total, 69.3 percent of the 

reports indicated contact with the MHS in the 90 days prior to the behavior. This included both 

physical- health visits (58.1%) and behavioral health visits (50.4%). Of the latter, 14.0% of 

visits were for inpatient behavioral health and 49.3 percent were for outpatient behavioral health 

services. Additionally, 9.7 percent of reports indicated participation with substance-abuse 

services and 4.4 percent identified participation with family assistance programs. These 

proportions were consistent with data from previous years. 

Psychosocial Stressors 

Overall, the presence of psychosocial stressors in CY 2016 is consistent with the proportionality 

of stressors in the previous three years. Relationship difficulties, especially strife within—or 

termination of—an intimate partner relationship, were present in 39.5 percent of suicide cases 

and 36.3 percent of suicide attempts. 

Individuals who died by suicide were frequently involved with legal and administrative stressors 

(25.1%), as were those who attempted to die by suicide (31.8%). Being ‘under investigation’

was a shared risk factor among both suicide cases (10.4%) and suicide-attempt (9.6%) reports.

51
Joint Results Summary 

Figure 21. Proportions of stress-related risk factors in CY 2016 

DoDSER suicide cases compared to the three-year average of CY 

2013 - CY 2015 

Calendar Year 2016 Annual Report

Figure 22. Proportions of stress-related risk factors in CY2016 

DoDSER suicide-attempt cases compared to the three-year average of

CY 2013 - CY 2015 

 

Figures 21 and 22 display the prevalence of six stressors queried in the DoDSER system from

CY 2016 compared to the three-year average from CY 2013 - CY 2015. Table 16 also provides 

data for stressors pertaining to relationships, family issues, legal or administrative problems, 

work and financial difficulties, and abuse victimization or perpetration. The prevalence of these 

factors was consistent over time for both suicide and suicide attempt reports. The one identified 

significant difference was a decrease in the prevalence of administrative/legal problems for 

suicide cases in CY 2016 relative to the average of CY 2013 - CY 2015. 

Sexual Assault 

To better assess and understand any potential association between sexual assault and the 

occurrence of suicide-related behavior, data collected from the DoDSER system were matched 

against records related to the filing of an unrestricted report of sexual assault. According to the 

analysis of these data, 1 DoDSER suicide case and 53 DoDSER suicide-attempt cases were 

associated with incidences of sexual assault that were reported via the unrestricted reporting 

option and which occurred at any point in time prior to the suicide event. When the date that a 

sexual assault occurred was restricted to the 12 months preceding the suicide behavior, no 

DoDSER suicide cases, and 24 DoDSER suicide-attempt cases, were associated with an 

unrestricted report of a sexual assault. Table 16 provides the number of sexual assaults recorded 

directly by the DoDSER system. Discrepancies between those cases identified by SAPRO and 

those identified on the DoDSER surveys could be due to several factors, including utilization of 

the restricted reporting option. 

Latent Class Analysis 

An important consideration in surveillance is that risk and protective factors often co-occur. 

Descriptive analyses that look at individual risk or protective factors may miss this. A latent 

class analysis was used to describe unique risk factor patterns that occurred in the data. The 

analysis also provides estimates of how common the various patterns are in the data. A threeclass model was identified as the best solution for the suicide case data. The three classes are 

52
 

Figure 24. Risk-factor prevalence within each of the latent 

classes identified among suicide-attempt cases

Figure 23. Risk-factor prevalence within each of the latent 

classes identified among suicide decedents

 

Joint Results Summary Calendar Year 2016 Annual Report

depicted in Figure 23. The first class was smallest with approximately 6% of cases assigned to 

it. They were defined by a strong endorsement of mood and anxiety disorders, substance abuse, 

active psychotropic medication use prior to death, relationship problems, and 

administrative/legal problems proximal to the date of death. 

The second class included approximately 25% of the suicide cases. This group was defined by a 

low prevalence of administrative/legal and work problems. Of the behavioral health conditions, 

mood disorders were the most commonly identified. The third class was the largest with the 

remaining 69% of suicide decedents assigned to it. This class was defined by a pronounced 

absence of endorsement of any of the included risk factors in the model. The most common risk 

factor was relationship difficulty prior to the event; however, this was common for all three 

classes so it did not contribute substantially in differentiating the class structures. 

The latent class analysis of the suicide-attempt cases (Figure 24) also identified a three-class 

solution as optimal. The first class had approximately 13% of suicide-attempt cases assigned to 

it. The most common risk factor was an endorsement of adjustment disorder. There was also a 

lack of comorbid sleep, anxiety, or mood disorders. The second class was slightly larger with 

approximately 36% of attempt cases assigned to it. The most salient risk factors for this group 

were mood disorders and active psychotropic medication use prior to the event. The third class 

was the largest with the remaining 51% of attempt cases assigned to it. This class had low 

endorsement for almost all risk factors included in the model. Similar to the third class for the 

suicide decedent model, this model had a moderate endorsement of relationship difficulties. 

Again, this may simply reflect the ubiquity of this risk factor in the population. 

Summary 

The occurrence and characteristics of risk factors that were present for cases of suicide and 

suicide attempt for CY 2016 are consistent, overall, with DoDSER findings from CY 2013 - CY

2015. 

53
 

Table 12. Demographic characteristics1 of suicide and suicide-attempt DoDSER reports

all Services

submitted for CY 2016, 

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. 

Sex 

% No. % 

Male 278 93.0 874 69.2 

Female 21 

Age

7.0 389 30.8 

17–19 14 4.7 198 15.7 

20–24 115 38.5 628 49.7 

25–29 72 24.1 219 17.3 

30–34 39 13.0 115 9.1 

35–39 28 9.4 61 4.8 

40–44 17 5.7 27 2.1 

45–64 14 

Race

4.7 15 1.2 

American Indian/Alaska Native 5 1.7 18 1.4 

Asian/Pacific Islander 13 4.3 84 6.7 

Black/African American 37 12.4 269 21.3 

White/Caucasian 241 80.6 874 69.2 

Other/Unknown 3 

Ethnicity

1.0 18 1.4 

Hispanic 31 10.4 192 15.2 

Not Hispanic 268 89.6 1,070 84.7 

Unknown 0 

Education

0.0 1 0.1 

Less than high school 0 0.0 11 0.9 

Alternative high school 20 6.7 76 6.0 

High school graduate 195 65.2 957 75.8 

Associate's or technical degree 31 10.4 138 10.9 

Four-year degree 32 10.7 57 4.5 

Postgraduate 20 6.7 23 1.8 

Unknown 1 

Marital status 

0.3 1 0.1 

Never married 126 42.1 688 54.5 

Married 147 49.2 515 40.8 

Separated 2 0.7 2 0.2

Divorced 23 7.7 58 4.6 

Widowed 1 0.3 0 0.0 1

 

Joint Results Summary Calendar Year 2016 Annual Report

Data on demographic characteristics primarily provided by DMDC.

54
 

Table 13. Military characteristics1 of suicide and suicide-attempt DoDSER reports, CY 2016, all Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

Component

No. % No. % 

Active 274 91.6 1,195 94.6 

Reserve 10 3.3 33 2.6 

Guard

Rank/grade 

15 5.0 35 2.8 

Cadet/midshipman 0 0.0 0 0.0 

Enlisted, unknown grade 0 0.0 32 2.5 

E1–E4 137 45.8 917 72.6 

E5–E9 121 40.5 273 21.6 

Warrant 4 1.3 2 

Officer 37 12.4 39 3.1 

Unknown

Enlisted occupational group

0 0.0 0 0.0 

Infantry, gun crews, and seamanship specialists 55 18.4 202 16.0 

Electronic equipment repairers 24 8.0 90 7.1 

Communications and intelligence specialists 35 11.7 105 8.3 

Health care specialists 18 6.0 119 9.4 

Other technical and allied specialists 9 3.0 22 1.7 

Functional support and administration 37 12.4 180 14.3 

Electrical/mechanical equipment repairers 50 16.7 186 14.7 

Craftsworkers 7 2.3 38 3.0 

Service and supply handlers 18 6.0 169 13.4 

Non-occupational 3 1.0 86 6.8 

Unknown 2 0.7 25 2.0 

Officer occupational group 

General officers and executives 1 0.3 0 0.0 

Tactical operations officers 12 4.0 14 1.1 

Intelligence officers 5 1.7 2 0.2 

Engineering and maintenance officers 10 3.3 7 0.6 

Scientists and professionals 1 0.3 2 0.2 

Health care officers 7 2.3 7 0.6 

Administrators 2 0.7 1 0.1 

Supply, procurement, and allied officers 1 0.3 6 0.5 

Non-occupational 2 0.7 2 0.2 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 168 56.2 448 35.5

Number of deployments 

1 66 22.1 251 19.9 

2 50 16.7 102 8.1 

3 or more 52 17.4 95 7.5 

 Specific deployment locations2

 

Afghanistan 72 24.1 195 15.4 

Iraq 55 18.4 132 10.5 

Kuwait 74 24.7 189 15.0

No 130 43.5 815 64.5 

Unknown 1 0.3 0 0.0 

 

Joint Results Summary Calendar Year 2016 Annual Report

0.2

1

Data on military characteristics primarily provided by DMDC. 2

Subcategories are not mutually exclusive. 

55
 

Table 14. Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, all Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. 

Event location country

% No. % 

United States 270 90.3 1,071 84.8 

Iraq 1 0.3 2 0.2 

Afghanistan 0 0.0 10 0.8 

Kuwait 0 0.0 23 1.8 

Korea 4 1.3 46 3.6 

Other Europe 3 1.0 8 0.6 

North America 0 0.0 3 0.2 

Central or South America 0 0.0 1 0.1 

Japan 8 2.7 44 3.5 

Belgium 0 0.0 2 0.2 

Germany 3 1.0 18 1.4 

United Kingdom 0 0.0 7 0.6 

Other 9 3.0 22 1.7 

Unknown 1 

Event setting 

0.3 6 0.5 

Own residence 143 47.8 472 37.4 

Barracks 57 19.1 555 43.9 

Residence of friend or family 23 7.7 45 3.6 

Work/jobsite 12 4.0 34 2.7 

Automobile 25 8.4 63 5.0 

Inpatient medical facility 1 0.3 12 1.0 

Hotel 13 4.3 10 0.8 

Other 23 7.7 68 5.4 

Unknown 2 

Event method1

0.7 4 0.3 

Drugs/alcohol 10 3.3 717 56.8 

Hanging/asphyxiation 84 28.1 179 14.2 

Poisoning 5 1.7 48 3.8 

Firearm 186 62.2 57 4.5 

Military firearm 7 2.3 13 1.0 

Non-military firearm 176 58.9 44 3.5 

Firearm of unknown origin 3 1.0 0 0 

Trauma, sharp or blunt force 14 4.7 240 19.0 

Other 0 0.0 18 1.4 

Pending/unknown 0

Used alcohol during event

0.0 4 0.3 

Yes 70 23.4 370 29.3 

No 87 29.1 854 67.6 

Unknown 142 47.5 39 3.1 

Joint Results Summary Calendar Year 2016 Annual Report

56
 

Table 14 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, all 

Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. 

Used drugs during event

% No. % 

Yes2 21 7.0 614 48.6 

Illegal drugs 

Used, overdose 0 0.0 41 3.2 

Used, no overdose 4 1.3 25 2.0 

Prescription drugs 

Used, overdose 6 2.0 325 25.7 

Used, no overdose 6 2.0 65 5.1 

Non-prescription drugs 

Used, overdose 5 1.7 250 19.8 

Used, no overdose 1 0.3 42 3.3 

No 135 45.2 618 48.9 

Unknown 143 

Death-risk gambling 

47.8 31 2.5 

Yes 3 1.0 23 1.8 

No 269 90.0 1,205 95.4 

Unknown 27 

Planned/premeditated 

9.0 35 2.8 

Yes 121 40.5 273 21.6 

No 106 35.5 870 68.9 

Unknown 72 

Observable 

24.1 120 9.5 

Yes 61 20.4 510 40.4 

No 220 73.6 689 54.6 

Unknown 18 

Suicide note left 

6.0 64 5.1 

Yes 78 26.1 131 10.4 

No 172 57.5 1,096 86.8 

Unknown 

Communicated potential for self-harm (other than suicide note) 

49 16.4 36 2.9 

Yes 70 23.4 286 22.6 

How communicated2

 

Written 3 1.0 9 0.7 

Verbal 43 14.4 175 13.9 

Text 31 10.4 115 9.1 

Other 3 1.0 11 0.9 

To whom communicated2

Supervisor 8 2.7 44 3.5 

Chaplain 3 1.0 4 0.3 

Mental health staff 14 4.7 68 5.4 

Friend 27 9.0 101 8.0 

Spouse 26 8.7 100 7.9 

Family 2 0.7 23 1.8 

Other 4 1.3 9 0.7 

No 194 64.9 916 72.5 

Unknown 35 11.7 61 4.8 

Joint Results Summary Calendar Year 2016 Annual Report

57
 

Table 14 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, all 

Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. 

Residence at time of event 

% No. % 

Barracks 75 25.1 617 48.9 

Bachelor Enlisted/Officer Quarters 12 4.0 24 1.9 

On-base family housing 33 11.0 102 8.1 

Off-base 157 52.5 451 35.7 

Ship 3 1.0 19 1.5 

Other 17 5.7 37 2.9 

Unknown 2 

Reside alone at time of event

0.7 13 1.0 

Yes 119 39.8 411 32.5 

No 169 56.5 824 65.2 

Unknown 11 

Gun in home/immediate environment 

3.7 28 2.2 

Yes 175 58.5 142 11.2 

No 86 28.8 1,035 81.9 

Unknown 38 

Duty environment2

12.7 86 6.8 

Garrison/permanent duty station 233 77.9 952 75.4 

Leave 18 6.0 35 2.8 

Temporary duty 7 2.3 9 0.7 

Training 16 5.4 120 9.5 

Other/unknown 40 13.4 107 8.5 

Deployed at time of event 

Yes 4 1.3 45 3.6 

Location

Afghanistan 0 0.0 11 0.9 

Kuwait 0 0.0 15 1.2 

Other 4 1.3 19 1.5 

No 295 98.6 1,218 96.4 

 

 

Joint Results Summary Calendar Year 2016 Annual Report

1

Data on the cause of the death were provided by AFMES. 2

Subcategories are not mutually exclusive. 

58
 

Table 15. Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 

2016, all Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. 

Any mental health diagnosis 

% No. % 

Yes1 132 44.1 780 61.8 

Mood disorder 65 21.7 392 31.0 

Anxiety disorder2 56 18.7 291 23.0 

Personality disorder 13 4.3 85 6.7 

Psychotic disorder 2 0.7 11 0.9 

Adjustment disorder 64 21.4 350 27.7 

Substance abuse disorder 62 20.7 284 22.5 

No 158 52.8 480 38.0 

Unknown 9 

Sleep disorder

3.0 3 0.2 

Yes 46 15.4 141 11.2 

No 237 79.3 1,097 86.9 

Unknown 16 

History of traumatic brain injury 

5.4 25 2.0 

Yes 11 3.7 49 3.9 

No 274 91.6 1,187 94.0 

Unknown 14 

Family history of mental illness 

4.7 27 2.1 

Yes 42 14.0 423 33.5 

No 148 49.5 752 59.5 

Unknown 109 

Prior self-injury 

36.5 88 7.0 

Yes 40 13.4 385 30.5 

Number of prior self-injuries

One 18 6.0 191 15.1 

More than one 22 7.4 191 15.1 

Unknown 0 0.0 3.0 0.2 

Current event similar to prior 11 3.7 199 15.8 

No 214 71.6 839 66.4 

Unknown 45 

Psychotropic medications, last 90 days 

15.1 39 3.1 

Yes1 49 16.4 396 31.4 

Antidepressant 40 13.4 343 27.2 

Antianxiety 16 5.4 182 14.4 

Antimanic 2 0.7 12 1.0 

Anticonvulsant 6 2.0 18 1.4 

Antipsychotic 7 2.3 36 2.9 

Sleep medication 23 7.7 196 15.5 

No 250 83.6 866 68.6 

Unknown 0 0.0 1 0.1 

Joint Results Summary Calendar Year 2016 Annual Report

59
 

Table 15 (cont). Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports

for CY 2016, all Services 

submitted 

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. % No. % 

Pain medication at time of event 

Yes 34 11.4 209 16.5 

Opioid medication 10 3.3 67 5.3 

No 216 72.2 1,004 79.5 

Unknown 49 16.4 50 4.0 

Health/social services, last 90 days 

Yes1 175 58.5 875 69.3 

Medical treatment facility 162 54.2 734 58.1 

Substance Abuse Services 31 10.4 123 9.7 

Family Assistance Program 11 3.7 56 4.4 

Outpatient mental health 84 28.1 623 49.3 

Inpatient mental health 19 6.4 177 14.0 

No 119 39.8 381 30.2 

Unknown 5 1.7 7 0.6 

 

 

Joint Results Summary Calendar Year 2016 Annual Report

1

Subcategories are not mutually exclusive. 

2

Survey form used for this CY used DSM-IV taxonomy for behavioral health diagnoses; thus posttraumatic stress disorder is subsumed under the 

“Anxiety disorder” category.

60
 

Joint Results Summary Calendar Year 2016 Annual Report

Table 16. Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for CY 

2016, all Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 132 44.1 522 41.3 

Intimate relationship 118 39.5 459 36.3 

Other relationship 37 12.4 140 11.1 

No 143 47.8 727 57.6 

Unknown 24 8.0 14 1.1 

Friend and family stressors, last 90 days 

Yes1 17 5.7 122 9.7 

Death of spouse or other family member (not suicide) 7 2.3 45 3.6 

Death of friend (not suicide) 2 0.7 29 2.3 

Serious illness of friend or family member 9 3.0 59 4.7 

No 255 85.3 1,124 89 

Unknown 27 9.0 17 1.3 

History of friend or family death by suicide 

Yes1 25 8.4 175 13.9 

Spouse 0 0.0 0 0.0 

Family other than spouse 13 4.3 72 5.7 

Friend 13 4.3 122 9.7 

No 263 88.0 1,073 85.0 

Unknown 11 3.7 15 1.2 

Administrative/legal problems, last 90 days 

Yes1 75 25.1 402 31.8 

Courts martial proceedings 6 2.0 9 0.7 

Article 15/Non-judicial punishment 14 4.7 85 6.7 

Administrative separation proceedings 11 3.7 123 9.7 

Away without leave/deserter status 7 2.3 25 2.0 

Medical evaluation board proceedings 9 3.0 117 9.3 

Civil legal proceedings 17 5.7 69 5.5 

Non-selection for promotion 7 2.3 38 3.0 

Under investigation 31 10.4 121 9.6 

No 219 73.2 854 67.6 

Unknown 5 1.7 7 0.6 

Excessive debt/bankruptcy, last 90 days 

Yes 13 4.3 83 6.6 

No 241 80.6 1,134 89.8 

Unknown 45 15.1 46 3.6 

Workplace, last 90 days 

Yes1 50 16.7 422 33.4 

Job problems 40 13.4 316 25.0 

Supervisor/coworker issues 17 5.7 241 19.1 

Poor performance review 16 5.4 131 10.4 

Unit/workplace hazing 0 0.0 35 2.8 

No 234 78.3 825 65.3 

Unknown 15 5.0 16 1.3 

61
 

Joint Results Summary Calendar Year 2016 Annual Report

Table 16 (cont). Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for 

CY 2016, all Services

Suicide 

(n = 299) 

Suicide attempt

(n = 1,263) 

No. % No. % 

Abuse, assault, or harassment victimization, last year

Yes1 8 2.7 155 12.3 

Physical abuse or assault 1 0.3 50 4.0 

Sexual abuse or assault 3 1.0 60 4.8 

Emotional abuse 5 1.7 84 6.7 

Sexual harassment 2 0.7 26 2.1 

No 255 85.3 1,089 86.2 

Unknown 36 12 19 1.5 

Abuse, assault, or harassment perpetration, last year

Yes1 25 8.4 73 5.8 

Physical abuse or assault 12 4.0 44 3.5 

Sexual abuse or assault 13 4.3 18 1.4 

Emotional abuse 8 2.7 24 1.9 

Sexual harassment 2 0.7 3 0.2 

No 244 81.6 1,163 92.1 

Unknown 30 10 27 2.1 1

Subcategories are not mutually exclusive. 

62
CHAPTER 4 

U.S. Air Force 

63
U.S. Air Force Calendar Year 2016 Annual Report

DoDSER Results Summary: Air Force 

This chapter presents data collected on cases of suicide and suicide attempt involving members 

of the Air Force. The DoDSER system collects data on demographic, contextual, behavioral 

health, historical, and risk-related factors for all incidences of suicide and all suicide attempts 

that result in hospitalization or evacuation from a military theater of operations. Cases involving 

both Active Component Service members and SELRES Service members who were in a duty 

status at the time of the event are subject to this reporting requirement. Particular variables of 

interest are presented in the following text, however, the reader is encouraged to examine the 

DoDSER data tables that follow this chapter’s text for the full Air Force data, presented 

separately by event type. 

Suicide Mortality

As of March 31, 2017, the AFMES had identified 66 confirmed or pending cases of suicide that 

occurred during CY 2016 and involved a member of the Air Force. A total of 61 of these deaths 

occurred among members of the Air Force’s Active Component. The remaining 5 deaths 

occurred among SELRES Service members who were in a duty status at the time of their death. 

A DoDSER survey was submitted for all 66 deaths. These 66 DoDSER surveys were used to 

populate the data tables included in this chapter. 

One of these suicide-related deaths was associated with one or more previous suicide attempts 

that occurred between CY 2010 and CY 2016. The number of days between the most recent 

suicide attempt and the date of death was 111. 

Incidence of Attempted Suicide 

Over the course of CY 2016, 297 non-fatal suicide attempts were identified among members of 

the Air Force. These reports provided data on suicide attempts for 278 unique individuals. A 

total of 264 Airmen had a single suicide-attempt recorded; two or more suicide-attempt were 

recorded for 14 (4.7%) individuals. The median number of days between the most recent suicide 

attempt and the penultimate attempt was 66 days. 

Event Information 

It is important to examine whether the Airmen who died by suicide had made an effort to 

communicate their suicidal thoughts or feelings to their family, social, and peer networks prior to 

engaging in suicidal behavior. Data from CY 2016 suggest that 19.7 percent of those who died 

by suicide had communicated their desire to die prior to engaging in the behavior that would 

ultimately cause their death. Most frequently, these communications involved verbal 

communications about their thoughts and feelings (13.6%) or sending electronic (10.6%) 

messages. Spouses (7.6%) and friends (10.6%) were the most common recipients of these 

messages. Communication of suicidal thoughts and feelings were either not made or recognized 

in 74.2 percent of suicide cases. Separately, suicide notes were left in 36.4 percent of Air Force 

suicide deaths. 

64
Figure 25. Proportion of CY 2016 Air Force DoDSER suicide cases’ method of

injury compared to the three-year average of CY 2013 - CY 2015

U.S. Air Force 

Firearms were the method of injury 

most often identified in Air Force 

suicide cases (56.1%). All (100.0%) 

of the firearms used were personal 

possessions; no firearm deaths 

resulted from self-directed use of a 

military-issued weapon. Regardless 

of the method of injury, firearms were 

present in the immediate environment 

of 54.5 percent of Airmen who died 

by suicide. Figure 25 identifies the 

two most common methods of injury 

and the proportion of deaths that are 

due to those methods. 

With regard to suicide attempts, drug 

and/or alcohol overdose was the most

frequently reported (52.5%) 

mechanism of injury among the Air 

Force’s DoDSER suicide-attempt 

cases. As seen in Figure 26, the other 

common methods of attempting 

suicide involved the self-directed use 

of a sharp or blunt object (19.2%) and 

asphyxiation (15.5%). 

An Airman’s primary residence, 

including military barracks, was the 

most common setting in which 

suicidal behavior occurred (74.2%), 

with a few cases occurring in other 

settings, for example, their work 

environment (3.0%), a vehicle 

(10.6%), or a hotel room (3.0%). 

Table 19 provides a descriptive 

overview of the settings and 

circumstances involved in these cases 

of suicide and attempted suicide. 

Demographic Characteristics

Calendar Year 2016 Annual Report

Figure 26. Proportion of CY 2016 Air Force DoDSER suicide-attempt cases’

method of injury compared to the three-year average of CY 2013 - CY 2015 

The most common demographic characteristics associated with suicide among members of the 

Air Force closely resembles the makeup of the Air Force population overall. The most common 

demographic profile was non-Hispanic, white males, age 20–24, rank/grade of E1–E4, and a 

high school education. This represented 15.2% of all suicide DoDSER cases.

65
Figure 27. Proportions of behavioral health risk factors in CY 

2016 Air Force DoDSER suicide cases compared to the threeyear average of CY 2013 - CY 2015 

Figure 28. Proportions of behavioral health risk factors in CY 

2016 Air Force DoDSER suicide-attempt cases compared to the 

three-year average of CY 2013 - CY 2015

U.S. Air Force Calendar Year 2016 Annual Report

The occurrence of suicide among female Airmen continues to comprise fewer than 20 cases a 

year, precluding a rate calculation. Similar to previous years, the proportion of male and female 

Airmen identified in each event type produced a demographic distinction between cases of 

suicide and cases of suicide attempt. Female Airmen accounted for 7.6 percent of DoDSER 

suicide cases and 38.7 percent of DoDSER suicide-attempt cases.

Demographic and military service characteristics for all Air Force DoDSER suicide and suicideattempt cases are detailed in Tables 17 and 18. 

Behavioral health History 

Of those individuals who died by suicide in CY 2016, 40.9 percent had met criteria for at least 

one current or past behavioral health diagnosis. Substance abuse (12.1%) and anxiety (16.7%) 

disorders were common. The most frequent diagnoses were mood (19.7%) and adjustment 

(19.7%) disorders. Conversely, 59.1 percent of Airmen who died by suicide had no known 

behavioral health history. 

Among reports of those who attempted to die by suicide, 66.7 percent identified at least one 

current or past behavioral health diagnosis present in their medical record. Again, adjustment 

(24.6%), anxiety (31.6%), and substance use (18.9%) disorders were common. However, the 

most frequent diagnosis pertained to a mood disorder (42.8%). Thirty-three percent of reports 

did not identify any known behavioral health history. 

Table 20 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Figure 27 displays the prevalence of various diagnoses, prior self-harm and 

the use of psychotropic medication in the 90 days prior to a suicide-related death. Figure 28 

displays the prevalence of the same factors among DoDSER suicide-attempt cases. 

66
U.S. Air Force Calendar Year 2016 Annual Report

Substance Use 

Alcohol use, during the time period immediately preceding death, was identified in 27.3 percent 

of Air Force suicide cases, though the “unknown” response for this item was endorsed for a 

substantial proportion of cases (45.5%; Table 19). Drug use (including illicit, prescription, and 

over-the-counter substances) was identified in 7.6 percent of Air Force suicides. Proportionally, 

few deaths resulted from drug/alcohol overdose (4.5%). 

Alcohol use immediately prior to the suicidal behavior was present in 33.3 percent of Air Force 

suicide-attempt case reports, and 46.8 percent of Air Force case reports indicated drug use 

immediately prior to the suicidal behavior. Prescription drugs had the highest overall frequency 

of overdose (27.9%). 

Health Care Utilization

Regardless of whether or not an individual voluntarily disclosed—or was assessed for—suicidal 

thoughts, feelings, and behavior, 65.2 percent of the Airmen who died by suicide in CY 2016 had 

been in contact with the MHS in the 90 days prior to their death (Table 20). Overall, 30.3 

percent had received either inpatient (4.5%) or outpatient (33.3%) behavioral health services. Of 

the total, 12.1 percent of Airmen who died by suicide had participated in either substance abuse 

or family assistance programs. 

A similar pattern was observed for suicide-attempt cases: 75.4 percent of the Airmen who 

attempted suicide in CY 2016 had been in contact with the MHS in the 90 days prior to the 

behavior. Overall, 54.2 percent had received either inpatient (16.8%) or outpatient (51.9%) 

behavioral health services. Of the total, 12.1 percent had participated in substance-abuse 

services and 7.1 percent had participated in family assistance programs. 

Psychosocial Stressors 

Overall, the presence of psychosocial stressors among Airmen in CY 2016 is consistent with the 

proportionality of stressors in the previous four years. Relationship difficulties, especially strife 

within—or termination of—an intimate-partner relationship, were present in 43.9 percent of Air 

Force suicide cases and 38.7 percent of Air Force suicide-attempt cases. 

Reports of deaths by suicide and suicide attempts identified legal/administrative risk factors as 

common for both groups at 25.8 percent and 32.0 percent, respectively. Figure 29 (cases of 

suicide) and Figure 30 (cases of suicide attempt) display the prevalence of six stressors queried 

in the DoDSER system from CY 2016 compared to the three-year average from CY 2013 -CY

2015. Table 21 also provides data for stressors pertaining to relationships, family issues, legal or 

administrative problems, work and financial difficulties, and abuse victimization or perpetration. 

67
 

 

 

 

U.S. Air Force Calendar Year 2016 Annual Report

Figure 29. Proportions of stress-related risk factors in CY 2016 

Air Force DoDSER suicide cases compared to the three-year

average of CY 2013 - CY 2015 

Figure 30. Proportions of behavioral health risk factors in CY 

2016 Air Force DoDSER suicide-attempt cases compared to the 

three-year average of CY 2013 - CY 2015

Sexual Assault 

To better assess and understand any potential association between sexual assault and the 

occurrence of suicide-related behavior, Air Force data collected from the DoDSER system were 

matched against records related to the filing of an unrestricted report of sexual assault. 

According to the analysis of these data, no Air Force DoDSER suicide cases and 3 Air Force 

DoDSER suicide-attempt cases were associated with an unrestricted report of a sexual assault 

that occurred during the 12 months preceding the suicide-related event. When the limit of the 12 

months preceding the suicide-related behavior was removed, no cases of suicide and 15 cases of 

attempted suicide were associated with unrestricted reports of sexual assault. Table 21 provides 

the number of sexual assaults recorded directly by the DoDSER system. Discrepancies between 

those cases identified by SAPRO and those identified on the DoDSER surveys could be due to 

several factors, including utilization of the restricted reporting option. 

68
 

U.S. Air Force Calendar Year 2016 Annual Report

Table 17. Demographic characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Air Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Sex 

Male 61 92.4 182 61.3 

Female 5 7.6 115 38.7 

Age

17–19 4 6.1 20 6.7 

20–24 14 21.2 143 48.1 

25–29 19 28.8 72 24.2 

30–34 11 16.7 30 10.1 

35–39 9 13.6 22 7.4 

40–44 5 7.6 8 2.7

45–64 4 6.1 2 0.7 

Race

American Indian/Alaska Native 0 0.0 4 1.3 

Asian/Pacific Islander 2 3.0 18 6.1 

Black/African American 7 10.6 44 14.8 

White/Caucasian 56 84.8 224 75.4 

Other/Unknown 1 1.5 7 2.4 

Ethnicity

Hispanic 7 10.6 36 12.1 

Not Hispanic 59 89.4 261 87.9 

Unknown 0 0.0 0 0.0 

Education

Less than high school 0 0.0 0 0.0 

Alternative high school 0 0.0 1 0.3 

High school graduate 41 62.1 216 72.7 

Associate's or technical degree 8 12.1 53 17.8 

Four-year degree 6 9.1 20 6.7 

Postgraduate 10 15.2 6 2.0 

Unknown 1 1.5 1 0.3 

Marital status 

Never married 30 45.5 141 47.5 

Married 27 40.9 129 43.4 

Separated 0 0.0 1 0.3 

Divorced 8 12.1 26 8.8 

Widowed 1 1.5 0 0.0 1

Data on demographic characteristics primarily provided by DMDC.

69
U.S. Air Force Calendar Year 2016 Annual Report

Table 18. Military characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Air 

Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Component

Active 61 92.4 285 96 

Reserve 3 4.5 5 1.7 

Guard 2 3.0 7 2.4 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

Enlisted, unknown grade 0 0.0 3 1.0 

E1–E4 22 33.3 193 65 

E5–E9 31 47 91 30.6 

Officer 13 19.7 10 3.4 

Unknown 0 0.0 0 0.0 

Enlisted occupational group

Infantry, gun crews and seamanship specialists 1 1.5 4 1.3 

Electronic equipment repairers 6 9.1 21 7.1 

Communications and intelligence specialists 5 7.6 19 6.4 

Health care specialists 2 3.0 34 11.4 

Other technical and allied specialists 3 4.5 6 2.0 

Functional support and administration 12 18.2 64 21.5 

Electrical/mechanical equipment repairers 15 22.7 52 17.5 

Craftsworkers 2 3.0 8 2.7 

Service and supply handlers 5 7.6 53 17.8 

Non-occupational 1 1.5 18 6.1 

Unknown 1 1.5 8 2.7 

Officer occupational group 

General officers and executives 0 0.0 0 0.0 

Tactical operations officers 3 4.5 3 1.0 

Intelligence officers 3 4.5 2 0.7 

Engineering and maintenance officers 2 3.0 2 0.7 

Scientists and professionals 1 1.5 0 0.0 

Health care officers 2 3.0 2 0.7 

Administrators 1 1.5 0 0.0 

Supply, procurement and allied officers 1 1.5 1 0.3 

Non-occupational 0 0.0 0 0.0 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 44 66.7 113 38.0 

Number of deployments 

1 14 21.2 57 19.2 

2 14 21.2 25 8.4 

3 or more 16 24.2 31 10.4 

Specific deployment locations2

Afghanistan 17 25.8 36 12.1 

Iraq 8 12.1 28 9.4 

Kuwait 14 21.2 21 7.1 

No 22 33.3 184 62.0 

Unknown 0 0.0 0 0.0 1

Data on military characteristics primarily provided by DMDC. 2

Subcategories are not mutually exclusive. 

70
 

U.S. Air Force Calendar Year 2016 Annual Report

Table 19. Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Air Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Event location country

United States 56 84.8 241 81.1 

Iraq 0 0.0 0 0.0 

Afghanistan 0 0.0 2 0.7 

Kuwait 0 0.0 1 0.3 

Korea 0 0.0 9 3.0

Other Europe 1 1.5 0 0.0 

North America 0 0.0 1 0.3 

Central or South America 0 0.0 0 0.0 

Japan 5 7.6 15 5.1 

Belgium 0 0.0 0 0.0 

Germany 0 0.0 12 4.0 

United Kingdom 0 0.0 7 2.4 

Other 4 6.1 8 2.7 

Unknown 0 0.0 1 0.3 

Event setting 

Own residence 40 60.6 144 48.5 

Barracks 9 13.6 85 28.6 

Residence of friend or family 5 7.6 15 5.1 

Work/jobsite 2 3.0 6 2.0 

Automobile 7 10.6 21 7.1 

Inpatient medical facility 0 0.0 4 1.3 

Hotel 2 3.0 5 1.7 

Other 1 1.5 17 5.7 

Unknown 0 0.0 0 0.0 

Event method1

Drugs/alcohol 3 4.5 156 52.5 

Hanging/asphyxiation 22 33.3 46 15.5 

Poisoning 2 3.0 12 4.0 

Firearm 37 56.1 17 5.7 

Military firearm 0 0.0 4 1.3 

Non-military firearm 37 56.1 13 4.4 

Firearm of unknown origin 0 0.0 0 0.0 

Trauma, sharp or blunt force 2 3.0 57 19.2 

Other 0 0.0 8 2.7 

Pending/unknown 0 0.0 1 0.3 

Used alcohol during event

Yes 18 27.3 99 33.3 

No 18 27.3 192 64.6 

Unknown 30 45.5 6 2.0 

71
 

U.S. Air Force Calendar Year 2016 Annual Report

Table 19 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Air 

Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Used drugs during event

Yes 5 7.6 139 46.8 

Illegal drugs 

Used, overdose 0 0.0 5 1.7 

Used, no overdose 1 1.5 3 1.0 

Prescription drugs 

Used, overdose 2 3.0 83 27.9 

Used, no overdose 0 0.0 21 7.1 

Non-prescription drugs 

Used, overdose 2 3.0 43 14.5 

Used, no overdose 1 1.5 14 4.7 

No 32 48.5 152 51.2 

Unknown 29 43.9 6 2 

Death-risk gambling 

Yes 0 0.0 7 2.4 

No 59 89.4 283 95.3 

Unknown 7 10.6 7 2.4 

Planned/premeditated 

Yes 21 31.8 71 23.9 

No 24 36.4 193 65.0 

Unknown 21 31.8 33 11.1 

Observable 

Yes 16 24.2 115 38.7 

No 48 72.7 174 58.6 

Unknown 2 3.0 8 2.7 

Suicide note left 

Yes 24 36.4 43 14.5 

No 37 56.1 245 82.5 

Unknown 5 7.6 9 3.0 

Communicated potential for self-harm (other than suicide note) 

Yes 13 19.7 74 24.9 

How communicated2

Written 2 3.0 4 1.3 

Verbal 9 13.6 48 16.2 

Text 7 10.6 21 7.1 

Other 0 0.0 5 1.7 

To whom communicated2

Supervisor 2 3.0 10 3.4 

Chaplain 1 1.5 0 0.0 

Mental health staff 4 6.1 24 8.1 

Friend 7 10.6 23 7.7 

Spouse 5 7.6 27 9.1 

Family 0 0.0 5 1.7 

Other 1 1.5 0 0.0 

No 49 74.2 214 72.1 

Unknown 4 6.1 9 3.0 

72
 

 

U.S. Air Force Calendar Year 2016 Annual Report

Table 19 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Air 

Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Residence at time of event 

Barracks 7 10.6 94 31.6 

Bachelor Enlisted/Officer Quarters 4 6.1 8 2.7 

On-base family housing 7 10.6 33 11.1 

Off-base 43 65.2 145 48.8 

Ship 0 0.0 0 0.0 

Other 5 7.6 14 4.7 

Unknown 0 0.0 3 1.0 

Reside alone at time of event

Yes 41 62.1 134 45.1 

No 25 37.9 158 53.2 

Unknown 0 0.0 5 1.7 

Gun in home/immediate environment 

Yes 36 54.5 42 14.1 

No 20 30.3 245 82.5 

Unknown 10 15.2 10 3.4 

Duty environment2

Garrison/permanent duty station 55 83.3 223 75.1 

Leave 5 7.6 13 4.4 

Temporary duty 0 0.0 4 1.3 

Training 2 3.0 10 3.4 

Other 4 6.1 43 14.5 

Deployed at time of event 

Yes 2 3.0 2 0.7 

Location

Afghanistan 0 0.0 0 0.0 

Kuwait 0 0.0 0 0.0 

Other/Unknown 2 3.0 2 0.6 

No 64 97.0 295 99.3 1

Data on the cause of the death were provided by AFMES. 2

Subcategories are not mutually exclusive. 

73
 

U.S. Air Force Calendar Year 2016 Annual Report

Table 20. Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Air Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Any mental health diagnosis 

Yes1 27 40.9 198 66.7 

Mood disorder 13 19.7 127 42.8 

Anxiety disorder2 11 16.7 94 31.6 

Personality disorder 3 4.5 36 12.1 

Psychotic disorder 0 0.0 5 1.7 

Adjustment disorder 13 19.7 73 24.6 

Substance abuse disorder 8 12.1 56 18.9 

No 39 59.1 99 33.3 

Unknown 0 0.0 0 0.0 

Sleep disorder

Yes 12 18.2 26 8.8 

No 53 80.3 270 90.9 

Unknown 1 1.5 1 0.3 

History of traumatic brain injury 

Yes 1 1.5 8 2.7 

No 64 97.0 289 97.3 

Unknown 1 1.5 0 0.0 

Family history of mental illness 

Yes 9 13.6 136 45.8 

No 26 39.4 141 47.5 

Unknown 31 47.0 20 6.7 

Prior self-injury 

Yes 4 6.1 81 27.3 

Number of prior self-injuries

One 2 3.0 40 13.5 

More than one 2 3.0 41 13.8 

Unknown 0 0.0 0 0.0 

Current event similar to prior 1 1.5 46 15.5 

No 52 78.8 210 70.7 

Unknown 10 15.2 6 2.0 

Psychotropic medications, last 90 days 

Yes1 12 18.2 118 39.7 

Antidepressant 10 15.2 102 34.3 

Antianxiety 4 6.1 55 18.5 

Antimanic 0 0.0 5 1.7 

Anticonvulsant 1 1.5 8 2.7 

Antipsychotic 1 1.5 17 5.7 

Sleep medication 6 9.1 46 15.5 

No 54 81.8 179 60.3 

Unknown 0 0.0 0 0.0 

74
 

 

U.S. Air Force Calendar Year 2016 Annual Report

Table 20 (cont). Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted 

for CY 2016, Air Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. % No. % 

Pain medication at time of event 

Yes 7 10.6 59 19.9 

Opioid medication 1 1.5 20 6.7 

No 53 80.3 233 78.5 

Health/social services, last 90 days 

Yes1 43 65.2 224 75.4 

Medical treatment facility 40 60.6 207 69.7 

Substance Abuse Services 4 6.1 36 12.1 

Family Assistance Program 4 6.1 21 7.1 

Outpatient mental health 19 28.8 154 51.9 

Inpatient mental health 3 4.5 50 16.8 

No 23 34.8 73 24.6 

Unknown 0 0.0 0 0.0 1

Subcategories are not mutually exclusive. 

2

Survey form used for this CY used DSM-IV taxonomy for behavioral health diagnoses, thus posttraumatic stress disorder is subsumed under the 

“Anxiety disorder” category.

75
Table 21. Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Air Force

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. 

Failed or failing relationship, last 90 days 

% No. % 

Yes1 30 45.5 130 43.8 

Intimate relationship 29 43.9 115 38.7 

Other relationship 10 15.2 38 12.8 

No 32 48.5 167 56.2 

Unknown 4 

Friend and family stressors, last 90 days 

6.1 0 0.0 

Yes1 4 6.1 29 9.8 

Death of spouse or other family member (not suicide) 2 3.0 14 4.7 

Death of friend (not suicide) 0 0.0 3 1.0 

Serious illness of friend or family member 2 3.0 16 5.4 

No 59 89.4 268 90.2 

Unknown 3 

History of friend or family death by suicide 

4.5 0 0.0 

Yes1 5 7.6 44 14.8 

Spouse 0 0.0 0 0.0 

Family other than spouse 2 3.0 18 6.1 

Friend 3 4.5 28 9.4 

No 61 92.4 252 84.8 

Unknown 0 

Administrative/legal problems, last 90 days 

0.0 1 0.3 

Yes1 17 25.8 95 32.0 

Courts martial proceedings 2 3.0 2 0.7 

Article 15/Non-judicial punishment 3 4.5 14 4.7 

Administrative separation proceedings 3 4.5 16 5.4 

Away without leave/deserter status 0 0.0 1 0.3 

Medical evaluation board proceedings 1 1.5 37 12.5 

Civil legal proceedings 7 10.6 19 6.4 

Non-selection for promotion 0 0.0 8 2.7 

Under investigation 7 10.6 29 9.8 

No 49 74.2 202 68 

Unknown 0 

Excessive debt/bankruptcy, last 90 days 

0.0 0 0.0 

Yes 6 9.1 24 8.1 

No 57 86.4 269 90.6 

Unknown 3 

Workplace, last 90 days 

4.5 4 1.3 

Yes1 16 24.2 111 37.4 

Job problems 11 16.7 89 30.0 

Supervisor/coworker issues 6 9.1 57 19.2 

Poor performance review 7 10.6 30 10.1 

Unit/workplace hazing 0 0.0 5 1.7 

No 50 75.8 186 62.6 

Unknown 0 0.0 0 0.0 

U.S. Air Force Calendar Year 2016 Annual Report

76
Table 21 (cont). Psychosocial determinants described in suicide and suicide-attempt DoDSER reports

CY 2016, Air Force

submitted for 

Suicide 

(n = 66) 

Suicide attempt

(n = 297) 

No. 

Abuse, assault, or harassment victimization, last year

% No. % 

Yes1 1 1.5 39 13.1 

Physical abuse or assault 1 1.5 9 3.0 

Sexual abuse or assault 1 1.5 20 6.7 

Emotional abuse 1 1.5 18 6.1 

Sexual harassment 0 0.0 6 2.0 

No 57 86.4 256 86.2 

Unknown 8 

Abuse, assault, or harassment perpetration, last year

12.1 2 0.7 

Yes1 6 9.1 21 7.1 

Physical abuse or assault 3 4.5 13 4.4 

Sexual abuse or assault 5 7.6 3 1.0 

Emotional abuse 2 3.0 11 3.7 

Sexual harassment 1 1.5 0 0.0 

No 59 89.4 271 91.2 

Unknown 1 1.5 5 1.7 

U.S. Air Force Calendar Year 2016 Annual Report

1

Subcategories are not mutually exclusive. 

77
CHAPTER 5 

U.S. Army 

78
 

U.S. Army Calendar Year 2016 Annual Report

DoDSER Results Summary: Army 

This chapter presents data collected on cases of suicide and suicide attempt involving members 

of the Army. The DoDSER system collects data on demographic, contextual, behavioral health, 

historical, and risk-related factors for all incidences of suicide and all suicide attempts that result 

in hospitalization or evacuation from a military theater of operations. Cases involving both 

Active Component Service members and SELRES Service members who were in a duty status at 

the time of the event are subject to this reporting requirement. Particular variables of interest are 

presented in the following text, however, the reader is encouraged to examine the DoDSER data 

tables that follow this chapter’s text for the full Army data, presented separately by event type. 

Suicide Mortality

As of March 31, 2017, the AFMES had identified 141 confirmed or pending cases of suicide that 

occurred during CY 2016 and involved a member of the Army. A total of 127 of these deaths 

occurred among members of the Army’s Active Component. The remaining 14 deaths occurred 

among SELRES Service members who were in a duty status at the time of their death. A 

DoDSER survey was submitted for 140 of the 141 deaths. These 140 DoDSER surveys were 

used to populate the data tables included in this chapter. A total of 5 suicide-related deaths were 

associated with one or more reported suicide attempts that occurred between CY 2008 and CY 

2016. The median number of days between the most recent suicide attempt and the date of death 

was 179. 

Incidence of Attempted Suicide 

Over the course of CY 2016, 586 non-fatal suicide attempts were identified within the Army. 

These reports provided data on suicide attempts for 572 unique individuals. A total of 561 

Soldiers had a single suicide attempt recorded; two or more suicide attempts were recorded for 

11 (1.9%) individuals. The median number of days between the most recent suicide attempt and 

the penultimate attempt was 91 days.

Event Information 

It is important to examine whether the Soldiers who died by suicide had made an effort to 

communicate their suicidal thoughts or feelings to their family, social, and peer networks prior to 

engaging in suicidal behavior. Data from CY 2016 suggest that 19.3 percent of those who died 

by suicide had communicated their desire to die by suicide prior to engaging in the behavior that 

would ultimately cause their death. Most frequently, these communications involved verbal 

communications about their thoughts and feelings (12.1%) or sending electronic (9.3%) 

messages. Most commonly, spouses (8.6%) and friends (5.0%) were the recipients of these 

messages. Communication of suicidal thoughts and feelings were either not made or recognized 

in 63.6 percent of suicide cases. Separately, suicide notes were left in 19.3 percent of Army 

suicide deaths. 

79
 

 

 

U.S. Army

Firearms were the method of injury 

most often identified in Army suicide 

cases (67.9%). Among the firearm

deaths, the majority of the firearms 

used (92.6%) were personal 

possessions, with only 4.2 percent of 

firearm deaths resulting from selfdirected use of a military-issued 

weapon. Regardless of the method of 

injury, firearms were present in the 

immediate environment of 61.4 

percent of those Soldiers who died by 

suicide. Figure 31 identifies the two 

most common methods of injury and 

the proportion of deaths that are due 

to those methods. 

With regard to suicide attempt 

records, drug and/or alcohol overdose 

was the most frequently reported 

(59.9%) mechanism of injury. As 

seen in Figure 32, the other common 

methods of attempting suicide 

involved the self-directed use of a 

sharp or blunt object (16.9%) and 

hanging/asphyxiation (14.2%). 

A Soldier’s primary residence, 

including military barracks, was the 

most common setting in which deaths 

by suicide occurred (67.9%), with a 

few cases occurring in other settings, 

for example, their work environment 

(3.6%), a vehicle (7.9%), or a hotel 

room (3.6%). Table 24 provides a 

descriptive overview of the settings 

and circumstances involved in cases 

of suicide and suicide attempt. 

Demographic Characteristics

Calendar Year 2016 Annual Report

Figure 31. Proportion of CY 2016 Army DoDSER suicide cases’ method of 

injury compared to the three-year average of CY 2013 - CY 2015

Figure 32. Proportion of CY 2016 Army DoDSER suicide cases’ method of 

injury compared to the three-year average of CY 2013 - CY 2015

The demographic characteristics of the Army suicide cases closely resembles the makeup of the 

Army overall. The most common demographic profile was non-Hispanic, white males, age 20–

24, rank/grade of E1–E4, and a high school education. This represented 15.0% of all suicide 

DoDSER cases.

80
Figure 33. Proportion of behavioral health risk factors in CY 

2016 Army suicide cases compared to the three-year average of 

CY 2013 - CY 2015 

Figure 34. Proportion of behavioral health risk factors in CY 

2016 Army suicide-attempt cases compared to the three-year 

average of CY 2013 - CY 2015 

U.S. Army Calendar Year 2016 Annual Report

The occurrence of suicide among female Soldiers continues to account for fewer than 20 cases a 

year, precluding a rate calculation. Similar to previous years, the proportion of male and female 

Soldiers identified in each event type produced a demographic distinction between cases of 

suicide and cases of suicide attempt. Female Soldiers accounted for 7.9 percent of DoDSER 

suicide cases and 28.2 percent of DoDSER suicide-attempt cases.

Demographic and military service characteristics for all Army DoDSER suicide and suicideattempt cases are detailed in Tables 22 and 23. 

Behavioral Health History 

Of those individuals who died by suicide in CY 2016, 50.7 percent had met criteria for at least 

one current or past behavioral health diagnosis. Substance use (24.3%) and anxiety (22.1%) 

disorders were common. However, the most frequently reported diagnoses were mood (26.4%) 

and adjustment (26.4%) disorders. Conversely, 46.4 percent of Soldiers who died by suicide had 

no known behavioral health history. 

Among suicide-attempt cases, 62.5 percent identified at least one current or past behavioral 

health diagnosis present in the medical record. Mood (28.2%), anxiety (22.4%), and substanceuse (21.8%) disorders were common. However, the most frequent diagnosis in this group was 

adjustment disorder (31.2%). Overall, 37.5 percent of reports did not identify a known 

behavioral health history. 

Table 25 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Figure 33 displays the prevalence of various diagnoses, prior self-harm, 

and the use of psychotropic medication in the 90 days prior to a suicide-related death. Figure 34 

displays the prevalence of the same factors among DoDSER suicide-attempt cases. 

Substance Use 

Alcohol use, during the time period immediately preceding death, was identified in 18.6 percent 

of Army suicide cases; though the “unknown” response for this item was endorsed for a 

81
 

 

U.S. Army Calendar Year 2016 Annual Report

substantial proportion of cases (50.7%; Table 24). Drug use (including illicit, prescription, and 

over-the-counter substances) was identified in 7.9 percent of Army suicides. Overall, very few 

deaths resulted from drug/alcohol overdose (1.4%). 

Alcohol use immediately prior to the suicidal behavior was reported in 27.1 percent of suicideattempt case reports; 50.3 percent of reports identified drug use immediately prior to the event. 

Prescription drugs had the highest overall frequency of overdose (26.1%). 

Health Care Utilization

Regardless of whether or not an individual voluntarily disclosed—or was assessed for—suicidal 

thoughts, feelings, and behavior, 62.1 percent of the Soldiers who died by suicide in CY 2016 

had been in contact with the MHS in the 90 days prior to their death (Table 25). Overall, 32.9 

percent had received either inpatient (6.4%) or outpatient (32.9%) behavioral health services. 

Respectively, 13.6 percent and 3.6 percent had participated in substance-abuse services or family 

assistance programs. 

A similar pattern was observed for suicide-attempt cases. Seventy-one percent of the Soldiers 

who attempted suicide in CY 2016 had been in contact with the MHS in the 90 days prior to the 

behavior. Overall, 52.0 percent had received either inpatient (13.5%) or outpatient (51.9%) 

behavioral health services. Additionally, 9.4 percent had participated in substance-abuse 

services and 4.4 percent had participated in family assistance programs. 

Psychosocial Stressors 

Relationship difficulties, especially strife within—or termination of—an intimate-partner 

relationship, were present in 36.4 percent of Army suicide cases and 35.7 percent of suicide 

attempts. Individuals who died by suicide were frequently involved with legal and 

administrative stressors (27.1%), as were those who attempted to die by suicide (34.5%). Those 

who died by suicide were most frequently ‘under investigation’ (10.7%) or facing non-judicial 

punishments (7.9%). These stressors held for those who attempted suicide as well, with 9.2 

Figure 35. Proportion of stress-related risk factors in CY 2016 

Army suicide cases compared to the three-year average of CY 

2013 - CY 2015 

Figure 36. Proportion of stress-related risk factors in CY 2016 

Army suicide-attempt cases compared to the three-year average 

of CY 2013 - CY 2015

82
 

U.S. Army Calendar Year 2016 Annual Report

percent endorsing being ‘under investigation’ and 12.1 percent endorsing non-judicial 

punishment. Figures 35 (cases of suicide) and 36 (cases of suicide attempt) display the 

prevalence of six stressors queried in the DoDSER system from CY 2016 compared to the threeyear average from CY 2013 -CY 2015. Table 26 also provides data for stressors pertaining to 

relationships, family issues, legal or administrative problems, work and financial difficulties, and 

abuse victimization or perpetration. 

Sexual Assault 

To better assess and understand any potential association between sexual assault and the 

occurrence of suicide-related behavior, Army data collected from the DoDSER system were 

matched against records related to the filing of an unrestricted report of sexual assault. 

According to the analysis of these data, no Army DoDSER suicide cases and 6 Army DoDSER 

suicide-attempt cases were associated with an unrestricted report of a sexual assault that occurred

during the 12 months preceding the suicide-related event. When the limit of the 12 months 

preceding the suicide-related behavior was removed, one case of suicide and 18 cases of 

attempted suicide were associated with unrestricted reports of sexual assault. Table 26 provides 

the number of sexual assaults recorded directly by the DoDSER system. Discrepancies between 

those cases identified by SAPRO and those identified on the DoDSER surveys could be due to 

several factors, including utilization of the restricted reporting option. 

83
 

U.S. Army Calendar Year 2016 Annual Report

Table 22. Demographic characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Sex 

Male 129 92.1 421 71.8 

Female 11 7.9 165 28.2 

Age

17–19 3 2.1 114 19.5 

20–24 51 36.4 264 45.1 

25–29 34 24.3 96 16.4 

30–34 22 15.7 65 11.1 

35–39 12 8.6 31 5.3 

40–44 10 7.1 8 1.4 

45–64 8 5.7 8 1.4 

Race

American Indian/Alaska Native 2 1.4 7 1.2 

Asian/Pacific Islander 6 4.3 36 6.1 

Black/African American 17 12.1 154 26.3 

White/Caucasian 113 80.7 385 65.7 

Other/Unknown 2 1.4 4 0.7 

Ethnicity

Hispanic 16 11.4 90 15.4 

Not Hispanic 124 88.6 495 84.5 

Unknown 0 0.0 1 0.2 

Education

Less than high school 0 0.0 10 1.7 

Alternative high school 13 9.3 63 10.8 

High school graduate 78 55.7 412 70.3 

Associate's or technical degree 19 13.6 68 11.6 

Four-year degree 20 14.3 23 3.9 

Postgraduate 10 7.1 10 1.7 

Unknown 0 0.0 0 0.0 

Marital status 

Never married 49 35.0 315 53.8 

Married 74 52.9 242 41.3 

Separated 2 1.4 0 0.0 

Divorced 15 10.7 29 4.9 

Widowed 0 0.0 0 0.0 1

Data on demographic characteristics primarily provided by DMDC.

84
 

U.S. Army Calendar Year 2016 Annual Report

Table 23. Military characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Component

Active 126 90.0 543 92.7 

Reserve 1 0.7 15 2.6 

Guard 13 9.3 28 4.8 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

Enlisted, unknown grade 0 0.0 24 4.1 

E1–E4 59 42.1 432 73.7 

E5–E9 55 39.3 110 18.8 

Warrant 4 2.9 2 0.3

Officer 22 15.7 18 3.1 

Unknown 0 0.0 0 0.0 

Enlisted occupational group

Infantry, gun crews, and seamanship specialists 42 30.0 140 23.9 

Electronic equipment repairers 10 7.1 28 4.8 

Communications and intelligence specialists 16 11.4 47 8.0 

Health care specialists 10 7.1 62 10.6 

Other technical and allied specialists 6 4.3 13 2.2 

Functional support and administration 14 10.0 75 12.8 

Electrical/mechanical equipment repairers 9 6.4 67 11.4 

Craftsworkers 0 0.0 16 2.7 

Service and supply handlers 7 5.0 85 14.5 

Non-occupational 0 0.0 22 3.8 

Unknown 0 0.0 11 1.9 

Officer occupational group 

General officers and executives 1 0.7 0 0.0 

Tactical operations officers 8 5.7 5 0.9 

Intelligence officers 2 1.4 0 0.0 

Engineering and maintenance officers 8 5.7 4 0.7 

Scientists and professionals 0 0.0 2 0.3 

Health care officers 5 3.6 3 0.5 

Administrators 1 0.7 1 0.2 

Supply, procurement, and allied officers 0 0.0 4 0.7 

Non-occupational 1 0.7 1 0.2 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 76 54.3 224 38.2 

Number of deployments 

1 28 20.0 128 21.8 

2 21 15.0 56 9.6 

3 or more 27 19.3 40 6.8 

Specific deployment locations2

Afghanistan 44 31.4 134 22.9 

Iraq 41 29.3 90 15.4 

Kuwait 56 40.0 155 26.5 

No 63 45.0 362 61.8 

Unknown 1 0.7 0 0.0 1

Data on military characteristics primarily provided by DMDC. 2

Subcategories are not mutually exclusive. 

85
 

U.S. Army Calendar Year 2016 Annual Report

Table 24. Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Event location country

United States 128 91.4 495 84.5 

Iraq 1 0.7 1 0.2 

Afghanistan 0 0.0 8 1.4 

Kuwait 0 0.0 21 3.6 

Korea 4 2.9 36 6.1 

Other Europe 1 0.7 3 0.5 

North America 0 0.0 0 0.0 

Central or South America 0 0.0 0 0.0 

Japan 0 0.0 3 0.5 

Belgium 0 0.0 2 0.3 

Germany 3 2.1 6 1.0 

United Kingdom 0 0.0 0 0.0 

Other 2 1.4 7 1.2 

Event setting 

Own residence 68 48.6 207 35.3 

Barracks 27 19.3 289 49.3 

Residence of friend or family 10 7.1 17 2.9 

Work/jobsite 5 3.6 16 2.7 

Automobile 11 7.9 29 4.9 

Inpatient medical facility 1 0.7 3 0.5 

Hotel 5 3.6 0 0.0 

Other 11 7.9 22 3.8 

Unknown 2 1.4 3 0.5 

Event method1

Drugs/alcohol 2 1.4 351 59.9 

Hanging/asphyxiation 34 24.3 83 14.2 

Poisoning 2 1.4 24 4.1 

Firearm 95 67.9 23 3.9 

Military firearm 4 2.8 5 0.8 

Non-military firearm 88 62.9 18 3.1 

Firearm of unknown origin 3 2.1 0 0.0 

Trauma, sharp or blunt force 7 5.0 99 16.9 

Other 0 0.0 4 0.7 

Pending/unknown 0 0.0 2 0.3 

Used alcohol during event

Yes 26 18.6 159 27.1 

No 43 30.7 413 70.5 

Unknown 71 50.7 14 2.4 

86
 

 

 

U.S. Army Calendar Year 2016 Annual Report

Table 24 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Used drugs during event

Yes 11 7.9 295 50.3 

Illegal drugs 

Used, overdose 0 0.0 26 4.4 

Used, no overdose 2 1.4 11 1.9 

Prescription drugs 

Used, overdose 3 2.1 153 26.1 

Used, no overdose 5 3.6 35 6.0 

Non-prescription drugs 

Used, overdose 1 0.7 117 20 

Used, no overdose 0 0.0 19 3.2 

No 62 44.3 277 47.3 

Unknown 67 47.9 14 2.4 

Death-risk gambling 

Yes 2 1.4 10 1.7 

No 120 85.7 557 95.1 

Unknown 18 12.9 19 3.2 

Planned/premeditated 

Yes 56 40.0 113 19.3 

No 51 36.4 428 73.0 

Unknown 33 23.6 45 7.7 

Observable 

Yes 26 18.6 208 35.5 

No 101 72.1 340 58 

Unknown 13 9.3 38 6.5 

Suicide note left 

Yes 27 19.3 60 10.2 

No 79 56.4 511 87.2 

Unknown 34 24.3 15 2.6 

Communicated potential for self-harm (other than suicide note) 

Yes 27 19.3 148 25.3 

How communicated2

Written 0 0.0 3 0.5 

Verbal 17 12.1 86 14.7 

Text 13 9.3 69 11.8 

Other 0 0.0 4 0.7 

To whom communicated2

Supervisor 2 1.4 25 4.3 

Chaplain 2 1.4 2 0.3

Mental health staff 3 2.1 31 5.3 

Friend 7 5.0 56 9.6 

Spouse 12 8.6 57 9.7 

Family 0 0.0 10 1.7 

Other 1 0.7 5 0.9 

No 89 63.6 417 71.2 

Unknown 24 17.1 21 3.6 

87
 

 

 

U.S. Army Calendar Year 2016 Annual Report

Table 24 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Residence at time of event 

Barracks 42 30.0 329 56.1 

Bachelor Enlisted/Officer Quarters 1 0.7 6 1.0 

On-base family housing 16 11.4 52 8.9 

Off-base 71 50.7 180 30.7 

Ship 0 0.0 0 0.0 

Other 8 5.7 11 1.9 

Unknown 2 1.4 8 1.4 

Reside alone at time of event

Yes 41 29.3 188 32.1 

No 88 62.9 382 65.2 

Unknown 11 7.9 16 2.7 

Gun in home/immediate environment 

Yes 86 61.4 69 11.8 

No 35 25.0 467 79.7 

Unknown 19 13.6 50 8.5 

Duty environment2

Garrison/permanent duty station 108 77.1 453 77.3 

Leave 6 4.3 12 2.0 

Temporary duty 1 0.7 2 0.3 

Training 1 0.7 66 11.3 

Other 21 15.0 21 3.6 

Deployed at time of event 

Yes 0 0.0 37 6.3 

Location

Afghanistan 0 0.0 10 1.7 

Kuwait 0 0.0 14 2.4 

Other/Unknown 0 0.0 13 2.2 

No 140 100.0 549 93.7 1

Data on the cause of the death were provided by AFMES. 2

Subcategories are not mutually exclusive. 

88
 

U.S. Army Calendar Year 2016 Annual Report

Table 25. Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Any mental health diagnosis 

Yes1 71 50.7 366 62.5 

Mood disorder1 37 26.4 165 28.2 

Anxiety disorder1 31 22.1 131 22.4 

Personality disorder 6 4.3 27 4.6 

Psychotic disorder 2 1.4 5 0.9 

Adjustment disorder 37 26.4 183 31.2 

Substance abuse disorder 34 24.3 128 21.8 

No 65 46.4 220 37.5 

Unknown 4 2.9 0 0.0 

Sleep disorder

Yes 24 17.1 87 14.8 

No 107 76.4 486 82.9 

Unknown 9 6.4 13 2.2 

History of traumatic brain injury 

Yes 9 6.4 32 5.5 

No 124 88.6 542 92.5 

Unknown 7 5.0 12 2.0 

Family history of mental illness 

Yes 23 16.4 170 29.0 

No 77 55.0 378 64.5 

Unknown 40 28.6 38 6.5 

Prior self-injury 

Yes 20 14.3 187 31.9 

Number of prior self-injuries

One 6 4.3 88 15.0 

More than one 14 10.0 96 16.4 

Unknown 0 0.0 3 0.5 

Current event similar to prior 8 5.7 89 15.2 

No 96 68.6 385 65.7 

Unknown 24 17.1 14 2.4 

Psychotropic medication, last 90 days 

Yes1 27 19.3 165 28.2 

Antidepressant 21 15.0 140 23.9 

Antianxiety 9 6.4 85 14.5 

Antimanic 2 1.4 4 0.7 

Anticonvulsant 5 3.6 8 1.4 

Antipsychotic 5 3.6 13 2.2 

Sleep medication 10 7.1 84 14.3 

No 113 80.7 420 71.7 

Unknown 0 0.0 1 0.2 1

Subcategories are not mutually exclusive 

89
 

U.S. Army Calendar Year 2016 Annual Report

Table 25 (cont). Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted 

for CY 2016, Army 

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Pain medication at time of event 

Yes 17 12.1 110 18.8 

Opioid medication 9 6.4 34 5.8 

No 102 72.9 451 77.0 

Unknown 21 15.0 25 4.3 

Health/social services, last 90 days 

Yes1 87 62.1 416 71.0 

Medical treatment facility 78 55.7 327 55.8 

Substance Abuse Services 19 13.6 55 9.4 

Family Assistance Program 5 3.6 26 4.4 

Outpatient mental health 46 32.9 304 51.9 

Inpatient mental health 9 6.4 79 13.5 

No 52 37.1 166 28.3 

Unknown 1 0.7 4 0.7 1

Subcategories are not mutually exclusive. 

90
U.S. Army Calendar Year 2016 Annual Report

Table 26. Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 57 40.7 240 41.0 

Intimate relationship 51 36.4 209 35.7 

Other relationship 13 9.3 62 10.6 

No 69 49.3 342 58.4 

Unknown 14 10.0 4 0.7 

Friend and family stressors, last 90 days 

Yes1 5 3.6 56 9.6 

Death of spouse or other family member (not suicide) 2 1.4 19 3.2 

Death of friend (not suicide) 1 0.7 14 2.4 

Serious illness of friend or family member 2 1.4 29 4.9 

No 119 85.0 523 89.2 

Unknown 16 11.4 7 1.2 

History of friend or family death by suicide 

Yes1 8 5.7 85 14.5 

Spouse 0 0.0 0 0.0 

Family other than spouse 6 4.3 36 6.1 

Friend 2 1.4 61 10.4 

No 125 89.3 494 84.3 

Unknown 7 5.0 7 1.2 

Administrative/legal problems, last 90 days 

Yes1 38 27.1 202 34.5 

Courts martial proceedings 2 1.4 5 0.9 

Article 15/Non-judicial punishment 11 7.9 71 12.1 

Administrative separation proceedings 5 3.6 76 13.0 

Away without leave/deserter status 3 2.1 11 1.9 

Medical evaluation board proceedings 6 4.3 50 8.5 

Civil legal proceedings 7 5.0 35 6.0 

Non-selection for promotion 5 3.6 21 3.6 

Under investigation 15 10.7 54 9.2 

No 97 69.3 382 65.2 

Unknown 5 3.6 2 0.3 

Excessive debt/bankruptcy, last 90 days 

Yes 4 2.9 39 6.7 

No 111 79.3 523 89.2 

Unknown 25 17.9 24 4.1 

Workplace, last 90 days 

Yes1 23 16.4 196 33.4 

Job problems 20 14.3 149 25.4 

Supervisor/coworker issues 7 5.0 123 21.0 

Poor performance review 6 4.3 64 10.9 

Unit/workplace hazing 0 0.0 19 3.2 

No 106 75.7 384 65.5 

Unknown 11 7.9 6 1.0 

91
U.S. Army Calendar Year 2016 Annual Report

Table 26 (cont). Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for 

CY 2016, Army

Suicide 

(n = 140) 

Suicide attempt

(n = 586) 

No. % No. % 

Abuse, assault, or harassment victimization, last year

Yes1 4 2.9 71 12.1 

Physical abuse or assault 0 0.0 24 4.1 

Sexual abuse or assault 2 1.4 23 3.9 

Emotional abuse 1 0.7 42 7.2 

Sexual harassment 2 1.4 12 2.0 

No 119 85 509 86.9 

Unknown 17 12.1 6 1.0 

Abuse, assault, or harassment perpetration, last year

Yes1 13 9.3 38 6.5 

Physical abuse or assault 8 5.7 22 3.8 

Sexual abuse or assault 5 3.6 10 1.7 

Emotional abuse 3 2.1 10 1.7 

Sexual harassment 0 0.0 2 0.3 

No 109 77.9 537 91.6 

Unknown 18 12.9 11 1.9 1

Subcategories are not mutually exclusive. 

92
CHAPTER 6 

U.S. Marine Corps 

93
 

 

U.S. Marine Corps Calendar Year 2016 Annual Report

DoDSER Results Summary: Marine Corps 

This chapter presents data collected on cases of suicide and suicide attempt involving members 

of the United States Marine Corps. The DoDSER system collects data on demographic, 

contextual, behavioral health, historical, and risk-related factors for all incidences of suicide and 

all suicide attempts that result in hospitalization or evacuation from a military theater of

operations. Cases involving both Active Component Service members and SELRES Service 

members who were in a duty status at the time of the event are subject to this reporting 

requirement. Particular variables of interest are presented in the following text, however, the 

reader is encouraged to examine the DoDSER data tables that follow this chapter’s text for the 

full Marine Corps data, presented separately by event type. 

Suicide Mortality

As of March 31, 2017, the AFMES had identified 38 confirmed or pending cases of suicide that 

occurred during CY 2016 and involved a member of the Marine Corps. All but one of the deaths 

occurred among Active-Component Marines; the remaining case was a Reserve-Component 

Marine in a duty status at the time of death. DoDSER surveys were submitted for all 38 deaths, 

which were used to populate the data tables included in this chapter.

One Marine Corps suicide-related death was associated with one or more reported suicide 

attempts that occurred between CY 2010 and CY 2016. The number of days between the most 

recent suicide attempt and the date of death was 324. 

Incidence of Attempted Suicide 

Over the course of CY 2016, 204 non-fatal, suicide attempts were identified. Of these, 198 

suicide attempts occurred among Active-Component Marines and 6 cases were ReserveComponent Marines who were in a duty status at the time of the suicide attempt. These reports 

provided data on suicide attempts for 198 unique individuals. A total of 193 Marines had a 

single suicide attempt recorded; 5 (2.5%) had two or more suicide attempts recorded, dating back 

to 2010. The median number of days between the most recent suicide attempt and the 

penultimate attempt was 86 days.

Event Information 

It is important to examine whether the Marines who died by suicide had made an effort to 

communicate their suicidal thoughts or feelings to their family, social, and peer networks prior to 

engaging in suicidal behavior. Data from CY 2016 indicate that 31.6 percent of those Marines 

who died by suicide had communicated their desire to die prior to engaging in the behavior that 

would ultimately cause their death. Most frequently, these communications involved verbal 

communications about their thoughts and feelings (23.7%) or sending electronic (7.9%) 

messages. Spouses (5.3%) and friends (10.5%) were the most common recipients of these 

messages. Communication of suicidal thoughts and feelings were either not made or recognized 

in 55.3 percent of suicide cases. Separately, suicide notes were left in 18.4 percent of deaths. 

94
Figure 37. Proportion of CY 2016 Marine Corps DoDSER suicide cases’ 

methods of injury compared to the three-year average of CY 2013 - CY 2015

Figure 38. Proportion of CY 2016 Marine Corps DoDSER suicide-attempt 

cases’ methods of injury compared to the three-year average of CY 2013 - CY 

2015

U.S. Marine Corps

Firearms were the method of injury 

most often identified in Marine Corps 

suicide cases (55.3%). The majority 

(90.5%) of the firearms used were 

personal possessions, with 9.5 percent 

of firearm deaths resulting from use 

of a military-issued weapon. 

Regardless of the method of injury, 

firearms were present in the 

immediate environment of 52.6 

percent of those Marines who died by 

suicide. Figure 37 identifies the two 

most common methods of injury and 

the proportion of deaths that are due 

to those methods. 

With regard to suicide attempts, drug 

and/or alcohol overdose was the most

frequently reported (55.9%) method 

of injury among the Marine Corps’ 

DoDSER suicide-attempt cases. As 

seen in Figure 38, the other common 

methods of attempting suicide 

involved the self-directed use of a 

sharp or blunt object (22.1%) and 

asphyxiation (11.3%). 

A Marine’s primary residence, 

including military barracks, was the 

most common setting in which 

suicidal behavior occurred (68.4%), 

with a few cases occurring in other 

settings, for example, their work 

environment (7.9%), the home of a 

family member or friend (10.5%), or 

a hotel room (5.3%). Table 29 

provides a descriptive overview of the 

settings and circumstances involved 

in these cases of suicide and 

attempted suicide. 

Demographic Characteristics

Calendar Year 2016 Annual Report

The demographic characteristics of suicide cases closely resemble the makeup of the Marine 

Corps overall. The most common profile of enlisted, non-Hispanic, White men below age 25 

with a high school education constituted 26.3% of the case group. 

95
Figure 39. Proportion of behavioral health risk factors in CY 

2016 Marine Corps DoDSER suicide cases compared to the threeyear average of CY 2013 - CY 2015

Figure 40. Proportion of behavioral health risk factors in CY 

2016 Marine Corps DoDSER suicide attempt cases compared to 

the three-year average of CY 2013 - CY 2015

U.S. Marine Corps Calendar Year 2016 Annual Report

The occurrence of suicide among female Marines continues to account for fewer than 20 cases a 

year, precluding a rate calculation. Similar to previous years, the proportion of male and female 

Marines identified in each event type produced a demographic distinction between cases of 

suicide and cases of suicide attempt. Female Marines constituted 2.6 percent of DoDSER 

suicide cases and 24.0 percent of DoDSER suicide-attempt cases. Demographic and military 

service characteristics for all Marine Corps DoDSER suicide and suicide-attempt cases are 

detailed in Tables 27 and 28. 

Behavioral health History 

Of those individuals who died by suicide in CY 2016, 31.6 percent had met criteria for at least 

one current or past behavioral health diagnosis. Mood (13.2%) disorders were common. 

However, the most frequent diagnosis was related to substance use (23.7%). Conversely, 65.8 

percent of Marines who died by suicide had no known behavioral health history. 

Among those who attempted to die by suicide, 53.4 percent had at least one current or past 

behavioral health diagnosis present in their medical record. Mood (23.5%) and substance-use 

(22.5%) disorders were common. However, the most frequently identified diagnosis was 

adjustment disorder (25.0%). Among those Marines who attempted suicide, 45.6 percent had no 

known behavioral health history. 

Table 29 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Figure 39 displays the prevalence of various diagnoses, prior self-harm, 

and the use of psychotropic medication in the 90 days prior to a suicide-related death. Figure 40 

displays the prevalence of the same factors among DoDSER suicide-attempt cases. 

Substance Use 

Alcohol use, during the period immediately preceding death, was identified in 18.4 percent of 

Marine Corps suicide cases; though the “unknown” response for this item was endorsed for a 

substantial proportion (65.8%) of cases (Table 29). Drug use (including illicit, prescription, and 

96
 

U.S. Marine Corps Calendar Year 2016 Annual Report

over-the-counter substances) was identified in 2.6 percent of Marine Corps suicides. No Marine 

Corps deaths resulted from overdose (0.0%). 

Alcohol use immediately prior to the suicidal behavior was present in 27.9 percent of suicideattempt cases, and 51.5 percent of cases were positive for drug use immediately prior to the 

suicidal behavior. Over-the-counter drugs and prescription drugs were the most common 

substances reported as overdosed, with 26.5 percent and 25.0 percent of cases reported as 

engaging in an overdose for each drug class, respectively. 

Health Care Utilization

Regardless of whether or not an individual voluntarily disclosed—or was assessed for—suicidal 

thoughts, feelings, and behavior, 55.3 percent of the Marines who died by suicide in CY 2016 

had been in contact with the MHS in the 90 days prior to their death (Table 30). Overall, 21.1 

percent had received either inpatient (7.9%) or outpatient (18.4%) behavioral health services. 

Respectively, 10.5 percent and 5.3 percent had participated in substance abuse or family 

assistance programs. 

A similar pattern was observed for suicide-attempt cases. Of the Marines who attempted suicide 

in CY 2016, 64.2 percent had been in contact with the MHS in the 90 days prior to the behavior. 

Overall, 45.1 percent had received either inpatient (13.7%) or outpatient (44.1%) behavioral 

health services. Additionally, 6.9 percent had participated in substance-abuse services and 2.9 

percent had participated in family assistance programs. 

Psychosocial Stressors 

Overall, the presence of psychosocial stressors among Marines in CY 2016 was consistent with 

the proportionality of stressors in the previous four years. Relationship difficulties, especially 

strife within—or termination of—an intimate-partner relationship, were present in 36.8 percent 

of Marine Corps suicide cases and 35.3 percent of suicide attempts. 

Figure 41. Proportion of stress-related risk factors in CY 2016 

Marine Corps DoDSER suicide cases compared to the three-year 

average of CY 2013 - CY 2015

Figure 42. Proportion of stress-related risk factors in CY 2016 

Marine Corps DoDSER suicide attempt cases compared to the 

three-year average of CY 2013 - CY 2015

97
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Individuals who died by suicide were frequently involved with legal and administrative stressors 

(18.4%), as were those who attempted to die by suicide (26.5%). The most common legal or 

administrative stressors among suicide cases were being ‘under investigation’ (5.3%) or facing 

court-martial proceedings (5.3%). Being ‘under investigation’ (9.3%) and medical separation 

from service (7.4%) were the most frequent administrative issues facing those who attempted 

suicide in CY 2016. Figures 41 (cases of suicide) and 42 (cases of suicide attempt) display the 

prevalence of six stressors queried in the DoDSER system from CY 2013 - CY 2016. 

Table 31 provides data for stressors pertaining to relationships, family issues, legal or 

administrative problems, work and financial difficulties, and abuse victimization or perpetration. 

Sexual Assault 

To better assess and understand any potential association between sexual assault and the 

occurrence of suicide-related behavior, Marine Corps data collected from the DoDSER system

were matched against records related to the filing of an unrestricted report of sexual assault. 

According to the analysis of these data, no Marine Corps DoDSER suicide cases and 13 Marine 

Corps DoDSER suicide-attempt cases were associated with an unrestricted report of a sexual 

assault that occurred during the 12 months preceding the suicide-related event. When the limit 

of the 12 months preceding the suicide-related behavior was removed, no cases of suicide and 16 

cases of attempted suicide were associated with unrestricted reports of sexual assault. Table 31 

provides the number of sexual assaults recorded directly by the DoDSER system. Discrepancies 

between those cases identified by SAPRO and those identified on the DoDSER surveys could be 

due to several factors, including utilization of the restricted reporting option. 

98
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 27. Demographic characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Marine Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Sex 

Male 37 97.4 155 76.0 

Female 1 2.6 49 24.0 

Age

17–19 4 10.5 48 23.5 

20–24 24 63.2 128 62.7 

25–29 5 13.2 21 10.3 

30–34 1 2.6 3 1.5

35–39 2 5.3 2 1.0 

40–44 1 2.6 2 1.0

45–64 1 2.6 0 0.0 

Race

American Indian/Alaska Native 3 7.9 3 1.5 

Asian/Pacific Islander 3 7.9 14 6.9 

Black/African American 5 13.2 25 12.3 

White/Caucasian 27 71.1 159 77.9 

Other/Unknown 0 0.0 3 1.5 

Ethnicity

Hispanic 1 2.6 41 20.1 

Not Hispanic 37 97.4 163 79.9 

Unknown 0 0.0 0 0.0 

Education

Less than high school 0 0.0 1 0.5 

Alternative high school 3 7.9 7 3.4 

High school graduate 33 86.8 192 94.1 

Associate's or technical degree 1 2.6 1 0.5 

Four-year degree 1 2.6 3 1.5 

Postgraduate 0 0.0 0 0.0

Unknown 0 0.0 0 0.0 

Marital status 

Never married 19 50.0 136 66.7 

Married 19 50.0 64 31.4 

Separated 0 0.0 1 0.5 

Divorced 0 0.0 3 1.5 

Widowed 0 0.0 0 0.0 1

Data on demographic characteristics primarily provided by DMDC.

99
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 28. Military characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Marine 

Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Component

Active 37 97.4 198 97.1 

Reserve 1 2.6 6 2.9 

Guard 0 0.0 0 0.0 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

Enlisted, unknown grade 0 0.0 2 1.0 

E1–E4 23 60.5 181 88.7 

E5–E9 14 34.2 18 8.8 

Warrant 0 0.0 0 0.0

Officer 1 2.6 3 1.5 

Unknown 0 0.0 0 0.0 

Enlisted occupational group

Infantry, gun crews and seamanship specialists 7 18.4 45 22.1 

Electronic equipment repairers 1 2.6 13 6.4 

Communications and intelligence specialists 7 18.4 21 10.3 

Health care specialists 0 0.0 0 0.0 

Other technical and allied specialists 0 0.0 3 1.5 

Functional support and administration 8 21.1 27 13.2 

Electrical/mechanical equipment repairers 8 21.1 24 11.8 

Craftsworkers 3 7.9 6 2.9 

Service and supply handlers 1 2.6 22 10.8 

Non-occupational 1 2.6 36 17.6 

Unknown 1 2.6 4 2.0 

Officer occupational group 

General officers and executives 0 0.0 0 0.0 

Tactical operations officers 0 0.0 2 1.0 

Intelligence officers 0 0.0 0 0.0 

Engineering and maintenance officers 0 0.0 0 0.0 

Scientists and professionals 0 0.0 0 0.0 

Health care officers 0 0.0 0 0.0 

Administrators 0 0.0 0 0.0 

Supply, procurement and allied officers 0 0.0 1 0.5 

Non-occupational 1 2.6 0 0.0 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 15 39.5 31 15.2 

Number of deployments 

1 8 21.1 19 9.3 

2 3 7.9 8 3.9 

3 or more 4 10.5 4 2.0 

Specific deployment locations2

Afghanistan 8 21.1 20 9.8 

Iraq 5 13.2 12 5.9 

Kuwait 2 5.3 10 4.9 

No 23 60.5 173 84.8 

Unknown 0 0.0 0 0.0 1

Data on military characteristics primarily provided by DMDC. 2

Subcategories are not mutually exclusive. 

100
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 29. Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Marine 

Corps 

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Event location country

United States 36 94.7 174 85.3 

Iraq 0 0.0 1 0.5 

Afghanistan 0 0.0 0 0.0 

Kuwait 0 0.0 1 0.5 

Korea 0 0.0 1 0.5

Other Europe 0 0.0 0 0.0 

North America 0 0.0 1 0.5 

Central or South America 0 0.0 0 0.0 

Japan 2 5.3 24 11.8 

Belgium 0 0.0 0 0.0 

Germany 0 0.0 0 0.0 

United Kingdom 0 0.0 0 0.0 

Other 0 0.0 2 1.0 

Event setting 

Own residence 13 34.2 43 21.1 

Barracks 13 34.2 133 65.2 

Residence of friend or family 4 10.5 7 3.4 

Work/jobsite 3 7.9 4 2.0 

Automobile 0 0.0 4 2.0 

Inpatient medical facility 0 0.0 3 1.5 

Hotel 2 5.3 1 0.5 

Other 3 7.9 9 4.4 

Unknown 0 0.0 0 0.0 

Event method1

Drugs/alcohol 0 0.0 114 55.9 

Hanging/asphyxiation 15 39.5 23 11.3 

Poisoning 1 2.6 6 2.9 

Firearm 21 55.3 12 5.9 

Military firearm 2 5.3 2 1.0 

Non-military firearm 19 50.0 10 4.9 

Firearm of unknown origin 0 0.0 0 0.0 

Trauma, sharp or blunt force 1 2.6 45 22.1 

Other 0 0.0 4 2.0 

Pending/unknown 0 0.0 0 0.0 

Used alcohol during event

Yes 7 18.4 57 27.9 

No 6 15.8 136 66.7 

Unknown 25 65.8 11 5.4 

101
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 29 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Marine Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Used drugs during event

Yes 1 2.6 105 51.5 

Illegal drugs 

Used, overdose 0 0.0 6 2.9 

Used, no overdose 0 0.0 3 1.5 

Prescription drugs 

Used, overdose 0 0.0 51 25.0 

Used, no overdose 1 2.6 3 1.5 

Non-prescription drugs 

Used, overdose 0 0.0 54 26.5 

Used, no overdose 0 0.0 3 1.5 

No 8 21.1 97 47.5 

Unknown 29 76.3 2 1.0 

Death-risk gambling 

Yes 1 2.6 2 1.0 

No 36 94.7 197 96.6 

Unknown 1 2.6 5 2.5 

Planned/premeditated 

Yes 13 34.2 58 28.4 

No 9 23.7 125 61.3 

Unknown 16 42.1 21 10.3 

Observable 

Yes 5 13.2 109 53.4 

No 30 78.9 84 41.2 

Unknown 3 7.9 11 5.4 

Suicide note left 

Yes 7 18.4 14 6.9 

No 22 57.9 184 90.2 

Unknown 9 23.7 6 2.9 

Communicated potential for self-harm (other than suicide note) 

Yes 12 31.6 31 15.2 

How communicated2

Written 0 0.0 2 1.0 

Verbal 9 23.7 20 9.8 

Text 3 7.9 14 6.9 

Other 0 0.0 0 0.0 

To whom communicated2

Supervisor 1 2.6 6 2.9 

Chaplain 0 0.0 1 0.5

Mental health staff 1 2.6 6 2.9 

Friend 4 10.5 13 6.4 

Spouse 2 5.3 5 2.5 

Family 1 2.6 4 2.0

Other 0 0.0 0 0.0 

No 21 55.3 157 77 

Unknown 5 13.2 16 7.8 

102
 

 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 29 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Marine Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Residence at time of event 

Barracks 15 39.5 140 68.6 

Bachelor Enlisted/Officer Quarters 2 5.3 6 2.9 

On-base family housing 5 13.2 8 3.9 

Off-base 14 36.8 43 21.1 

Ship 0 0.0 0 0.0 

Other 2 5.3 6 2.9 

Unknown 0 0.0 1 0.5 

Reside alone at time of event

Yes 15 39.5 40 19.6 

No 23 60.5 159 77.9 

Unknown 0 0.0 5 2.5 

Gun in home/immediate environment 

Yes 20 52.6 16 7.8 

No 12 31.6 172 84.3 

Unknown 6 15.8 16 7.8 

Duty environment2

Garrison/permanent duty station 29 76.3 151 74.0 

Leave 6 15.8 4 2.0 

Temporary duty 5 13.2 2 1.0 

Training 3 7.9 25 12.3 

Other 8 21.1 20 9.8 

Deployed at time of event 

Yes 0 0.0 3 1.5 

Location

Afghanistan 0 0.0 1 0.5 

Kuwait 0 0.0 1 0.5 

Other/Unknown 0 0.0 1 0.5 

No 38 100 201 98.5 1

Data on the cause of the death were provided by AFMES. 2

Subcategories are not mutually exclusive. 

103
U.S. Marine Corps Calendar Year 2016 Annual Report

Table 30. Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Marine Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Any mental health diagnosis 

Yes1 12 31.6 109 53.4 

Mood disorder1 5 13.2 48 23.5 

Anxiety disorder1 3 7.9 27 13.2 

Personality disorder 3 7.9 11 5.4 

Psychotic disorder 0 0.0 1 0.5 

Adjustment disorder 3 7.9 51 25.0 

Substance abuse disorder 9 23.7 46 22.5 

No 25 65.8 93 45.6 

Unknown 1 2.6 2 1.0 

Sleep disorder

Yes 5 13.2 15 7.4 

No 31 81.6 181 88.7 

Unknown 2 5.3 8 3.9 

History of traumatic brain injury 

Yes 0 0.0 6 2.9 

No 36 94.7 188 92.2 

Unknown 2 5.3 10 4.9 

Family history of mental illness 

Yes 3 7.9 59 28.9 

No 16 42.1 125 61.3 

Unknown 19 50.0 20 9.8 

Prior self-injury 

Yes 5 13.2 56 27.5 

Number of prior self-injuries

One 2 5.3 28 13.7 

More than one 3 7.9 28 13.7 

Unknown 0 0.0 0 0.0 

Current event similar to prior 0 0.0 29 14.2 

No 30 78.9 137 67.2 

Unknown 3 7.9 11 5.4 

Psychotropic medications, last 90 days 

Yes1 2 5.3 63 30.9 

Antidepressant 2 5.3 55 27.0 

Antianxiety 0 0.0 21 10.3 

Antimanic 0 0.0 2 1.0 

Anticonvulsant 0 0.0 1 0.5 

Antipsychotic 0 0.0 4 2.0 

Sleep medication 1 2.6 38 18.6 

No 36 94.7 141 69.1 

Unknown 0 0.0 0 0.0 

104
 

U.S. Marine Corps Calendar Year 2016 Annual Report

Table 30 (cont). Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted 

for CY 2016, Marine Corps 

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Pain medication, last 90 days 

Yes 5 13.2 20 9.8 

Opioid medication 0 0.0 5 2.5 

No 23 60.5 172 84.3 

Unknown 10 26.3 12 5.9 

Health/social services, last 90 days 

Yes1 21 55.3 131 64.2 

Medical treatment facility 20 52.6 114 55.9 

Substance Abuse Services 4 10.5 14 6.9 

Family Assistance Program 2 5.3 6 2.9 

Outpatient mental health 7 18.4 90 44.1 

Inpatient mental health 3 7.9 28 13.7 

No 16 42.1 72 35.3 

Unknown 1 2.6 1 0.5 1

Subcategories are not mutually exclusive. 

105
U.S. Marine Corps Calendar Year 2016 Annual Report

Table 31. Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Marine Corps

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 18 47.4 81 39.7 

Intimate relationship 14 36.8 72 35.3 

Other relationship 7 18.4 21 10.3 

No 16 42.1 118 57.8 

Unknown 4 10.5 5 2.5 

Friend and family stressors, last 90 days 

Yes1 4 10.5 16 7.8 

Death of spouse or other family member (not suicide) 2 5.3 5 2.5 

Death of friend (not suicide) 0 0.0 4 2.0 

Serious illness of friend or family member 3 7.9 7 3.4 

No 30 78.9 184 90.2 

Unknown 4 10.5 4 2.0 

History of friend or family death by suicide 

Yes1 6 15.8 26 12.7 

Spouse 0 0.0 0 0.0 

Family other than spouse 2 5.3 9 4.4 

Friend 5 13.2 20 9.8 

No 30 78.9 174 85.3 

Unknown 2 5.3 4 2.0 

Administrative/legal problems, last 90 days 

Yes1 7 18.4 54 26.5 

Courts martial proceedings 2 5.3 2 1.0 

Article 15/Non-judicial punishment 0 0.0 0 0.0 

Administrative separation proceedings 1 2.6 14 6.9 

Away without leave/deserter status 1 2.6 7 3.4 

Medical evaluation board proceedings 1 2.6 15 7.4 

Civil legal proceedings 1 2.6 8 3.9 

Non-selection for promotion 0 0.0 7 3.4 

Under investigation 2 5.3 19 9.3 

No 31 81.6 147 72.1 

Unknown 0 0.0 3 1.5 

Excessive debt/bankruptcy, last 90 days 

Yes 1 2.6 9 4.4 

No 26 68.4 186 91.2 

Unknown 11 28.9 9 4.4 

Workplace, last 90 days 

Yes1 3 7.9 54 26.5 

Job problems 2 5.3 39 19.1 

Supervisor/coworker issues 0 0.0 31 15.2 

Poor performance review 1 2.6 19 9.3 

Unit/workplace hazing 0 0.0 5 2.5 

No 31 81.6 145 71.1 

Unknown 4 10.5 5 2.5 

106
Table 31 (cont). Psychosocial determinants described in suicide and suicide-attempt DoDSER reports

CY 2016, Marine Corps

submitted for 

Suicide 

(n = 38) 

Suicide attempt

(n = 204) 

No. 

Abuse, assault, or harassment victimization, last year

% No. % 

Yes1 2 5.3 19 9.3 

Physical abuse or assault 0 0.0 5 2.5 

Sexual abuse or assault 0 0.0 7 3.4 

Emotional abuse 2 5.3 8 3.9 

Sexual harassment 0 0.0 2 1.0 

No 32 84.2 180 88.2 

Unknown 4 

Abuse, assault, or harassment perpetration, last year

10.5 5 2.5 

Yes1 3 7.9 4 2.0

Physical abuse or assault 1 2.6 3 1.5 

Sexual abuse or assault 2 5.3 0 0.0 

Emotional abuse 2 5.3 2 1.0 

Sexual harassment 0 0.0 1 0.5 

No 30 78.9 195 95.6 

Unknown 5 13.2 5 2.5 

U.S. Marine Corps Calendar Year 2016 Annual Report

1

Subcategories are not mutually exclusive. 

107
CHAPTER 7 

U.S. Navy 

108
 

U.S. Navy Calendar Year 2016 Annual Report

DoDSER Results Summary: Navy 

This chapter presents data collected on cases of suicide and suicide attempt involving members 

of the Navy. The DoDSER system collects data on demographic, contextual, behavioral health, 

historical, and risk-related factors for all incidences of suicide and all suicide attempts that result 

in hospitalization or evacuation from a military theater of operations. Cases involving both 

Active Component Service members and SELRES Service members who were in a duty status at 

the time of the event are subject to this reporting requirement. Particular variables of interest are 

presented in the following text, however, the reader is encouraged to examine the DoDSER data 

tables that follow this chapter’s text for the full Navy data, presented separately by event type. 

Suicide Mortality

As of March 31, 2017, the AFMES had identified 55 confirmed or pending cases of suicide that 

occurred during CY 2016 and involved a Navy Sailor. A total of 50 of these deaths occurred 

among members of the Navy’s Active Component. The remaining 5 cases occurred among 

SELRES Sailors who were in a duty status at the time of their death. DoDSER surveys were 

submitted for all 55 of these deaths, which were used to populate the data tables included in this 

chapter. 

A total of 3 deaths were associated with one or more reported suicide attempts that occurred 

between CY 2008 and CY 2016. The median number of days between the most recent suicide 

attempt and the date of death was 113. 

Incidence of Attempted Suicide 

Over the course of CY 2016, 176 suicide attempts were identified. These reports provided data 

on suicide attempts for 170 unique individuals. A total of 164 had a single suicide attempt 

recorded, while 6 Sailors (3.4%) had two or more suicide attempts recorded, dating back to 2010. 

The median number of days between the most recent suicide attempt and the penultimate attempt 

was 52.5 days. 

Event Information 

It is important to examine whether the Sailors who died by suicide had made an effort to 

communicate their suicidal thoughts or feelings to their family, social, and peer networks prior to 

engaging in suicidal behavior. Data from CY 2016 suggest that 32.7 percent of those who died 

by suicide had communicated their desire to die prior to engaging in the behavior that would 

ultimately cause their death. Most frequently, these communications involved verbal 

communications about their thoughts and feelings (14.5%) or sending electronic (14.5%) 

messages. Most commonly, spouses (12.7%), friends (16.4%), and behavioral health providers 

(10.9%) were the recipients of these messages. Communication of suicidal thoughts and feelings 

were either not made or not recognized in 63.6 percent of suicide cases. Separately, suicide 

notes were left in 36.4 percent of deaths. 

109
Figure 43. Proportion of CY 2016 Navy DoDSER suicide cases’ method 

of injury compared to the three-year average of CY 2013 - CY 2015

U.S. Navy Calendar Year 2016 Annual Report

Figure 44. Proportion of CY 2016 Navy DoDSER suicide-attempt cases’

method of injury compared to the three-year average of CY 2013 - CY 2015 

Firearms were the method of injury 

most often identified in Navy suicide 

cases (60.0%). The majority (97.0%) 

of the firearms used were personal 

possessions, with only 3.0 percent of 

firearm deaths resulting from selfdirected use of a military-issued 

weapon. Regardless of the method of 

injury, firearms were present in the 

immediate environment of 60.0 

percent of those Sailors who died by 

suicide. Figure 43 identifies the two 

most common methods of injury and 

the proportion of deaths that are due 

to those methods. 

With regard to suicide attempts, drug 

and/or alcohol overdose was the most

frequently reported (54.5%) mechanism

of injury amongst the Navy’s suicideattempt DoDSER reports. As seen in 

Figure 44, the other common 

methods of attempting suicide 

involved the self-directed use of a 

sharp or blunt object (22.2%) and 

hanging/asphyxiation (15.3%). 

A Sailor’s primary residence, 

including military barracks, was the 

most common setting in which fatal 

suicidal behavior occurred (54.5%), 

with a few cases occurring in other 

settings, for example, their work 

environment (3.6%), a vehicle 

(12.7%), or a hotel room (7.3%). Table 

34 provides a descriptive overview of 

the settings and circumstances involved 

in these cases of suicide and attempted 

suicide. 

Demographic Characteristics

The most common demographic characteristics of suicide decedents closely resembles the 

makeup of the Navy overall. The most common profile was enlisted, non-Hispanic, white men 

below age 25 with a high school education at 27.3 percent of the suicide cases.

110
 

 

 

U.S. Navy Calendar Year 2016 Annual Report

The occurrence of suicide among female Sailors continues to account for fewer than 20 cases a 

year, precluding a rate calculation. Similar to previous years, the proportion of male and female 

Sailors identified in each event type produced a demographic distinction between cases of 

suicide and cases of suicide attempt. Female Sailors accounted for 7.3 percent of DoDSER 

suicide cases and 34.1 percent of DoDSER suicide-attempt cases.

Demographic and military service characteristics for all Navy DoDSER suicide and suicide 

attempt cases are detailed in Tables 32 and 33. 

Behavioral Health History 

Of those individuals who died by suicide in CY 2016, 40.0 percent had met criteria for at least 

one current or past behavioral health diagnosis. Mood (18.2%) disorders were common, 

however the most frequent diagnoses were anxiety (20.0%), adjustment (20.0%), and substance 

abuse (20.0%) disorders. Conversely, 52.7 percent of Sailors who died by suicide had no known 

history of a behavioral health diagnosis. 

Among those who attempted to die by suicide, 60.8 percent had at least one current or past 

behavioral health diagnosis present in their medical record. Anxiety (22.2%) and adjustment 

(24.4%) disorders were common. However, the most frequent diagnoses were mood (29.5%) 

and substance use (30.7%) disorders. Among those Sailors who attempted suicide, 38.6 percent 

had no known behavioral health history. 

Table 35 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Figure 45 displays the prevalence of various diagnoses, prior self-harm, 

and the use of psychotropic medication in the 90 days prior to a suicide-related death. Figure 46 

displays the prevalence of the same factors among DoDSER suicide-attempt cases. 

Substance Use 

Alcohol use, during the time period immediately preceding death, was identified in 34.5 percent 

of Navy suicide cases, though the “unknown” response for this item was endorsed for a 

Figure 45. Proportion of behavioral health risk factors in CY 

2016 Navy DoDSER suicide cases compared to the three-year 

average of CY 2013 - CY 2015 

Figure 46. Proportion of behavioral health risk factors in CY 

2016 Navy DoDSER suicide-attempt cases compared to the 

three-year average of CY 2013 - CY 2015

111
 

 

 

U.S. Navy Calendar Year 2016 Annual Report

substantial proportion of cases (29.1%; Table 34). Drug use (including illicit, prescription, and 

over-the-counter substances) was identified in 7.3 percent of Navy suicides. Proportionally, few 

deaths resulted from drug/alcohol overdose (9.1%). 

Alcohol use immediately prior to the suicidal behavior was present in 31.3 percent of suicideattempt cases, and 42.6 percent of cases were positive for drug use immediately prior to the 

suicidal behavior. Prescription-drug misuse was the most common method of overdose (21.6%). 

Health Care Utilization

Regardless of whether or not an individual voluntarily disclosed—or was assessed for—suicidal 

thoughts, feelings, and behavior, 43.6 percent of the Sailors who died by suicide in CY 2016 had 

been in contact with the MHS in the 90 days prior to their death (Table 35). A total of 23.6 

percent had received either inpatient (7.3%) or outpatient (21.8%) behavioral health services. 

Additionally, 4.3 percent had participated in substance-abuse programs. No suicides occurred 

among Sailors engaged in family assistance programs. 

A similar pattern was observed for suicide-attempt cases. Of the Sailors who attempted suicide 

in CY 2016, 59.1 percent had been in contact with the MHS in the 90 days prior to the behavior. 

A total of 44.9 percent had received either inpatient (11.4%) or outpatient (42.6%) behavioral 

health services. Additionally, 10.2 percent had participated in substance-abuse services and 1.7 

percent had participated in family assistance programs. 

Psychosocial Stressors 

Overall, the presence of psychosocial stressors among Sailors in CY 2016 is consistent with the 

proportionality of stressors in the previous four years. Relationship difficulties, especially strife 

Figure 47. Proportion of stress-related risk factors in CY 2016 

Navy DoDSER suicide cases compared to the three-year average 

of CY 2013 - CY 2015

Figure 48. Proportion of stress-related risk factors in CY 2016 

Navy DoDSER suicide-attempt cases compared to the three-year

average of CY 2013 - CY 2015 

112
 

U.S. Navy Calendar Year 2016 Annual Report

within—or termination of—an intimate partner relationship, were present in 43.6 percent of 

Navy suicide cases and 35.8 percent of suicide attempts. 

Individuals who died by suicide were frequently involved with legal and administrative stressors 

(23.6%), as were those who attempted to die by suicide (29.0%). Those who died by suicide 

were most frequently facing an investigation (12.7%). For suicide attempts, being under 

investigation (10.8%) or medical (8.5%) and administrative (9.7%) separation from service were 

the most frequently cited administrative issues. Figures 47 (cases of suicide) and 48 (cases of 

suicide attempt) display the prevalence of six stressors queried in the DoDSER system from CY 

2016 compared to the three-year average from CY 2013 - CY 2015. Table 36 also provides data 

for stressors pertaining to relationships, family issues, legal or administrative problems, work 

and financial difficulties, and abuse victimization or perpetration. 

Sexual Assault 

To better assess and understand any potential association between sexual assault and the 

occurrence of suicide-related behavior, Navy data collected from the DoDSER system were 

matched against records related to the filing of an unrestricted report of sexual assault. 

According to the analysis of these data, no Navy DoDSER suicide cases and 2 Navy DoDSER 

suicide-attempt cases were associated with an unrestricted report of a sexual assault that occurred

during the 12 months preceding the suicide-related event. When the limit of the 12 months 

preceding the suicide-related behavior was removed, no cases of suicide and 4 cases of attempted 

suicide were associated with unrestricted reports of sexual assault. Table 36 provides the 

number of sexual assaults recorded directly by the DoDSER system. Discrepancies between 

those cases identified by SAPRO and those identified on the DoDSER surveys could be due to 

several factors, including utilization of the restricted reporting option. 

113
 

U.S. Navy Calendar Year 2016 Annual Report

Table 32. Demographic characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Sex 

Male 51 92.7 116 65.9 

Female 4 7.3 60 34.1 

Age

17–19 3 5.5 16 9.1 

20–24 26 47.3 93 52.8 

25–29 14 25.5 30 17.0 

30–34 5 9.1 17 9.7 

35–39 5 9.1 6 3.4 

40–44 1 1.8 9 5.1

45–64 1 1.8 5 2.8 

Race

American Indian/Alaska Native 0 0.0 4 2.3 

Asian/Pacific Islander 2 3.6 16 9.1 

Black/African American 8 14.5 46 26.1 

White/Caucasian 45 81.8 106 60.2 

Other/Unknown 0 0.0 4 2.3 

Ethnicity

Hispanic 7 12.7 25 14.2 

Not Hispanic 48 87.3 151 85.8 

Unknown 0 0.0 0 0.0 

Education

Less than high school 0 0.0 0 0.0 

Alternative high school 4 7.3 5 2.8 

High school graduate 43 78.2 137 77.8 

Associate's or technical degree 3 5.5 16 9.1 

Four-year degree 5 9.1 11 6.3 

Postgraduate 0 0.0 7 4.0

Unknown 0 0.0 0 0.0 

Marital status 

Never married 28 50.9 96 54.5 

Married 27 49.1 80 45.5 

Separated 0 0.0 0 0.0 

Divorced 0 0.0 0 0.0 

Widowed 0 0.0 0 0.0 1

Data on demographic characteristics primarily provided by DMDC.

114
U.S. Navy Calendar Year 2016 Annual Report

Table 33. Military characteristics1 of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Component

Active 50 90.9 169 96.0 

Reserve 5 9.1 7 4.0 

Guard 0 0.0 0 0.0 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

Enlisted, unknown grade 0 0.0 3 1.7 

E1–E4 33 60.0 111 63.1 

E5–E9 21 38.2 54 30.7 

Warrant 0 0.0 0 0.0

Officer 1 1.8 8 4.5 

Enlisted occupational group

Infantry, gun crews, and seamanship specialists 5 9.1 13 7.4 

Electronic equipment repairers 7 12.7 28 15.9 

Communications and intelligence specialists 7 12.7 18 10.2 

Health care specialists 6 10.9 23 13.1 

Other technical and allied specialists 0 0.0 0 0.0 

Functional support and administration 3 5.5 14 8.0 

Electrical/mechanical equipment repairers 18 32.7 43 24.4 

Craftsworkers 2 3.6 8 4.5 

Service and supply handlers 5 9.1 9 5.1 

Non-occupational 1 1.8 10 5.7 

Unknown 0 0.0 2 1.1 

Officer occupational group 

General officers and executives 0 0.0 0 0.0 

Tactical operations officers 1 1.8 4 2.3 

Intelligence officers 0 0.0 0 0.0 

Engineering and maintenance officers 0 0.0 1 0.6 

Scientists and professionals 0 0.0 0 0.0 

Health care officers 0 0.0 2 1.1 

Administrators 0 0.0 0 0.0 

Supply, procurement, and allied officers 0 0.0 0 0.0 

Non-occupational 0 0.0 1 0.6 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 33 60.0 80 45.5 

Number of deployments 

1 16 29.1 47 26.7 

2 12 21.8 13 7.4 

3 or more 5 9.1 20 11.4 

Specific deployment locations2

Afghanistan 3 5.5 5 2.8 

Iraq 1 1.8 2 1.1 

Kuwait 2 3.6 3 1.7 

No 22 40.0 96 54.5 

Unknown 0 0.0 0 0.0 1

Data on military characteristics primarily provided by DMDC. 2

Subcategories are not mutually exclusive. 

115
 

U.S. Navy Calendar Year 2016 Annual Report

Table 34. Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Event location country

United States 50 90.9 161 91.5 

Iraq 0 0.0 0 0.0 

Afghanistan 0 0.0 0 0.0 

Kuwait 0 0.0 0 0.0 

Korea 0 0.0 0 0.0

Other Europe 1 1.8 5 2.8 

North America 0 0.0 1 0.6 

Central or South America 0 0.0 1 0.6 

Japan 1 1.8 2 1.1 

Belgium 0 0.0 0 0.0 

Germany 0 0.0 0 0.0 

United Kingdom 0 0.0 0 0.0 

Other 3 5.5 5 2.8 

Event setting 

Own residence 22 40.0 78 44.3 

Barracks 8 14.5 48 27.3 

Residence of friend or family 4 7.3 6 3.4 

Work/jobsite 2 3.6 8 4.5 

Automobile 7 12.7 9 5.1 

Inpatient medical facility 0 0.0 2 1.1 

Hotel 4 7.3 4 2.3 

Other 8 14.5 20 11.4 

Unknown 0 0.0 1 0.6 

Event method1

Drugs/alcohol 5 9.1 96 54.5 

Hanging/asphyxiation 13 23.6 27 15.3 

Poisoning 0 0.0 6 3.4 

Firearm 33 60.0 5 2.8 

Military firearm 1 1.8 2 1.1 

Non-military firearm 32 58.2 3 1.7 

Firearm of unknown origin 0 0.0 0 0.0 

Trauma, sharp or blunt force 4 7.3 39 22.2 

Other 0 0.0 2 1.1 

Pending/unknown 0 0.0 1 0.6 

Used alcohol during event

Yes 19 34.5 55 31.3 

No 20 36.4 113 64.2 

Unknown 16 29.1 8 4.5 

116
 

U.S. Navy Calendar Year 2016 Annual Report

Table 34 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Used drugs during event

Yes2 4 7.3 75 42.6 

Illegal drugs 

Used, overdose 0 0.0 4 2.3 

Used, no overdose 1 1.8 8 4.5 

Prescription drugs 

Used, overdose 1 1.8 38 21.6 

Used, no overdose 0 0.0 6 3.4 

Non-prescription drugs 

Used, overdose 2 3.6 36 20.5 

Used, no overdose 0 0.0 6 3.4 

No 33 60.0 92 52.3 

Unknown 18 32.7 9 5.1 

Death-risk gambling 

Yes 0 0.0 4 2.3 

No 54 98.2 168 95.5 

Unknown 1 1.8 4 2.3 

Planned/premeditated 

Yes 31 56.4 31 17.6 

No 22 40 124 70.5 

Unknown 2 3.6 21 11.9 

Observable 

Yes 14 25.5 78 44.3 

No 41 74.5 91 51.7 

Unknown 0 0.0 7 4.0 

Suicide note left 

Yes 20 36.4 14 8.0 

No 34 61.8 156 88.6 

Unknown 1 1.8 6 3.4 

Communicated potential for self-harm (other than suicide note) 

Yes 18 32.7 33 18.8 

How communicated2

Written 1 1.8 0 0.0 

Verbal 8 14.5 21 11.9 

Text 8 14.5 11 6.3 

Other 3 5.5 2 1.1 

To whom communicated2

Supervisor 3 5.5 3 1.7 

Chaplain 0 0.0 1 0.6

Mental health staff 6 10.9 7 4.0 

Friend 9 16.4 9 5.1 

Spouse 7 12.7 11 6.3 

Family 1 1.8 4 2.3

Other 2 3.6 4 2.3 

No 35 63.6 128 72.7 

Unknown 2 3.6 15 8.5 

117
 

 

U.S. Navy Calendar Year 2016 Annual Report

Table 34 (cont). Event characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 2016, 

Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Residence at time of event 

Barracks 11 20.0 54 30.7 

Bachelor Enlisted/Officer Quarters 5 9.1 4 2.3 

On-base family housing 5 9.1 9 5.1 

Off-base 29 52.7 83 47.2 

Ship 3 5.5 19 10.8 

Other 2 3.6 6 3.4 

Unknown 0 0.0 1 0.6 

Reside alone at time of event

Yes 22 40.0 49 27.8 

No 33 60.0 125 71 

Unknown 0 0.0 2 1.1 

Gun in home/immediate environment 

Yes 33 60.0 15 8.5 

No 19 34.5 151 85.8 

Unknown 3 5.5 10 5.7 

Duty environment2

Garrison/permanent duty station 41 74.5 125 71.0 

Leave 1 1.8 6 3.4

Temporary duty 1 1.8 1 0.6 

Training 10 18.2 19 10.8 

Other 7 12.7 23 13.1 

Deployed at time of event 

Yes 2 3.6 3 1.7 

Location

Afghanistan 0 0.0 0 0.0 

Kuwait 0 0.0 0 0.0 

Other/Unknown 2 3.6 3 1.7 

No 53 96.4 173 98.3 1

Data on the cause of the death were provided by AFMES. 2

Subcategories are not mutually exclusive. 

118
U.S. Navy Calendar Year 2016 Annual Report

Table 35. Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Any mental health diagnosis 

Yes1 22 40.0 107 60.8 

Mood disorder1 10 18.2 52 29.5 

Anxiety disorder1 11 20.0 39 22.2 

Personality disorder 1 1.8 11 6.3 

Psychotic disorder 0 0.0 0 0.0 

Adjustment disorder 11 20 43 24.4 

Substance abuse disorder 11 20 54 30.7 

No 29 52.7 68 38.6 

Unknown 4 7.3 1 0.6 

Sleep disorder

Yes 5 9.1 13 7.4 

No 46 83.6 160 90.9 

Unknown 4 7.3 3 1.7 

History of traumatic brain injury 

Yes 1 1.8 3 1.7 

No 50 90.9 168 95.5 

Unknown 4 7.3 5 2.8 

Family history of mental illness 

Yes 7 12.7 58 33.0 

No 29 52.7 108 61.4 

Unknown 19 34.5 10 5.7 

Prior self-injury 

Yes 11 20.0 61 34.7 

Number of prior self-injuries

One 8 14.5 35 19.9 

More than one 3 5.5 26 14.8 

Unknown 0 0.0 0 0.0 

Current event similar to prior 2 3.6 35 19.9 

No 2 3.6 35 19.9 

Unknown 8 14.5 8 4.5 

Psychotropic medications, last 90 days 

Yes1 8 14.5 50 28.4 

Antidepressants 7 12.7 46 26.1 

Antianxiety 3 5.5 21 11.9 

Antimanic 0 0.0 1 0.6 

Anticonvulsant 0 0.0 1 0.6 

Antipsychotic 1 1.8 2 1.1 

Sleep medication 6 10.9 28 15.9 

No 47 85.5 126 71.6 

Unknown 0 0.0 0 0.0 

119
 

U.S. Navy Calendar Year 2016 Annual Report

Table 35 (cont). Medical and behavioral characteristics of suicide and suicide-attempt DoDSER reports submitted 

for CY 2016, Navy 

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Pain medication at time of event 

Yes 5 9.1 20 11.4 

Opioid medication 0 0.0 8 4.5 

No 38 69.1 148 84.1 

Unknown 12 21.8 8 4.5 

Health/social services, last 90 days 

Yes1 24 43.6 104 59.1 

Medical treatment facility 24 43.6 86 48.9 

Substance Abuse Services 4 7.3 18 10.2 

Family Assistance Program 0 0.0 3 1.7 

Outpatient mental health 12 21.8 75 42.6 

Inpatient mental health 4 7.3 20 11.4 

No 28 50.9 70 39.8 

Unknown 3 5.5 2 1.1 1

Subcategories are not mutually exclusive. 

120
U.S. Navy Calendar Year 2016 Annual Report

Table 36. Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for CY 

2016, Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 27 49.1 71 40.3 

Intimate relationship 24 43.6 63 35.8 

Other relationship 7 12.7 19 10.8 

No 26 47.3 100 56.8 

Unknown 2 3.6 5 2.8 

Friend and family stressors, last 90 days 

Yes1 4 7.3 21 11.9 

Death of spouse or other family member (not suicide) 1 1.8 7 4.0 

Death of friend (not suicide) 1 1.8 8 4.5 

Serious illness of friend or family member 2 3.6 7 4.0 

No 47 85.5 149 84.7 

Unknown 4 7.3 6 3.4 

History of friend or family death by suicide 

Yes1 6 10.9 20 11.4 

Spouse 0 0.0 0 0.0 

Family other than spouse 3 5.5 9 5.1 

Friend 3 5.5 13 7.4 

No 47 85.5 153 86.9 

Unknown 2 3.6 3 1.7 

Administrative/legal problems, last 90 days 

Yes1 13 23.6 51 29 

Courts martial proceedings 0 0.0 0 0.0 

Article 15/Non-judicial punishment 0 0.0 0 0.0 

Administrative separation proceedings 2 3.6 17 9.7 

Away without leave/deserter status 3 5.5 6 3.4 

Medical evaluation board proceedings 1 1.8 15 8.5 

Civil legal proceedings 2 3.6 7 4.0 

Non-selection for promotion 2 3.6 2 1.1 

Under investigation 7 12.7 19 10.8 

No 42 76.4 123 69.9 

Unknown 0 0.0 2 1.1 

Excessive debt/bankruptcy, last 90 days 

Yes 2 3.6 11 6.3 

No 47 85.5 156 88.6 

Unknown 6 10.9 9 5.1 

Workplace, last 90 days 

Yes1 8 14.5 61 34.7 

Job problems 7 12.7 39 22.2 

Supervisor/coworker issues 4 7.3 30 17.0 

Poor performance review 2 3.6 18 10.2 

Unit/workplace hazing 0 0.0 6 3.4 

No 47 85.5 110 62.5 

Unknown 0 0.0 5 2.8 

121
 

U.S. Navy Calendar Year 2016 Annual Report

Table 36 (cont). Psychosocial determinants described in suicide and suicide-attempt DoDSER reports submitted for 

CY 2016, Navy

Suicide 

(n = 55) 

Suicide attempt

(n = 176) 

No. % No. % 

Abuse, assault, or harassment victimization, last year

Yes1 1 1.8 26 14.8 

Physical abuse or assault 0 0.0 12 6.8 

Sexual abuse or assault 0 0.0 10 5.7 

Emotional abuse 1 1.8 16 9.1 

Sexual harassment 0 0.0 6 3.4 

No 47 85.5 144 81.8 

Unknown 7 12.7 6 3.4 

Abuse, assault, or harassment perpetration, last year

Yes1 3 5.5 10 5.7 

Physical abuse or assault 0 0.0 6 3.4 

Sexual abuse or assault 1 1.8 5 2.8 

Emotional abuse 1 1.8 1 0.6 

Sexual harassment 1 1.8 0 0.0 

No 46 83.6 160 90.9 

Unknown 6 10.9 6 3.4 1

Subcategories are not mutually exclusive.

122
 

Chapter 8 

SELECTED RESERVE

NON DUTY STATUS

123
 

Selected Reserve: Non Duty Status Calendar Year 2016 Annual Report

Selected Reserve, Not in Duty Status 

Historically, the DoDSER system collected standardized data on demographic, contextual, 

behavioral health, historical, and risk-related factors for all identified suicides and suicide 

attempts that occur among Active Component members of the Armed Forces of the United States 

as well as Service members in the Reserves and National Guard who were in a duty status at the 

time of the event. 

However, evolving policy directed the incorporation of surveillance of suicide events that occur 

among members of the Reserve Component who are not in a duty status at the time of their 

death. In service of that goal, CY 2016 represents the first year that DoDSER reports were 

entered for Service men and women who were in a civilian (non-duty) status at the time of their 

death. 

These individuals are considered to be part of the Selected Reserve, or SELRES. The SELRES 

is defined as those service members within the Ready Reserve of each of the reserve 

components. The Selected Reserve consists of units, and, as designated by the Secretary 

concerned, of Reserves, trained as prescribed in section 10147(a)(1) of title 10 U.S. Code § 

10143 or section 502(a) of title 32, as appropriate. The organization and unit structure of the 

Selected Reserve shall be approved in the case of all reserve components other than the Coast 

Guard Reserve, by the Secretary of Defense based upon recommendations from the military 

departments as approved by the Chairman of the Joint Chiefs of Staff in accordance with 

contingency and war plans. (Source: 10 U.S. Code § 10143). 

Identifying and collecting extensive data on non-duty suicide events was a major challenge for 

the Services. The processes that are used to achieve this goal are being refined to ensure that the 

reporting compliance and data-quality goals for DoDSER reports can be achieved. For the CY 

2016 DoDSER report, data on demographic variables were obtained from the DMDC after 

suicide cases were provided by the Services to the AFMES. 

Over the course of CY 2016, 178 deaths due to suicide were recorded among Service members 

in the Reserve and Guard Components who were not in a duty status at the time of their death. 

Table 37 displays the demographic and Service characteristics of these Service members who 

died by suicide. While not formally compared using a statistical analysis, these distributions 

were qualitatively similar to those for Service members who died by suicide in an Active Duty 

status (Tables 12 and 13). 

124
 

 

Selected Reserve: Non Duty Status Calendar Year 2016 Annual Report

Table 37. Characteristics of suicide cases reported from the Services to the AFMES from among SELRES Service 

members not in a duty status at the time of death. 

Count (n = 178) % 

Service

Air Force 19 10.7 

Army 136 76.4 

Marine Corps 18 10.1 

Navy 5 2.8 

Component

Reserve 69 38.8 

Guard 109 61.2 

Sex 

Male 169 94.9 

Female 9 5.1 

Age

17–19 16 9.0 

20–24 65 36.5 

25–29 55 30.9 

30–34 17 9.6 

35–39 9 5.1 

40–44 7 3.9 

45–64 9 5.1 

Education

Less than high school 6 3.4 

Alternative high school 19 10.7 

High school graduate 116 65.2 

Associate's or technical degree 21 11.8 

Four-year degree 12 6.7 

Postgraduate 2 1.7 

Unknown 2 1.7 

Ethnicity

Hispanic 8 4.5 

Not Hispanic 170 95.5 

Unknown 0 0.0 

Race

American Indian/Alaska Native 5 2.8 

Asian/Pacific Islander 9 5.1 

Black/African American 15 8.4 

White/Caucasian 142 79.8 

Other/Unknown 7 3.9 

Marital Status 

Never married 120 67.4 

Married 51 28.7 

Legally separated 0 0.0 

Divorced 7 3.9 

Widowed 0 0.0 

Rank/Grade 

E1-E4 117 65.7 

E5-E9 53 29.8 

Warrant officer 0 0.0 

Officer 8 4.5 1

Demographic and Service characteristics provided by the DMDC.

125
Appendix A 

PROPORTIONATE MORTALITY 

ANALYSIS

126
 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Chapter two provided the results of the statistical analysis of the suicide mortality rates for each 

Component and Service in the DoD. The analyses also compared these rates to estimates from previous 

years and to the US total population (age 17 –59). This appendix provides one additional analysis of the 

data – proportionate mortality. The rates from chapter two examined the overall occurrence in the 

population. The rates were constructed as the number of suicides that occurred over a particular CY 

divided by the approximate population at risk for the service (the twelve-month end-strength average). 

Proportionate mortality, in contrast, considers the number of cases and the population size separately. 

Proportions (often expressed as percentages) are calculated across categories of interest and compared. 

As an example of proportionate mortality, consider the data from a fictitious population described in 

Table 38 below. The population is evenly divided between males and females. If we assume that sex has 

no effect on suicide risk, these percentages (50.0 and 50.0) serve as expected values for the distribution of 

cases. In other words, we expect one-half of the cases to be male and the other half to be female. In the 

data, we observe that 66.7 percent of cases were male, and the remaining 33.3 percent were female. As 

estimates, these values are clearly not the same as 50 percent. However, similar to the analysis of rates, 

the consideration of uncertainty, or error, is paramount here. The 95% CI provides upper and lower 

bounds on percentage values consistent with our data. Part of the analysis is to consider whether or not 

the expected value (the population percentage; in this case, 50) is contained within the interval. If it is, 

then there is insufficient evidence to conclude that the percentage of suicide cases differs from the 

population expected value. In contrast, if the interval excludes the expected value, then it is reasonable to 

conclude that there is a difference between the distribution of suicide cases across categories a particular 

variable and the distribution of the total population across the same categories.

One caveat about these values is that they are not adjusted for other demographic variables. As a result, 

over- or under-representation of a group in terms of proportionate mortality may be explained by another 

variable. As an example, if we observe a disproportionate number of cases in the junior enlisted ranks, it 

may be because this group is younger than other rank groups. 

Table 38. Example of proportionate mortality analysis 

Suicide deaths Population

Count Percent 95% CI Count Percent

Males 200 66.7 61.0, 72.0 20,000 50.0 

Females 100 33.3 28.0, 39.0 20,000 50.0 

Tables 39–45 below provide the observed distribution of suicide cases for each Component (total force) 

and for the Active Component of each Service, CY 2016. They also provide the 95% confidence interval 

and the distribution of the characteristic in the population. For the Active Component, total force, the 

following demographic groups had a higher proportion of cases than expected based on the population of 

the total force: male, non-Hispanic, white/Caucasian, not Hispanic, age 20–24, at or below a high school 

education, and divorced. Some demographic groups had a lower proportion than expected. These were: 

females, officers, and those with some college or a four-year college degree. 

127
 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 39. Percent of suicides in the Active Component, all Services, CY 2016, by demographic characteristics 

relative to the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 92.7 89.0, 95.5 84.1 

Female 7.3 4.5, 11.0 15.9 

Race

American Indian/Alaska Native 2.2 0.8, 4.7 1.2 

Asian/Pacific Islander 3.3 1.5, 6.1 5.4 

Black/African American 11.6 8.1, 16.0 17.3 

White/Caucasian 77.1 71.7, 81.9 68.1 

Ethnicity

Hispanic 9.8 6.6, 14.0 14.2 

Non-Hispanic 88.0 83.6, 91.6 81.7 

Age

17–19 5.1 2.8, 8.4 7.0 

20–24 41.1 35.2, 47.2 32.0 

25–29 23.6 18.7, 29.1 23.2 

30–34 12.7 9.0, 17.3 16.2 

35–39 9.5 6.3, 13.5 11.3 

40–44 4.4 2.3, 7.5 6.3 

45–64 2.9 1.3, 5.7 2.9 

Rank/Grade 

E1–E4 49.1 43.0, 55.2 43.3 

E5–E9 38.2 32.4, 44.2 38.2 

Officer 11.6 8.1, 16.0 16.1 

Warrant officer 1.1 0.2, 3.2 1.4 

Education

Alternative high school certification 7.3 4.5, 11.0 2.8 

High school graduate 67.6 61.8, 73.1 60.2 

Some college, no degree 6.2 3.6, 9.7 4.1 

Associate's degree or technical certification 2.9 1.3, 5.7 8.6 

Four-year college degree 8.7 5.7, 12.7 13.1 

Master's degree or greater 6.9 4.2, 10.6 8.2 

Marital Status 

Never married 42.9 37.0, 49.0 42.7 

Married 48.4 42.3, 54.4 53.3 

Divorced 7.6 4.8, 11.4 3.8 

128
 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 40. Percent of suicides in the Reserve Component, all Services, CY 2016, by demographic characteristics 

relative to the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 95.0 87.7, 98.6 78.3 

Female 5.0 1.4, 12.3 21.7 

Race

American Indian/Alaska Native 0.0 0.0, 4.5 0.9 

Asian/Pacific Islander 1.3 0.0, 6.8 6.3 

Black/African American 6.3 2.1, 14.0 19.5 

White/Caucasian 78.8 68.2, 87.1 67.4 

Ethnicity

Hispanic 8.8 3.6, 17.2 14.4 

Non-Hispanic 91.3 82.8, 96.4 83.7 

Age

17–19 6.3 2.1, 14.0 5.1 

20–24 31.3 21.3, 42.6 20.2 

25–29 32.5 22.4, 43.9 20.7 

30–34 11.3 5.3, 20.3 17.0 

35–39 6.3 2.1, 14.0 13.0 

40–44 5.0 1.4, 12.3 9.0 

45–64 2.5 0.3, 8.7 8.1 

Rank/Grade 

E1–E4 57.5 45.9, 68.5 40.0 

E5–E9 36.3 25.8, 47.8 40.9 

Officer 6.3 2.1, 14.0 18.1 

Warrant officer 0.0 0.0, 4.5 1.0 

Education

Alternative high school certification 7.5 2.8, 15.6 2.6 

High school graduate 75.0 64.1, 84.0 54.9 

Some college, no degree 2.5 0.3, 8.7 4.4 

Associate's degree or technical certification 5.0 1.4, 12.3 7.6 

Four-year college degree 6.3 2.1, 14.0 17.3 

Master's degree or greater 2.5 0.3, 8.7 9.6 

Marital Status 

Never married 60.0 48.4, 70.8 45.8 

Married 35.0 24.7, 46.5 46.7 

Divorced 5.0 1.4, 12.3 7.3 

129
 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 41. Percent of suicides in the National Guard Component, Air Force and Army, CY 2016, by demographic 

characteristics relative to the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 95.1 89.7, 98.2 82.6 

Female 4.9 1.8, 10.3 17.4 

Race

American Indian/Alaska Native 3.3 0.9, 8.1 0.7 

Asian/Pacific Islander 4.9 1.8, 10.3 3.3 

Black/African American 7.3 3.4, 13.4 14.3 

White/Caucasian 80.5 72.4, 87.1 79.1 

Ethnicity

Hispanic 3.3 0.9, 8.1 8.6 

Non-Hispanic 96.7 91.9, 99.1 91.3 

Age

17–19 8.9 4.5, 15.4 7.3 

20–24 35.0 26.6, 44.1 24.5 

25–29 29.3 21.4, 38.1 20.7 

30–34 9.8 5.1, 16.4 15.7 

35–39 4.9 1.8, 10.3 11.4 

40–44 6.5 2.8, 12.4 7.7 

45–64 3.3 0.9, 8.1 6.7 

Rank/Grade 

E1–E4 60.2 50.9, 68.9 43.9 

E5–E9 32.5 24.4, 41.6 42.6 

Officer 6.5 2.8, 12.4 11.5 

Warrant officer 0.8 0, 4.4 1.9 

Education

Alternative high school certification 10.6 5.7, 17.4 4.8 

High school graduate 53.7 44.4, 62.7 40.8 

Some college, no degree 15.4 9.6, 23.1 24.8 

Associate's degree or technical certification 1.6 0.2, 5.8 6.3 

Four-year college degree 12.2 7, 19.3 15.2 

Master's degree or greater 0.8 0, 4.4 5.2 

Marital Status 

Never married 65.9 56.8, 74.2 51.3 

Married 30.1 22.1, 39 42.3 

Divorced 4.1 1.3, 9.2 6.2 

130
 

 

 

 

 

 

 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 42. Percent of suicides in the Active Component, Air Force, CY 2016, by demographic characteristics 

relative to the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 91.8 81.9, 97.3 80.6 

Female 8.2 2.7, 18.1 19.4 

Race

American Indian/Alaska Native 0.0 0, 5.9 0.6 

Asian/Pacific Islander 0.0 0, 5.9 4.6

Black/African American 9.8 3.7, 20.2 14.2

White/Caucasian 85.2 73.8, 93 71.3

Ethnicity

Hispanic 8.2 2.7, 18.1 11.1

Non-Hispanic 90.2 79.8, 96.3 84.4

Age

17–19 6.6 1.8, 15.9 5.0

20–24 23 13.2, 35.5 27.2

25–29 27.9 17.1, 40.8 25.7

30–34 16.4 8.2, 28.1 19.1

35–39 14.8 7, 26.2 13.1 

40–44 6.6 1.8, 15.9 6.6

45–64 4.9 1, 13.7 2.5 

Rank/Grade 

E1–E4 36.1 24.2, 49.4 37.9

E5–E9 44.3 31.5, 57.6 41.5

Officer 19.7 10.6, 31.8 19.2

Education

Alternative high school certification 0.0 0, 5.9 0.0 

High school graduate 65.6 52.3, 77.3 51.1

Some college, no degree 0.0 0, 5.9 0.0 

Associate's degree or technical certification 9.8 3.7, 20.2 19.7

Four-year college degree 8.2 2.7, 18.1 13.9

Master's degree or greater 14.8 7, 26.2 12.9

Marital Status 

Never married 44.3 31.5, 57.6 37.7

Married 41.0 28.6, 54.3 56.0

Divorced 13.1 5.8, 24.2 6.2

131
 

 

 

 

 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 43. Percent of suicides in the Active Component, Army, CY 2016, by demographic characteristics relative to 

the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 92.1 86.0, 96.2 85.4 

Female 7.9 3.8, 14.0 14.6 

Race

American Indian/Alaska Native 2.4 0.5, 6.7 0.7

Asian/Pacific Islander 3.9 1.3, 8.9 5.8

Black/African American 13.4 8, 20.6 21.9 

White/Caucasian 76.4 68, 83.5 66.7

Ethnicity

Hispanic 11.8 6.8, 18.7 13.8

Non-Hispanic 88.2 81.3, 93.2 85.2

Age

17–19 2.4 0.5, 6.7 7.0

20–24 39.4 30.8, 48.4 29.6

25–29 25.2 17.9, 33.7 22.3

30–34 15 9.3, 22.4 16.5

35–39 8.7 4.4, 15 12.0

40–44 5.5 2.2, 11 7.3

45–64 3.1 0.9, 7.9 3.8

Rank/Grade 

E1–E4 47.2 38.3, 56.3 43.8

E5–E9 36.2 27.9, 45.2 35.8

Officer 14.2 8.6, 21.5 16.4

Warrant officer 2.4 0.5, 6.7 3.1

Education

Alternative high school certification 10.2 5.6, 16.9 5.1

High school graduate 59.1 50, 67.7 53.8

Some college, no degree 11.8 6.8, 18.7 10.1

Associate's degree or technical certification 0.8 0, 4.3 5.3 

Four-year college degree 10.2 5.6, 16.9 15.8

Master's degree or greater 7.9 3.8, 14 8.4

Marital Status 

Never married 37 28.6, 46 37.7

Married 51.2 42.2, 60.1 57.0

Divorced 10.2 5.6, 16.9 5.2

132
 

 

 

 

 

 

 

 

 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 44. Percent of suicides in the Active Component, Marine Corps, CY 2016, by demographic characteristics 

relative to the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 97.3 85.8, 99.9 92.0 

Female 2.7 0.1, 14.2 8.0 

Race

American Indian/Alaska Native 8.1 1.7, 21.9 1.1

Asian/Pacific Islander 5.4 0.7, 18.2 3.8

Black/African American 10.8 3, 25.4 10.8 

White/Caucasian 70.3 53, 84.1 79.5

Ethnicity

Hispanic 2.7 0.1, 14.2 19.3

Non-Hispanic 97.3 85.8, 99.9 80.7

Age

17–19 10.8 3, 25.4 13.4 

20–24 64.9 47.5, 79.8 47.5

25–29 10.8 3, 25.4 17.6 

30–34 2.7 0.1, 14.2 10.0

35–39 5.4 0.7, 18.2 6.4

40–44 2.7 0.1, 14.2 3.3

45–64 2.7 0.1, 14.2 1.4

Rank/Grade 

E1–E4 62.2 44.8, 77.5 59.1

E5–E9 35.1 20.2, 52.5 29.6

Officer 2.7 0.1, 14.2 10.2

Warrant officer 0.0 0, 9.5 1.1

Education

Alternative high school certification 8.1 1.7, 21.9 1.9

High school graduate 86.5 71.2, 95.5 82.2

Some college, no degree 2.7 0.1, 14.2 0.7

Associate's degree or technical certification 0.0 0, 9.5 2.2 

Four-year college degree 2.7 0.1, 14.2 9.6

Master's degree or greater 0.0 0, 9.5 2.2 

Marital Status 

Never married 51.4 34.4, 68.1 53.7

Married 48.6 31.9, 65.6 43.1

Divorced 0.0 0, 9.5 3.1 

133
 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Table 45. Percent of suicides in the Active Component, Navy, CY 2016, by demographic characteristics relative to 

the distribution of the total population 

Suicide 95% CI Population

Sex 

Male 92.0 80.8, 97.8 81.3 

Female 8.0 2.2, 19.2 18.7 

Race

American Indian/Alaska Native 0.0 0.0, 7.1 2.7 

Asian/Pacific Islander 4.0 0.5, 13.7 6.5 

Black/African American 10.0 3.3, 21.8 17.1 

White/Caucasian 74.0 59.7, 85.4 60.9 

Ethnicity

Hispanic 12.0 4.5, 24.3 15.0 

Non-Hispanic 78.0 64.0, 88.5 74.5 

Age

17–19 6.0 1.3, 16.5 5.5 

20–24 50.0 35.5, 64.5 31.3 

25–29 24.0 13.1, 38.2 25.2 

30–34 10.0 3.3, 21.8 16.5 

35–39 8.0 2.2, 19.2 11.4 

40–44 0.0 0.0, 7.1 6.2 

45–64 0.0 0.0, 7.1 2.8 

Rank/Grade 

E1–E4 60.0 45.2, 73.6 38.7 

E5–E9 38.0 24.7, 52.8 43.3 

Officer 2.0 0.1, 10.6 16.1 

Warrant officer 0.0 0.0, 7.1 0.5 

Education

Alternative high school certification 8.0 2.2, 19.2 2.4 

High school graduate 78.0 64.0, 88.5 65.8 

Some college, no degree 2.0 0.05, 10.6 1.2 

Associate's degree or technical certification 2.0 0.05, 10.6 6.1 

Four-year college degree 10.0 3.3, 21.8 10.6 

Master's degree or greater 0.0 0, 7.1 6.7 

Marital Status 

Never married 50.0 35.5, 64.5 48.8 

Married 50.0 35.5, 64.5 50.9 

Divorced 0.0 0, 7.1 0.0 

134
 

Proportionate Mortality Analysis Calendar Year 2016 Annual Report

Appendix B 

GLOSSARY

135
Glossary

Active Component 

Article 15

Confidence Interval 

(95%) 

death-risk gambling 

deployment 

DoDSER annual 

report 

Calendar Year 2016 Annual Report

Per the Office of the Deputy Chief Management Officer, the Active 

Component is, “the portion of the armed forces as identified in annual 

authorization acts as ‘active forces,’ and in section 115 of Title 10 USC 

as those active duty personnel paid from funds appropriated for active 

duty personnel.” 

A provision under the Uniform Code of Military Justice that gives 

commanding officers the ability to impose non-judicial punishment 

upon Service members who commit minor offenses within their units.

A band of plausible values that represent all 95% confidence intervals 

that could be constructed from repeated random samples of size n, 95% 

will contain the parameter (Rosner, 2006). Said another way, it is a 

range of values so defined that there is a 95% probability that the value 

of a parameter lies within it. See Rosner, B. 2006. Fundamentals of 

biostatistics. 6th Edition. Belmont, CA: Duxbury Press. 

Any game of chance with death or serious injury as a potential 

outcome. Examples include “Russian roulette.” 

Per the Office of the Chairman, the Joint Chiefs of Staff, a deployment 

is defined as “a troop movement resulting from a Joint Chiefs of Staff 

(JCS)/combatant command deployment order for 30 continuous days or 

greater to a land-based location outside the United States. This 

deployment location does not have permanent U.S. military medical 

treatment facilities (i.e., funded by the Defense Health Program) and 

may or may not be directly supported by deployed medical forces.” 

Service members who deployed and had at one location identified as 

part of Operation Enduring Freedom (OEF), Operation Iraqi Freedom

(OIF) or Operation New Dawn (OND) were considered to have been 

OEF/OIF/OND-deployed. Per the RAND report, “Army Deployments 

to OIF and OEF,” published in 2010, the identified locations included: 

Afghanistan, Bahrain, Djibouti, Iraq, Kuwait, Kyrgyzstan, Oman,

Qatar, Saudi Arabia and Uzbekistan. Additionally, the sea boundaries 

of the Red Sea, the Gulf of Aden, the Gulf of Oman and the Arabian 

Sea, north of the 10oN latitude and west of the 68oE longitude and the 

air space over all countries and sea boundaries listed here. 

A yearly summary providing a descriptive report of data from the 

United States Armed Forces on the incidence of suicides and suicide

attempts between January 1 and December 31 each year. This report is 

prepared by the Psychological Health Center of Excellence, a 

component of the Defense Health Agency’s Research and Development 

directorate. 

136
Glossary Calendar Year 2016 Annual Report

DoDSER survey The DoDSER data-collection form utilized by each Service to collect a 

core set of standardized data elements, as well as a set of Servicespecific items, regarding cases of suicide and attempted suicide. 

DoDSER system A secure web-based data-collection program, available at 

https://dodser.t2.health.mil, through which DoDSER surveys are 

completed and submitted. 

duty status Service members are considered to be in a duty status if they are 

members of the Active Component and are not identified as being

AWOL or in a deserter status. Per the Office of the Assistant Secretary 

of Defense for Reserve Affairs, Service members of the Selected

Reserve are also considered to be in a duty status if they are identified 

as currently engaged in Drill or Training, or in the Simultaneous 

Membership Program, Active Guard/Reserve, or Full-Time Support 

roles.

medical evaluation 

board 

Informal proceeding evaluating the medical history of a Service

member to determine how the injury and/or disease will respond to 

treatment protocols. This is used to determine if the medical condition 

and/or physical defect will render the Service member unfit for duty. 

planned and/or 

premeditated 

Evidence that the event was planned and/or premeditated includes 

verbal discussion of plan, written notes, e-mail and/or chat-room

discussion, or other evidence of plan such as preparatory behaviors 

(e.g., giving possessions away, purchase of materials to facilitate 

suicide, etc.). 

protective factor Factors that stem from physical, psychological, spiritual, family, social, 

financial, vocational, and emotional well-being. Factors that make it 

less likely those individuals will develop a disorder. Protective factors 

may encompass biological, psychological, or social factors in the 

individual, family, and environment. 

psychotropic 

medications 

A type of medication that directly affects the mental, emotional, and 

behavioral states when consumed by an individual. Such medications 

are used to treat disorders such as depression or bipolar disorder. 

risk factor Factors caused by stress, trauma, or other circumstances that cause a 

schism in protective factors. Factors that make it more likely those 

individuals will develop a disorder or pre-dispose one to high risk for 

self-injurious behaviors. Risk factors may encompass biological, 

psychological, or social factors in the individual, family, and

environment. 

137
Glossary Calendar Year 2016 Annual Report

Selected Reserve 

self-harm (without 

intent to die) 

sexual assault 

suicidal ideation

suicide

suicide attempt 

Traumatic Brain 

Injury

Per the Office of the Assistant Secretary of Defense for Reserve 

Affairs, the Selected Reserve “consists of those units and individuals 

within the Ready Reserve designated by their respective Services and 

approved by the Chairman, Joint Chiefs of Staff, as so essential to 

initial wartime missions that they have priority over all other Reserves. 

All selected Reservists are in an active status, but not necessarily a duty 

status. This category includes all Guard and Reserve personnel who 

have Selected Reserve agreements, whether trained or not. 

A self-inflicted, potentially injurious behavior for which there is

evidence (either implicit or explicit) that the person did not intend to 

kill himself or herself (i.e., had no intent to die).

The use of physical force to compel a person to engage in a sexual act 

against his or her will, regardless of whether or not the act is 

completed. Or, an attempted or completed sex act involving a person 

who is unable to understand the nature or condition of the act, to 

decline participation, or to communicate unwillingness to engage in the 

sexual act (e.g., because of illness, disability, or the influence of 

alcohol or other drugs, or because of intimidation or pressure). 

Any self-reported thoughts of engaging in suicide-related behaviors.

Self-inflicted death with evidence (either explicit or implicit) of intent 

to die. 

A self-inflicted, potentially injurious behavior with a non-fatal outcome

for which there is evidence (either explicit or implicit) of intent to die. 

A traumatically induced structural injury and/or physiological 

disruption of brain function as a result of an external force that is 

indicated by new onset or worsening of at least one of these clinical 

signs immediately following the event: 

a) Any period of loss of or a decreased level of consciousness;

b) Any loss of memory for events immediately before or after the 

injury; 

c) Any alteration in mental state at the time of the injury (confusion, 

disorientation, slowed thinking, etc.) Neurological deficits (weakness, 

loss of balance, change in vision, praxis, paresis/plegia, sensory loss, 

aphasia, etc.) that may or may not be due to a transient intracranial 

lesion used to treat disorders such as depression or bipolar disorder. 

138
Glossary Calendar Year 2016 Annual Report

unrestricted report 

of sexual assault 

Within the DoD, a formal report of the occurrence of a sexual assault in 

which the victim desires medical treatment, counseling, legal 

assistance, SARC and/or SHARP Specialist assistance, and an official 

investigation of the crime. 

139
Appendix C 

ACRONYMS

140
Acronyms Calendar Year 2016 Annual Report

AFMES Armed Forces Medical Examiner System 

AWOL Absent Without Official Leave 

CAC Common Access Card

CDC Centers for Disease Control and Prevention 

CI Confidence Interval 

CY Calendar Year 

DHA Defense Health Agency 

DMDC Defense Manpower Data Center 

DoD Department of Defense

DoDSER Department of Defense Suicide Event Report 

DSM-IV Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition – Text 

Revision 

DSPO Defense Suicide Prevention Office 

MHS Military Health System 

OEF OPERATION ENDURING FREEDOM 

OIF OPERATION IRAQI FREEDOM 

OMB Office of Management and Budget 

OND OPERATION NEW DAWN 

POC Point of Contact 

PHCoE Psychological Health Center of Excellence 

SAPRO Sexual Assault Prevention and Response Office 

SELRES Selected Reserve 

SMR Standardized Mortality Ratio

SPARRC Suicide Prevention and Risk Reduction Committee 

SPPM Suicide Prevention Program Manager 

T2 National Center for Telehealth & Technology 

U.S. United States 

WISQARS Web-based Injury Statistics Query and Reporting System 

141
Appendix D 

LIST OF TABLES AND FIGURES

142 
 

 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

List of Tables 

TABLE 1. DODSER SURVEY CONTENT AREAS.................................................................PAGE 9 

TABLE 2. DEMONSTRATION OF THE CALCULATION OF THE AGE- AND SEX-ADJUSTED SUICIDE RATE USING 

THE INDIRECT METHOD FOR THE ACTIVE COMPONENT, ALL SERVICES, CY 2012 ............PAGE 14 

TABLE 3. FREQUENCY AND UNADJUSTED RATE OF SUICIDE, BY COMPONENT AND SERVICE, FOR CY 2014

–CY 2016...............................................................................................PAGE 23

TABLE 4. OBSERVED NUMBER OF SUICIDE DEATHS AND THE NUMBER OF SUICIDE DEATHS REQUIRED TO 

INCREASE OR DECREASE THE CY 2016 SUICIDE-MORTALITY RATE.............................PAGE 31

TABLE 5. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE ACTIVE COMPONENT, ALL SERVICES, CY

2014 – CY 2016, OVERALL AND BY DEMOGRAPHIC CHARACTERISTICS........................PAGE 40 

TABLE 6. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE RESERVE COMPONENT OF THE SELECTED 

RESERVE IRRESPECTIVE OF DUTY STATUS, ALL SERVICES, CY 2014 – CY 2016, OVERALL AND BY 

DEMOGRAPHIC CHARACTERISTICS..................................................................PAGE 41

TABLE 7. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE GUARD COMPONENT OF THE SELRES,

AIR FORCE AND ARMY, CY 2014 – CY 2016, OVERALL AND BY DEMOGRAPHIC

CHARACTERISTICS.....................................................................................PAGE 42

TABLE 8. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE ACTIVE COMPONENT, AIR FORCE, CY

2014 – CY 2016, OVERALL AND BY DEMOGRAPHIC CHARACTERISTICS........................PAGE 43 

TABLE 9. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE ACTIVE COMPONENT, ARMY, CY 2014 –

CY 2016, OVERALL AND BY DEMOGRAPHIC CHARACTERISTICS.................................PAGE 44 

TABLE 10. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE ACTIVE COMPONENT, MARINE CORPS,

CY 2014 – CY 2016, OVERALL AND BY DEMOGRAPHIC CHARACTERISTICS...................PAGE 45

TABLE 11. RATES OF SUICIDE AMONG SERVICE MEMBERS IN THE ACTIVE COMPONENT, NAVY, CY 2014 –

CY 2016, OVERALL AND BY DEMOGRAPHIC CHARACTERISTICS.................................PAGE 46 

TABLE 12. DEMOGRAPHIC CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, ALL SERVICES..........................................................PAGE 54

TABLE 13. MILITARY CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, ALL SERVICES..........................................................PAGE 55

TABLE 14. EVENT CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS SUBMITTED 

FOR CY 2016, ALL SERVICES........................................................................PAGE 56

TABLE 15. MEDICAL AND BEHAVIORAL CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, ALL SERVICES...............................................PAGE 59

TABLE 16. PSYCHOSOCIAL DETERMINANTS DESCRIBED IN SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, ALL SERVICES...............................................PAGE 61

TABLE 17. DEMOGRAPHIC CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, AIR FORCE..............................................................PAGE 69

143 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

TABLE 18. MILITARY CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSERS SUBMITTED FOR 

CY 2016, AIR FORCE...................................................................................PAGE 70

TABLE 19. EVENT CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS SUBMITTED 

FOR CY 2016, AIR FORCE.............................................................................PAGE 71

TABLE 20. MEDICAL AND BEHAVIORAL CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, AIR FORCE...................................................PAGE 74

TABLE 21. PSYCHOSOCIAL DETERMINANTS DESCRIBED IN SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, AIR FORCE...................................................PAGE 79

TABLE 22. DEMOGRAPHIC CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSERS SUBMITTED 

FOR CY 2016, ARMY..................................................................................PAGE 84

TABLE 23. MILITARY CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSERS SUBMITTED FOR 

CY 2016, ARMY........................................................................................PAGE 85

TABLE 24. EVENT CHARACTERISTICS OF SUICIDE AND SUICIDE ATTEMPT DODSER REPORTS SUBMITTED 

FOR CY 2016, ARMY...................................................................................PAGE 86

TABLE 25. MEDICAL AND BEHAVIORAL CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, ARMY........................................................PAGE 89

TABLE 26. PSYCHOSOCIAL DETERMINANTS DESCRIBED IN SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, ARMY........................................................PAGE 91

TABLE 27. DEMOGRAPHIC CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, MARINE CORPS.........................................................PAGE 99

TABLE 28. MILITARY CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, MARINE CORPS.......................................................PAGE 100

TABLE 29. EVENT CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS SUBMITTED 

FOR CY 2016, MARINE CORPS.....................................................................PAGE 101

TABLE 30. MEDICAL AND BEHAVIORAL CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, MARINE CORPS...........................................PAGE 104

TABLE 31. PSYCHOSOCIAL DETERMINANTS DESCRIBED IN SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, MARINE CORPS...........................................PAGE 106

TABLE 32. DEMOGRAPHIC CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, NAVY...................................................................PAGE 114

TABLE 33. MILITARY CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS

SUBMITTED FOR CY 2016, NAVY..................................................................PAGE 115

TABLE 34. EVENT CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER REPORTS SUBMITTED 

FOR CY 2016, NAVY.................................................................................PAGE 116

TABLE 35. MEDICAL AND BEHAVIORAL CHARACTERISTICS OF SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, NAVY.......................................................PAGE 119

TABLE 36. PSYCHOSOCIAL DETERMINANTS DESCRIBED IN SUICIDE AND SUICIDE-ATTEMPT DODSER

REPORTS SUBMITTED FOR CY 2016, NAVY.......................................................PAGE 121

144 
 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

TABLE 37. CHARACTERISTICS OF SUICIDE CASES REPORTED FROM THE SERVICES TO THE AFMES FROM

AMONG SELRES SERVICE MEMBERS NOT IN A DUTY STATUS AT THE TIME OF DEATH....PAGE 125 

TABLE 38. EXAMPLE OF PROPORTIONATE MORTALITY ANALYSIS.......................................PAGE 127

TABLE 39. PERCENT OF SUICIDES IN THE ACTIVE COMPONENT, ALL SERVICES, CY 2016, BY

DEMOGRAPHIC CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION

..........................................................................................................PAGE 128

TABLE 40. PERCENT OF SUICIDES IN THE RESERVE COMPONENT, ALL SERVICES, CY 2016, BY

DEMOGRAPHIC CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION 

..........................................................................................................PAGE 129

TABLE 41. PERCENT OF SUICIDES IN THE NATIONAL GUARD COMPONENT, AIR FORCE AND ARMY, CY

2016, BY DEMOGRAPHIC CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL 

POPULATION ..........................................................................................PAGE 130

TABLE 42. PERCENT OF SUICIDES IN THE ACTIVE COMPONENT, AIR FORCE, CY 2016, BY DEMOGRAPHIC 

CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION..........PAGE 131

TABLE 43. PERCENT OF SUICIDES IN THE ACTIVE COMPONENT, ARMY, CY 2016, BY DEMOGRAPHIC 

CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION .........PAGE 132

TABLE 44. PERCENT OF SUICIDES IN THE ACTIVE COMPONENT, MARINE CORPS, CY 2016, BY

DEMOGRAPHIC CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION 

..........................................................................................................PAGE 133

TABLE 45. PERCENT OF SUICIDES IN THE ACTIVE COMPONENT, NAVY, CY 2016, BY DEMOGRAPHIC 

CHARACTERISTICS RELATIVE TO THE DISTRIBUTION OF THE TOTAL POPULATION ............PAGE 134 

145 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

List of Figures 

FIGURE 1. ILLUSTRATION OF THE SCALE OF SUICIDE IN THE MILITARY........................PAGE 20

FIGURE 2. ILLUSTRATION OF POPULATION DIFFERENCES (IN THE AGE AND SEX MAKEUP) OF THE 

U.S. GENERAL POPULATION COMPARED TO THE SERVICE MEMBER POPULATION OF THE 

ARMED FORCES..............................................................................PAGE 21 

FIGURE 3. ADJUSTED ANNUAL RATES OF SUICIDE IN THE ACTIVE COMPONENT, ALL SERVICES,

CY 2011 – CY 2016........................................................................PAGE 24 

FIGURE 4. ADJUSTED ANNUAL RATES OF SUICIDE IN THE RESERVE COMPONENT, ALL

SERVICES, CY 2011 – CY 2016...........................................................PAGE 25

FIGURE 5. ADJUSTED ANNUAL RATES OF SUICIDE IN THE NATIONAL GUARD COMPONENT, AIR 

FORCE AND ARMY, CY 2011 – CY 2016................................................PAGE 26

FIGURE 6. ADJUSTED ANNUAL RATES OF SUICIDE IN THE ACTIVE COMPONENT, AIR FORCE, CY

2011 – CY 2016..............................................................................PAGE 27

FIGURE 7. ADJUSTED ANNUAL RATES OF SUICIDE IN THE ACTIVE COMPONENT, ARMY, CY

2011 – CY 2016.............................................................................PAGE 28

FIGURE 8. ADJUSTED ANNUAL RATES OF SUICIDE IN THE ACTIVE COMPONENT, MARINE 

CORPS, CY 2011 – CY 2016..............................................................PAGE 29

FIGURE 9. ADJUSTED ANNUAL RATES OF SUICIDE IN THE ACTIVE COMPONENT, NAVY, CY 2011

– CY 2016.....................................................................................PAGE 30

FIGURE 10. SUICIDE RATE FOR THE ACTIVE COMPONENT, ALL SERVICES, CY 2011 – 2016,

AFTER INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 

17 – 59........................................................................................PAGE 32

FIGURE 11. SUICIDE RATE FOR THE RESERVE COMPONENT, ALL SERVICES, CY 2011 – 2016,

AFTER INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 

17 – 59. ..................................................................................................................PAGE 33

FIGURE 12. SUICIDE RATE FOR THE NATIONAL GUARD COMPONENT, AIR FORCE AND ARMY,

CY 2011 – 2016, AFTER INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL 

POPULATION, AGE 17 -59.....................................................................................PAGE 34

FIGURE 13. SUICIDE RATE FOR THE ACTIVE COMPONENT, AIR FORCE, CY 2011 – 2016, AFTER 

INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 17 –

59.................................................................................................PAGE 35

FIGURE 14. SUICIDE RATE FOR THE ACTIVE COMPONENT, ARMY, CY 2011 – 2016, AFTER

INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 17 –

59..............................................................................................PAGE 36 

146 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

FIGURE 15. SUICIDE RATE FOR THE ACTIVE COMPONENT, MARINE CORPS, CY 2011 – 2016,

AFTER INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 

17 – 59...........................................................................................PAGE 37 

FIGURE 16. SUICIDE RATE FOR THE ACTIVE COMPONENT, NAVY, CY 2011 – 2016, AFTER

INDIRECT ADJUSTMENT FOR AGE AND SEX TO THE U.S. TOTAL POPULATION, AGE 17 –

59..............................................................................................PAGE 38 

FIGURE 17. PROPORTION OF CY 2016 DODSER SUICIDE CASES’ METHOD OF INJURY COMPARED 

TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015............................... PAGE 49 

FIGURE 18. PROPORTION OF CY 2016 DODSER SUICIDE-ATTEMPT CASES’ METHOD OF INJURY

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015................ PAGE 49

FIGURE 19. PROPORTIONS OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 DODSER

SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015........PAGE 51

FIGURE 20. PROPORTIONS OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 DODSER

SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................PAGE 51

FIGURE 21. PROPORTIONS OF STRESS RELATED RISK FACTORS IN CY 2016 DODSER SUICIDE 

CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015..................................................................................................................PAGE 52

FIGURE 22. PROPORTIONS OF STRESS RELATED RISK FACTORS IN CY2016 DODSER SUICIDEATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015..........................................................................................PAGE 52 

FIGURE 23. RISK FACTOR PREVALENCE WITHIN EACH OF THE LATENT CLASSES IDENTIFIED 

AMONG SUICIDE DECEDENTS..............................................................PAGE 53

FIGURE 24. RISK FACTOR PREVALENCE WITHIN EACH OF THE LATENT CLASSES IDENTIFIED 

AMONG SUICIDE-ATTEMPT CASES.........................................................PAGE 53

FIGURE 25. PROPORTION OF CY 2016 AIR FORCE DODSER SUICIDE CASES’ METHOD OF INJURY 

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015.....................PAGE 65

FIGURE 26. PROPORTION OF CY 2016 AIR FORCE DODSER SUICIDE-ATTEMPT CASES’ METHOD 

OF INJURY COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015....PAGE 65

FIGURE 27. PROPORTIONS OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 AIR FORCE 

DODSER SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015..........................................................................................PAGE 66 

FIGURE 28. PROPORTIONS OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 AIR FORCE 

DODSER SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY

2013 - CY 2015..............................................................................PAGE 66

147 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

FIGURE 29. PROPORTIONS OF STRESS-RELATED RISK FACTORS IN CY 2016 AIR FORCE DODSER

SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................PAGE 68

FIGURE 30. PROPORTIONS OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 AIR FORCE 

DODSER SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY

2013 - CY 2015..............................................................................PAGE 68

FIGURE 31. PROPORTION OF CY 2016 ARMY DODSER SUICIDE CASES’ METHOD OF INJURY 

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015.................PAGE 80

FIGURE 32. PROPORTION OF CY 2016 ARMY DODSER SUICIDE CASES’ METHOD OF INJURY 

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015................ PAGE 80

FIGURE 33. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 ARMY SUICIDE 

CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015...........PAGE 81

FIGURE 34. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 ARMY SUICIDEATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015......................................................................................................................PAGE 81

FIGURE 35. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 ARMY SUICIDE CASES 

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015..................PAGE 82

FIGURE 36. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 ARMY SUICIDEATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................................PAGE 82

FIGURE 37. PROPORTION OF CY 2016 MARINE CORPS DODSER SUICIDE CASES’ METHODS OF 

INJURY COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015....... PAGE 95

FIGURE 38. PROPORTION OF CY 2016 MARINE CORPS DODSER SUICIDE-ATTEMPT CASES’

METHODS OF INJURY COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................PAGE 95

FIGURE 39. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 MARINE CORPS 

DODSER SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................PAGE 96

FIGURE 40. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 MARINE CORPS 

DODSER SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY

2013 - CY 2015..............................................................................PAGE 96

FIGURE 41. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 MARINE CORPS 

DODSER SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................PAGE 97

FIGURE 42. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 MARINE CORPS 

DODSER SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY

2013 - CY 2015..............................................................................PAGE 97

148 
 

 

 

 

 

 

 

 

 

 

 

 

List of Tables and Figures Calendar Year 2016 Annual Report

FIGURE 43. PROPORTION OF CY 2016 NAVY DODSER SUICIDE CASES’ METHOD OF INJURY 

COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015...............PAGE 110

FIGURE 44. PROPORTION OF CY 2016 NAVY DODSER SUICIDE-ATTEMPT CASES’ METHOD OF 

INJURY COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY 2015...... PAGE 110

FIGURE 45. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 NAVY DODSER

SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015...........................................................................................................PAGE 111

FIGURE 46. PROPORTION OF BEHAVIORAL HEALTH RISK FACTORS IN CY 2016 NAVY DODSER

SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015.........................................................................................PAGE 111

FIGURE 47. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 NAVY DODSER

SUICIDE CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015..............................................................................................................PAGE 112

FIGURE 48. PROPORTION OF STRESS-RELATED RISK FACTORS IN CY 2016 NAVY DODSER

SUICIDE-ATTEMPT CASES COMPARED TO THE THREE-YEAR AVERAGE OF CY 2013 - CY

2015.........................................................................................PAGE 112

149 
 

Appendix E 

FEEDBACK

150
 

Feedback Calendar Year 2016 Annual Report

In a continuing effort to provide a DoDSER annual report that is useful to the DoD community it serves, 

we request your feedback on the information we’ve provided and your suggestions for ways in which we 

could make the DoDSER annual report more useful. 

Please return your completed survey by mail, fax or email to 

Dr. Larry D. Pruitt

Psychological Health Center of Excellence 

9933 West Hayes St., Box 339500 MS 34, 

Joint Base Lewis-McChord, WA 98431 

Fax: 253.968.4192

Email: larry.d.pruitt21.civ@mail.mil

Strongly 

Disagree

Disagree Neutral Agree Strongly 

Agree

I found the information in the CY 2016 

DoDSER Annual Report helpful. 

What other statistics or comparisons would you like to have in future DoDSER annual reports? 

How did/will you use this report (e.g., inform leadership, policy, processes)?

Do you have any other feedback or suggestions? 

Optional: 

Name: _______________________________ Title: _________________________________

Organization: _________________________________________________________________

Email: ________________________________ Phone: _______________________________

151