-· - ~ 

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The estimated cost of report for the Deportment of Defense is 

app roximately $45,000 for the 2016 Fiscal Year. This includes 

$4,340 in expenses and $40,000 in DoD labo r. 

Gene rated on 2016Jun21 ReflD: E-6A4ED71 
OFFICE OF THE UNDER SECRETARY OF DEFENSE 

4000 DEFENSE PENTAGON 

WASHINGTON , D.C. 20301-4000 

PERSONNEL ANO 

READINESS 

JUN - 7 ?'"". 

Dear Military Leade rs and Community Members: 

The Department of Defense (DoD) prioritizes suicide prevention among Service 

members of the United States' Armed Forces. In service of that goal, a high-quality surveillance 

program is essential for the assessment, implementation, and refinement of suicide prevention 

efforts to better prov ide for the needs of our Service members. 

DoD's princi pa l suicide surveillance tool , the Department of Defense Suicide Event 

Report (DoDSER), has two primary purposes. It collects and reports extensive data on the 

contextual factors pr esent among Service members engaging in suicide-related behavior: event 

circumstances, medical and behavioral health factors , military-related factors , psycho soc ial and 

lifestyle stressors , and demographics. It also provides statistical informat ion from the Army, 

Navy, Air Force, and Marine Corps about Service members' suicides and suicide attempts, 

includ ing data from both the Active and Reserve Components. DoD uses this information to 

implement programs and policies designed to prevent future suicid es. 

I encourage you to review the Calendar Year 2015 DoDSER. The dissemination of the 

data within this repo rt ensures that leaders have access to the accurate and valuable information 

guiding current suicide prevention initiatives. Thank you for your continued support of DoD's 

efforts to reduce the heartbreaking occurrence of suicide deaths among our Service men and 

women. 

Sincerely, 

A. M. Kurta 

Performing the Duties of the Under Secretary of 

Defense for Personnel and Readiness 
Calendar Year 2015 Annual Report 

Acknowledgements 

The Department of Defense Suicide Event Report (DoDSER) Calendar Year 2015 Annual 

Report would not be possible without the continued efforts of our partner organizations. We 

would like to offer our sincere gratitude to the Armed Forces Medical Examiner System 

(AFMES), the Defense Manpower Data Center (DMDC), the Services’ DoDSER Program 

Managers and the Sexual Assault Prevention and Response Office (SAPRO) for their efforts in 

providing the best data possible on suicide and non-fatal suicide behavior for calendar year 

(CY) 2015. 

We would also like to recognize the efforts of the Defense Suicide Prevention Office (DSPO) 

and the members of the Suicide Prevention and Risk Reduction Committee (SPARRC) toward 

translating the information contained within this annual report into their suicide prevention 

programs and strategies. 

Finally, the authors would like to acknowledge the T2 staff members, past and present, who 

work behind the scenes on the Internet technology, security and administrative requirements of 

the DoDSER data collection system. To all of those involved with the DoDSER program, thank 

you for your hard work and collaboration. To be confronted on a daily basis with suicide 

reporting material is difficult, however, your dedication to the mission allows this surveillance 

effort to be successful. 

Authors 

Larry D. Pruitt, Ph.D. 

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

Nigel E. Bush, Ph.D. 

Nancy A. Skopp, Ph.D. 

Timothy V. Hoyt, Ph.D. 

Brian J. Grady, M.D., M.S. 

iii 
Calendar Year 2015 Annual Report 

Table of Contents 

ACKNOWLEDGEMENTS ............................................................................................................................. iii 

EXECUTIVE SUMMARY ............................................................................................................................... v 

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

CHAPTER 1: METHODOLOGY .....................................................................................................................3 

CHAPTER 2: SUICIDE RATES ...................................................................................................................16 

CHAPTER 3: COMBINED DATA - ALL SERVICES..........................................................................................30 

CHAPTER 4: U.S. AIR FORCE ..................................................................................................................44 

CHAPTER 5: U.S. ARMY..........................................................................................................................56 

CHAPTER 6 U.S. MARINE CORPS ............................................................................................................68 

CHAPTER 7: U.S. NAVY ..........................................................................................................................80 

CHAPTER 8: SELECTED RESERVE ............................................................................................................92 

APPENDIX A: GLOSSARY .........................................................................................................................95 

APPENDIX B: ACRONYMS ........................................................................................................................99 

APPENDIX C: LIST OF TABLES ................................................................................................................101 

APPENDIX D: FEEDBACK & SUGGESTIONS ..............................................................................................104 

iv 
Calendar Year 2015 Annual Report 

Executive Summary 

This report presents data from the United States (U.S.) Armed Forces on the incidence of 

suicide and suicide attempts between January 1, 2015 and December 31, 2015 (CY 2015). The 

annual rate of suicide is provided separately for Service members in the Active Component and 

those in the Selected Reserve Component of the Ready Reserve (SELRES), subdivided by the 

Reserve and National Guard. Data collection and reporting was required for all suicides and 

identified suicide attempts that occurred among Service members in the Active Component and 

those that occurred among SELRES who were in a duty or training status. These reports 

provided additional data on contextual factors and known or suspected determinants of suicide. 

This report was completed and submitted for public release on 31 July, 2016 

Suicide Rates 

1. Across the Services, there were 266 suicides in the Active Component (rate = 20.2 per 

100,000), 90 in the Reserve Component of the SELRES (rate = 24.7 per 100,000) and 

123 in the National Guard Component of the SELRES (rate = 27.1 per 100,000). These 

rates were statistically indistinguishable from one another after adjusting for age and 

sex differences between the three components. 

2. The suicide rates for the Active Component of the Air Force (rate = 20.5 per 100,000), 

the Army (rate = 24.4 per 100,000) and the Marine Corps (rate = 21.2 per 100,000) were 

statistically comparable. The CY 2015 suicide rate for the Navy (13.1 per 100,000) 

was lower than the rate for both the Air Force and the Army, but indistinguishable from 

the Marine Corps rate, after adjustment for age and sex differences. 

3. The rate of suicide of all Services for CY 2015 did not differ from the average rate for 

CY 2012 – CY 2014 for any Component. Furthermore, the Service-specific, Active 

Component suicide rates did not differ from the average rates for CY 2012 – CY 2014. 

4. The suicide rates for the Active Component and the Reserve Component of the SELRES 

were consistent with what would be expected if the military had the same age and 

sex composition as the U.S. general population. The rate of suicide for the National 

Guard was higher than expected, compared to the general population, after adjusting 

for age and sex. 

Key Findings Associated With Suicide Cases 

1. Firearms continue to be the most common method of suicide within the DoD. 

2. The prevalence of behavioral health factors and psychosocial stressors was consistent 

with previous reporting years. 

3. The CY 2015 suicide rates for the Active and Reserve Components were consistent with 

the average rates from CY 2012 – CY 2014. 

4. The CY 2015 suicide rates for each branch of Service within the Active Component were 

consistent with the average rates from CY 2012 – CY 2014. 

v 
Executive Summary Calendar Year 2015 Annual Report 

Key findings associated with cases of attempted suicide 

1. Drug and alcohol overdose was the most common method of injury identified on CY 

2015 DoDSER suicide attempt reports. 

2. The prevalence of behavioral health factors and psychosocial stressors was consistent 

with previous reporting years. 

Conclusions 

The rates of suicide for CY 2015 in the Active Component and the Reserve and Guard 

Components of the SELRES, after adjusting for age and sex, were statistically indistinguishable 

from the previous three years. These data were also consistent with patterns observed in the 

U.S. general population as described in the Web-based Injury Statistics Query and Reporting 

System (WISQARS) developed by the U.S. Centers for Disease Control and Prevention (CDC). 

The descriptive findings from the CY 2015 DoDSER reporting cycle suggest that the 

characteristics and risk factors associated with suicide and suicide attempts in the military are 

consistent with those identified in recent years. 

It is important to note that a change in the reported values, compared to past DoDSER Annual 

Reports, does not necessarily indicate a true increase or decrease in occurrence. Only 

statistical comparisons that factor in changes in the size and composition of the overall 

population (to ensure the comparison groups are equivalent) can be used to determine 

increases or decreases over time. Comparing any of the categories described in this report to 

values reported in previous years, without the appropriate statistical adjustments, will very likely 

result in erroneous conclusions. 

vi 
PREFACE 

1 
Preface 

The DoD Suicide Event Report (DoDSER) 

The DoDSER acronym is used to identify not only the web-based system for collecting caselevel data relevant to suicide-related behavior among members of the Armed Forces, but also 

the annual report of findings generated by that system and the survey form used for data 

collection. To clarify which aspect of the DoDSER is being referenced, a specification such as 

“system” or “survey,” has been added following the use of the acronym within this document. 

Primary Questions 

Over the course of each annual reporting cycle, two important questions related to suicide 

surveillance guide the development of the DoDSER Annual Report. These questions are: 

1. What is the rate of suicide among Service members? 

2. How common were various known or suspected determinants of suicide among those 

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

The DoDSER system utilizes two different case definitions in order to answer these questions. 

For the first question, all suicide cases identified by either the AFMES or the Services for the 

Active Component and the SELRES populations, irrespective of duty status at the time of death, 

are used to determine suicide rates for the total population. 

For the second question, we used data reported directly to the DoDSER system on specific risk 

and protective factors to describe the prevalence in the cases. For CY 2015, a completed 

DoDSER survey was required for all Active Component Service members who die by suicide. A 

completed DoDSER survey is also required for all SELRES Service members who die by 

suicide while in a duty status. The combination of Active Component and SELRES suicides, in a 

duty status, makes the total number of deaths described in the DoDSER-specific data not 

directly comparable to the number of Active Component suicides in the rate calculation. 

Furthermore, to comply with the timeline requirements of this report, only cases where suicide 

was confirmed as the manner of death by January 31, 2016 would have fallen in the 60-day 

required reporting window ensuring a DoDSER submission. As such, the total number of 

suicides described in the DoDSER-specific data may be less than the sum of all Active 

Component suicides and all SELRES suicides that occurred among Service members in a duty 

status. Data from previous years may be updated to include cases that were not part of a given 

year’s Annual Report based on the DoDSER system’s data-collection timeline. 

Caveats 

The majority of the content within the DoDSER Annual Report provides descriptive information 

regarding the prevalence of various suspected risk and protective factors associated with the 

occurrence of suicide related behavior within the DoD. Statistical comparisons of selected 

determinants between CY 2015 and the three previous calendar years are provided to examine 

the stability of determinant distributions over time. Neither these comparisons nor the 

descriptive reports allow any causal inferences to be made regarding specific risk factors or 

correlates. The primary reason for this is that 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 

making inferences about the role of any specific risk or protective factor. 

2 
CHAPTER 1 

METHODOLOGY 

3 
Methodology Calendar Year 2015 Annual Report 

Introduction 

Each year the DoDSER Annual Report is prepared by the National Center for Telehealth & 

Technology (T2). T2 is a branch of the Defense Centers of Excellence for Psychological Health 

and Traumatic Brain Injury (DCoE). As of February 7, 2016, DCoE and T2 fall under the 

authority of the Healthcare Operations directorate of the Defense Health Agency (DHA). 

This, the Annual Report for CY 2015, was completed and submitted for public release on 31 

July, 2016. 

The DoDSER system (and, by extension, the DoDSER Annual Report) is a collaborative effort 

between T2, the Suicide Prevention Program Offices of the Air Force, Army, Marine Corps and 

Navy, and the Defense Suicide Prevention Office (DSPO). The objective of this program is to 

create and refine a system for collecting and reporting data on a set of core standardized 

variables relevant to every Service member regardless of branch, component or duty status. 

The outcome is a comprehensive report designed to characterize suicide-related behavior, in a 

consistent manner, across the four largest branches of military service. This report presents 

data from the United States (U.S.) Armed Forces on the incidence of suicides and suicide 

attempts that occurred between January 1, 2015 and December 31, 2015. The Active and 

Reserve Components of the Army, Air Force, Marine Corps and Navy participate in suicide data 

surveillance, and this includes the Army National Guard and Air National Guard. 

The DoDSER Annual Report provides decision-making authorities with a tool to track the 

trajectory of suicide-related behavior that occurs among the United States’ Armed Forces. 

Calendar year 2015 was the DoDSER system’s eighth year of operation. Each of the past seven 

DoDSER Annual Reports are available online via the National Center for Telehealth & 

Technology website at: http://www.t2health.dcoe.mil/programs/dodser. 

In addition to the prevalence of suicide-related behavior, the DoDSER Annual Report seeks to 

contextualize these tragic events in a manner that is accurate, comprehensive and informative. 

This report is designed to serve as a standardized reference point that decision-making 

authorities can use to measure the trajectory of suicide-related behavior that occurs across the 

U.S. military. 

Data for each individual DoDSER case were collected and submitted by each Service and were 

augmented by data from the Armed Forces Medical Examiner System (AFMES; for active duty 

suicide decedents) and the Defense Manpower Data Center (DMDC; for suicide decedents and 

cases of suicide attempt). Primary data sources in cases of suicide included the decedent’s 

medical, behavioral health and personnel records. Primary data sources in cases of suicide 

attempt included medical, behavioral health and personnel records, as well as a direct interview 

of the individual who was the subject of the report. For both event types, additional information 

may have been collected from the individual’s Commander, peers, family or social network. 

All identifiable information in this report has been redacted in order to maintain the privacy of the 

individuals whose information is collected by the DoDSER system. No singular case-level data 

are presented; rather, aggregated data are presented for the DoD as a whole (Chapter 3) as 

well as for each individual branch of Service (Chapters 4-7). Data for the Selected Reserve is 

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

death or suicide attempt. 

4 
Methodology Calendar Year 2015 Annual Report 

The DoDSER system is expanding to include reports on all Service members who die by 

suicide, irrespective of duty status at the time of death. During CY 2015, only Service members 

in the Active Component and those in the SELRES in a duty status at the time of death were 

eligible for inclusion in the system. Cases in which the Service member was officially classified 

as either Absent Without Leave (AWOL) or in a Deserter Status, when the event occurred, were 

excluded from this report to conform to the definition of end strength used in the rate 

calculations. The CY 2015 DoDSER survey form contained more than 500 data elements to 

provide comprehensive information about the Service member, the psychosocial and emotional 

context of their life, military history, legal/disciplinary actions and the specific characteristics of 

the suicide related event. Additional data related to demographic characteristics and 

deployment histories were provided by the DMDC to both cross-reference and to augment what 

the DoDSER system collected. 

Changes to the DoDSER in CY 2015 

Revisions to the DoDSER system occur annually. These changes typically include minor system 

and database improvements, operating software updates and revision of the data collection 

survey’s content. Changes to the content of the DoDSER survey are particularly important, as 

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

Program managers at T2 and each of the Services collect suggestions for revision over the 

course of each calendar year. Formal presentation and discussion related to these changes 

between T2, the Services and a representative from the Defense Suicide Prevention Office 

results in a final list of annual changes to be made. The changes discussed later in this report 

became active in the DoDSER system on January 1, 2015. 

The CY 2015 data-collection cycle was significant because it represented the first opportunity 

for T2 to deploy system and survey changes related to the data-quality recommendations 

suggested by the DoD Inspector General’s Office during their DoD Suicide Event Report Data 

Quality Assessment (Report DODIG-2015-016; accessible at 

http://www.dodig.mil/pubs/documents/DODIG-2015-016.pdf). The remaining changes that could 

not be deployed within the CY 2015 cycle will be completed and released during subsequent 

data cycles. This year, we introduced eight important changes: 

1. In accordance with recommendation 3.b.3 in DODIG-2015-16, the DoDSER Help Text, 

which is available on an item-by-item basis within the survey form, was revised to inform 

users about the parameters of each question. The majority of the changes improved the: 

a. Standardization of item responses. 

b. Clarification of the definitions associated with objective questions. 

c. Addition of relevant diagnostic codes to questions about mental health history. 

d. Readability of the text. 

e. Identification of the potential sources where data relevant to any particular item 

may be located. 

2. In accordance with IG recommendation 3.c and 4.d in DoDIG-2015-16, ongoing 

processes were implemented to assess the quality of the data input into the DoDSER 

system. In addition to the 80 percent data-completeness goal for each completed 

DoDSER survey, we conducted: 

a. Weekly after-action reviews, in which the system user for one randomly selected 

DoDSER submission was contacted and interviewed about the usability and 

5 
Methodology Calendar Year 2015 Annual Report 

content of the DoDSER survey. The goal was to identify questions, responses, or 

website functions that were difficult to use, confusing, or that may otherwise have 

impeded the user’s ability to complete reports. 

b. A monthly review of 10 percent of the submitted DoDSER surveys to assess data 

quality. The quality assurance reviews included examining variables where the 

“cannot determine” and “data unavailable” response options were used, 

calculating the submission timeline, and evaluating the agreement between the 

qualitative and quantitative elements of the survey form. 

3. To comply with the Paperwork Reduction Act, an item was added to the end of the data 

collection instrument to determine the level of burden placed on government and nongovernment civilian individuals in completing a DoDSER survey. This item asked the 

DoDSER system user to identify how many minutes they spent interviewing individuals 

in each relevant category. 

4. An additional item was added to collect data on the amount of time the form submitter 

spent collecting, organizing and inputting data into the system. 

5. Per regulations of the Office of Management of Budget, the order for collecting data on 

race and ethnicity was reversed so that ethnicity was assessed prior to race. 

6. Outdated suicide-related terminology (e.g. completed, completion) was removed from all 

areas of the survey form. 

7. The survey logic that guided the user through the Army version of the survey form was 

edited for cases of suicidal ideation and non-suicidal self-harm so that only the first five 

questions (i.e., event identification) were presented. 

8. The user interface was updated to allow a DoDSER system user to sort reports by event 

date and to receive a reminder after a report was in an “in-progress” status for 30 days 

or more. 

Data-Collection Process and Data Sources 

DoDSER Items 

The items contained within the DoDSER survey form provide a comprehensive set of 

information obtained from a range of sources. The goal underlying the DoDSER system is to 

enhance the DoD’s understanding of suicide and to inform suicide-prevention efforts by 

systematically and comprehensively characterizing suicide-related behavior. The content of the 

current DoDSER survey was the result of a collaborative process that included these steps: 

1. Structured reviews of each Services’ historical suicide-surveillance systems/procedures 

2. Workgroup deliberations with representation from all four Services 

3. A systematic review of the suicide literature 

4. Feedback on content from nationally recognized civilian and military experts 

5. Feedback from senior military leaders and key stakeholders 

6 
Methodology Calendar Year 2015 Annual Report 

Each year, a workgroup, which includes the Suicide Prevention Program Manager (SPPM) for 

each Service, meets to refine the DoDSER survey form’s items based on the Services’ evolving 

needs. The categories of DoDSER survey’s content areas are displayed in Table 1. 

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 Psychological and medical history 

Military History Deployment history, disciplinary action 

Personal History Developmental history, family history 

Narrative Summary Information on data-collection strategy 

Reporting Mandate 

Completed DoDSER surveys were required for all suicides that occurred among Service 

members in the Active Component and in the SELRES, provided the Service member was in a 

duty status at the time of the event. All Services were required to submit DoDSER surveys for 

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

Army also required DoDSER surveys for other non-fatal events (self-harm and suicidal 

ideation). 

DoDSER Survey Submission Process 

The DoDSER survey forms were completed using a web-based system available via a secure 

website (https://dodser.t2.health.mil/). The DoDSER system is hosted at a DoD Information 

Assurance Certification and Accreditation Process-approved facility. Basic data entry users do 

not have access to any DoDSER data other than those which they collect and submit 

themselves. 

The descriptive DoDSER data presented in this CY 2015 report were compiled from DoDSER 

survey forms submitted by respondents across the DoD. For all Services, cases of death by 

suicide were tracked between the SPPMs and the AFMES to maintain an official list of 

confirmed suicides and to meet reporting timelines. Variations in the data-collection process 

among the four Services include: 

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

that received the AFMES notification and completed the DoDSER survey within 60 days. 

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

AFMES notifications, contacted the behavioral health point of contact (POC) at the 

Service member’s assigned medical treatment facility, and requested that a behavioral 

health clinician complete a DoDSER survey within 60 days. 

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

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

7 
Methodology Calendar Year 2015 Annual Report 

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

Health Data Surveillance section, contacted the local command and requested an 

appropriate POC to meet the requirement within 15 working days. 

Policy establishes that the rate of suicide for a calendar year (CY) can be calculated no sooner 

than 90 days after the end of the CY to allow for resolution of case determinations1

. As such, 

March 31, 2016 served as the final reporting date for cases used in the rate calculations and for 

the aggregate data from the DoDSER system presented in this report. 

All suicides that were confirmed by January 31, 2016 were required to have a DoDSER survey 

submitted by March 31, 2016. Deaths confirmed after January 31, 2016 still required a DoDSER 

survey to be submitted in accordance with the appropriate Service’s timeline. However, these 

reports were not required to be submitted by March 31, 2016. 

When evaluating DoDSER submission compliance for each of the Services, this CY 2015 report 

used each Service’s number of confirmed suicides as of January 31, 2016. However, all counts 

and rates used the most complete data available as of March 31, 2016. In cases involving nonfatal events, the reporting window is more constrained, and requires a DoDSER suicide attempt 

survey to be completed within 30 days of the hospitalization or evacuation from a theater of 

operations. 

Data Sources 

Following a suicide or non-fatal suicide attempt, Service personnel reviewed medical and 

behavioral health records, personnel records, investigative agency records and records related 

to the individual’s manner of death. Information was also collected through interviews with the 

individual’s command, investigative agency officer(s) and/or other professionals, if possible. For 

some Services, family members may have been interviewed if they were willing to participate 

and if the interview process would not cause undue distress. In cases where the suicidal 

behavior did not result in death, Service personnel also attempted to interview the individual. 

In addition to the items collected directly in the DoDSER survey form, supplementary data are 

obtained from additional enterprise sources in an effort to improve overall data completeness 

and accuracy. 

For CY 2015, these data sources included: 

 The Armed Forces Medical Examiner Service, which provided data on official manner 

and cause of death determinations for suicides that occurred among Service members. 

These data came 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. 

 The Defense Manpower Data Center, which provided data from the Defense Enrollment 

Eligibility Reporting System (DEERS) to deliver demographic information for all events 

submitted to the DoDSER system. DMDC also provided data from the Contingency 

Tracking System (CTS), the repository of official deployment-related information. 

 The DoD Sexual Assault Prevention and Response Office, which provided analytics in 

which DoDSER cases were matched against unrestricted, sexual assault reporting data. 

8 
Methodology Calendar Year 2015 Annual Report 

SAPRO analysts examined the relationship between sexual assault and suicide related 

behavior. 

In the case of missing or unavailable data that occurred in these various enterprise data 

sources, data from the DoDSER surveys were used to generate the final variable set used in 

this report. Discrepancies were resolved with the Service’s Suicide Prevention Program 

Managers to the extent feasible given the timeline. 

Data Quality 

Addressing suicide in a meaningful way demands that the data entered into the DoDSER 

system are as accurate and complete as possible. The DoDSER system uses several types of 

data-quality controls designed to improve the overall quality of DoDSER data. These include: 

 Controls on system login and data submission that require a DoDSER account 

associated with the DoDSER user’s common access card (CAC) credentials. Basic 

users can only access the active reports that are assigned to them. This assures that the 

system is private and gives the users confidence that they are entering information for 

the correct individual. 

 Design of the data-submission website structure minimizes the possibility of data-entry 

errors. 

 The use of 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). 

 Cases for which a high degree of missing data is indicated on the survey form (i.e. those 

that are less than 80 percent complete) are flagged as having ‘low data quality’ and the 

user is warned that submitting the report, as is, will count against their Service’s overall 

level of compliance. 

 Corroboration of suicide-event reports against data from the AFMES to ensure that a 

suicide event is valid and present in both independent systems. If a case is present in 

the DoDSER system without a corresponding AFMES report match, it is not included in 

the analytics of the report. 

 Review of all DoDSER surveys to ensure that multiple reports are not submitted for the 

same event. Potential duplicates are identified so that the Service’s DoDSER Program 

Managers can determine which submission represents the most accurate and complete 

data record. 

 Review of open-ended fields and the selection of the “Other” response option to identify 

text responses that should have been coded using the existing-item coding structure or 

to generate new response categories based on multiple responses with similar text. 

 Use of data from the AFMES and the DMDC to improve the accuracy of data for several 

fields. The AFMES’s data inform manner and cause of death for suicide reports, and the 

DMDC data provide information on deployment history and demographic characteristics. 

Data provided by these external sources are given primacy in developing the analytic 

9 
Methodology Calendar Year 2015 Annual Report 

variables used in this report. 

 Updated Help Text, as of January 1, 2015, to inform users about the definitions and 

parameters relevant to each question. These include relevant diagnostic codes, 

identification of data sources relevant to a given item and improved readability of the 

text. 

 Assessment of ten percent of submitted DoDSER surveys, on a monthly basis, to 

monitor data quality. These data-quality reviews examine variables where the “Cannot 

Determine” and “Data Unavailable” response options are used and assess the 

submission timeline and the correlation between the qualitative and quantitative 

elements of the survey form. 

Suicide Rate Data 

For this CY 2015 DoDSER Annual Report, the AFMES compiled official case lists of suicides 

that occurred 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 a duty status at the time of 

the event) relied on information entered into the Defense Casualty Information Processing 

System (DCIPS) as well as consultation with the Service’s SPPM. This determination was 

relevant to validating case submission in the DoDSER system. 

Cadets and midshipmen at the designated military academies (West Point in West Point, NY; 

the U.S. Naval Academy in Annapolis, MD; and the U.S. Air Force Academy in Colorado 

Springs, CO) were considered to be in a duty status. For members of the SELRES population, 

suicides that occurred among Service members not in a duty status, data were compiled by the 

AFMES from the Service-specific SPPM reports for the Air Force, Army, Marine Corps and 

Navy. The SELRES suicide case numbers presented in this report were current as of May 31, 

2016. 

Rate Calculation 

The process for determining the rates of various suicide-related characteristics was developed 

through a collaborative process facilitated by DSPO and included participation from the Services 

as well as staff from the Office of the Secretary of Defense. Decisions were made with 

consensus from all included parties. Crude and stratified rates were calculated separately for: 

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

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

individually for each Service) 

 The National Guard of the SELRES (irrespective of duty status; in aggregate and 

individually for Air Force and Army) 

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

rank/grade within the aforementioned components. The AFMES collaborated with the DMDC to 

identify the number of Service members in each combination of Service, component and 

demographic characteristic at the end of each month (end strength) for CY 2015. The average 

10 
Methodology Calendar Year 2015 Annual Report 

of the monthly end-strength tota ls was the denominator for the rate calculations. All rates 

associated with fewer than 20 suicide cases were suppressed because of the statistical 

instability that occurs in rates calculated from small numerators. 

Mathematical Formula 

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

Sg Rate - -~- -------- X 100,000 1 12 12 L..m=1 ESmg 

In this formula, S9 is the number of suicides in a particular population group and ESmg is the end 

strength of a particular month for the same population group. The populations (g) used in each 

rate calculation were: 

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 

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 

The Web-based Injury Statistics Query and Reporting System 2 (WISQARS) was used to identify 

the rates of suicide for CY 2012 through CY 2014 in the United States population (CY 2014 data 

were the latest population data available at the time this report was written). The WISQARS 

system is maintained by the Centers for Disease Control and Prevention (CDC) and provides 

aggregate data on fatal and non-fatal injuries and deaths. 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 was used to calculate the number of expected cases in each age- and 

sex-specific stratum of the component and Service subpopulations. Indirect, as opposed to 

direct, standardization was selected because of the small rates 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 age- and sex-specific stratum 

11 
Methodology Calendar Year 2015 Annual Report 

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 is3 : 

In this formula, Pia is the stratum-specific rate for the study population (i.e., the specific 

component or Service under consideration) and nia is the number of Service members in that 

stratum . The product of these values gives the observed number of suicides within each 

stratum. The sum of the observed numbers across the strata yields the numerator for the 

formula. In the denominator, Pis is the stratum-specific rate from the standard population (in this 

instance, the U.S. population) . The product of this rate with the number of Service members in 

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

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 

are for the Active Component suicide rate using data from all Services combined for CY 2012, 

and 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 per 100,000 persons. 

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 

CY 2012 Service- CY 2012 U.S Expected deaths 

Stratum aggregated denominator population rate (P;s) (n,aP,s) 

n ;a 

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 

67726 

375972 

296051 

188920 

137064 

87498 

33105 

8912 

2082 

13382 

67558 

52184 

32318 

20794 

12161 

4869 

1603 

513 

.000153 

.000221 

.000240 

.000228 

.000248 

.000266 

.000288 

.000315 

.000309 

.000039 

.000049 

.000056 

.000062 

.000072 

.000082 

.000100 

.000104 

.000091 

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 

12 
Methodology Calendar Year 2015 Annual Report 

The adjusted rate provides the comparison of the rate of suicide in the population of interest to 

what would be expected if the rate of suicide were equivalent to the total U.S. population. The 

95 percent confidence intervals (CI) associated with the adjusted rates were calculated using 

the Poisson distribution. These intervals provide a range of values for the adjusted rate that are 

consistent with the data and that account for uncertainty associated with the estimation and 

adjustment of the rates. If the interval excludes the U.S. population rate, then we can conclude 

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

general U.S. population. 

Since we used indirect standardization, the comparisons were limited to just the populations of 

interest and the comparison against expected rates in the total U.S. population. Within a 

particular year, it is not possible to compare, directly, the SMRs or associated adjusted rates 

between components or Services because the age and sex distributions may still differ between 

the subpopulations. 

Internal Comparisons of Rates between Components, Services and over Time 

We conducted a second set of analyses that used a Poisson regression model4

 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. The regression model compared the natural 

logarithmic transformation of the number of cases for each population of interest to a referent 

group. An offset term was included in the model that represented the natural logarithmic 

transformation of the number of Service members in each combination of age and sex for each 

of the subpopulations included in the model. 

Statistical Analysis of Determinants 

In this Annual Report of the DoDSER data, statistical comparisons of a defined set of 

determinants have been included to examine change over time within DoDSER suicide and 

suicide-attempt survey forms. Logistic regression models were used to compare CY 2015 

suicide and suicide-attempt DoDSER findings to findings from CY 2012 – CY 2014. We used 

the three previous calendar years of data to provide a stable base of comparison in determining 

whether the data observed for CY 2015 reflected a departure from what would be expected. 

Specific determinants included in the models were: 

 Mechanism of injury 

 Mood disorder 

 Anxiety disorder 

 Adjustment disorder 

 Substance abuse history 

 History of prior self-injury 

 Use of psychotropic medications in 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 

13 
Methodology Calendar Year 2015 Annual Report 

These variables were selected given their prominence in the suicide research literature as major 

determinants of suicide and suicide attempts. Each model was adjusted for age, race, ethnicity, 

rank/grade, sex, marital status and Service branch. A full-information maximum likelihood 

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

included in the models5

. Given the small number of individuals with more than one DoDSER 

case in the system (both a suicide attempt and a suicide, or multiple suicide attempts), only the 

most recent report has been retained for analysis to satisfy the assumption of independent 

observations in the regression model. 

Interpretive Considerations 

The purpose of this report, and 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 data from the DoDSER system are used to support hypothesis-driven 

research and program development, such as suicide-prevention efforts. These data are also 

used to inform decision-making and policy around suicide and suicide prevention. 

Often, questions are asked about the relative contributions of specific variables as risk and 

protective factors. However, it is not possible to determine, statistically, whether any particular 

variable is a risk or protective factor for suicide by relying solely on the data presented in this 

report. Data on the distribution of any particular variable among the broader population is 

required before any statistical inferences or causal statements about the relationship between 

that factor and the occurrence of suicide can be made using the descriptive data provided in this 

report. 

Many DoDSER items contain a response option that allows the user to select “data unavailable” 

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

negative response. While the latest version of the DoDSER survey has been modified to 

minimize the need to use this particular response option, it is inevitable that some information 

for some individuals will be unknown or unavailable. For example, whether there is a family 

history of mental illness. This information may be obtainable for Service members who had 

engaged the military’s behavioral health system. However, for Service members who had not 

sought behavioral health services, this information may not be known. Because of this, the 

impact of missing information on interpretive considerations that the reader makes regarding the 

findings of this report should be weighed against what information was not available. For 

example, percentages for many DoDSER items were calculated using the total number of 

reports for a given outcome as the denominator. If one group had a higher “data unavailable” 

response proportion than comparison groups, comparisons that include proportions of “yes” 

responses could lead to misinterpretation. 

Finally, the content area of any given DoDSER item should be taken into account when results 

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

objective (e.g., the location of a Service member’s current permanent duty station), whereas 

others are highly subjective (e.g., whether or not the Service member had experienced recent 

problems with a supervisor or coworker). 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 error in the measurement of these factors. 

14 
Methodology Calendar Year 2015 Annual Report 

Figures and Tables 

In this report, graphical displays of data are included to present the prevalence of specific 

variables in CY 2012 – CY 2015. 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 DoDSER case for that year. The reader is encouraged to be aware that 

separate tables may present separate types of information such as counts, rates and statistical 

comparisons, which cannot be directly compared. 

References 

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

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

Office. 

2. 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 

3. Kahn, H. A., & Sempos, C. T. (1989). Statistical methods in epidemiology. New York: 

Oxford University Press. 

4. Hilbe, J. M. (2011). Negative binomial regression (2nd ed.). New York: Cambridge 

University Press. 

5. Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press. 

15 
CHAPTE R 2 

SUICIDE RATES 

16 
Calendar Year 2015 Annual Report 

Suicide Rates 

Background information 

The suicide rate provides an estimate of the number of suicides that occur for every 100,000 

people within a given population. Because suicide is a statistically rare outcome, rates are 

presented per 100,000 people to allow for whole number rate values. In this chapter, we present 

descriptive rates for each Component and Service, from CY 2013 – CY 2015. When possible, 

we also provide demographic distributions of cases and associated rates. 

The descriptive rates cannot be used in direct comparisons between years, Services, 

Components, or the general U.S. population; these groups all have different age and gender 

compositions. Any comparison that does not account for this will be inappropriate and will 

provide misinformation. Furthermore, all of the descriptive rates provided are estimates; each of 

them is associated with uncertainty. Arithmetic differences between two rates will often exist; 

however, accounting for uncertainty helps determine which differences exceed what we expect. 

Because of the problems inherent in direct comparison of the descriptive data in this chapter, 

we provide several statistical analyses that address differences over time, between Services, 

between Components and with suicide data for the U.S. general population. 

Table 3. Frequency and unadjusted rate of suicide, by Component and Service, for CY 2013 – CY 2015. 

2013

Component and Service No. Rate 

2014

No. Rate 

2015 

No. Rate 

Active, all Services 256 18.5 

Air Force 48 14.4 

Army 121 22.7 

Marine Corps 46 23.6 

Navy 41 12.7 

Reserve2

, all Services 85 22.8 

Air Force 10 -

Army 59 29.6 

Marine Corps 11 -

Navy 5 -

Guard2

, Air Force and Army 133 28.9 

Air Force 13 -

Army 120 33.7 

276 20.4 

62 19.1 

126 24.6 

34 17.9 

54 16.6 

79 21.6 

10 -

42 21.4 

12 -

15 -

91 19.8 

14 -

77 21.8 

266 

64 

120 

39 

43 

90 

10

55 

11

14

123 

21 

102 

20.2 

20.5 

24.4 

21.2 

13.1 

24.7 

-

27.7 

-

-

27.1 

19.9 

29.2 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. 

Summary 

The overall suicide rates for each Component and for each of the Services are listed in Table 3. 

All groups with fewer than 20 suicides over the course of the year do not have a rate associated 

with them since this would be an unreliable value. The Reserve and Guard Components of the 

SELRES include all suicides, irrespective of duty status at the time of death. As stated in the 

Methodology chapter, the AFMES has oversight of mortality surveillance for Active Component 

and SELRES Service members who were in a duty status at the time of death. For all other 

SELRES deaths, the AFMES relied on reporting from the Services for case accrual. For CY 

2015, after accounting for age, sex and Service distributions, there was no statistically 

17 
Calendar Year 2015 Annual Report 

significant difference in the suicide rate between the Active Component, the Reserve 

Component of the SELRES and the National Guard Component of the SELRES. Within the 

Active Component, the rate of suicide for the Navy was lower than the average rate of all the 

Services, and was also lower than the Air Force and Army rates. 

Figure 1 displays the CY 2015 rates of suicide for the Active Component and the Reserve and 

Guard Components of the SELRES were consistent with the average rates from CY 2012 – CY 

2014. In other words, there were no interpretable differences between the Component rates (all 

Services) in CY 2015 and the rates from the previous three years. Figure 2 shows this pattern 

continuing within the Active Component when examining each of the Services. The Air Force 

rate, after age and sex adjustment, was slightly higher than expected given the confidence 

interval for the three-year average (the gray shaded region); however, given this margin of error 

it is likely that this CY 2015 rate does not statistically differ from the average of CY 2012 – CY 

2014. 

A common, referential data source when working with mortality rates is the U.S. general 

population. These data provide an expected number of suicides in any subset of the U.S. 

population. This expected number is improved by considering the age and sex composition of 

the population of interest and how it differs from the U.S. general population. In this instance, 

the Services tend to be much younger and have a substantially higher prevalence of males 

compared to the U.S. population. 

Figure 3 displays the rates of suicide for all Services combined, by Component, compared to the 

U.S. rate for all individuals aged 17 – 59. The Service rates (in color) were adjusted for age and 

sex differences between the Services and the U.S. general population. For CY 2015, the Active 

Component and the Reserve Component of the SELRES suicide rates were consistent with 

what was expected given the data in the U.S. general population for CY 2014 (the last year of 

available data). The CY 2015 rate for the Guard Component was higher than expected given 

the U.S. general population data. In the Active Component, the conclusions were similar for all 

of the Services except the Navy. Figure 4 shows that the Navy CY 2015 suicide rate was lower 

than expected, given the data from the U.S. general population for CY 2014. 

Table 4 presents the Active Component rate of suicide for all Services broken down by 

demographic characteristics. Qualitatively, the distribution and rate of suicide within 

demographic subgroups is consistent with CY 2013 and CY 2014. Data specific to the Reserve 

and Guard Components, all Services, and the Active Component of each Service are presented 

in Tables 5 – 10. 

18 
- I - ---- ~ 

Suicide Rates Calendar Year 2015 Annual Report 

All Services, Active All Services, Reserve 

Rate per 100,000 

0 5 10 25 30 0 5 25 30 10 15 20 

10 15 20 0 5 25 30 

2012 2013 2014 2015 2012 2013 2014 2015 

Air Force and Army, Guard 

15 20 

2012 2013 2014 2015 

Calendar year 

Figure 1. Adjusted annual rates of suicide in the Active Component and the Reserve 

and Guard Components of the SELRES (in color), irrespective of duty status, CY 2012 

– CY 2015. Note: All rates are adjusted for age, sex and Service. The gray dashed line 

represents the three-year average of CY 2012 – CY 2014. The gray shaded area 

represents the 95% confidence interval for the three-year average. The black bracket 

for CY 2015 is the 95% confidence interval around the CY 2015 point estimate. Overlap 

of this interval with the gray dashed line indicates no statistically significant difference 

between CY 2015 and the average of the three previous CYs. 

19 
- ______________ ----, ~ - -- -~ - -~"!!!I~ - -~-=1' ~---- ---- 1 

Suicide Rates Calendar Year 2015 Annual Report 

Army, Active Air Force, Active 

0 5 10 15 20 

2012 2013 2014 2015 

0 5 10 15 20 

2012 2013 2014 2015 

5 10 15 20 25 30

Marine Corps, Active 

5 10 15 20 25 30

Navy, Active 

Rate per 100,000 

0 25 30 0 25 30 

2012 2013 2014 2015 2012 2013 2014 2015 

Calendar year 

Figure 2. Adjusted annual rates of suicide in the Active Component of each Service (in 

color), CY 2012 – CY 2015. Note: All rates are adjusted for age and sex. The gray 

dashed line represents the three-year average of CY 2012 – CY 2014. The gray 

shaded area represents the 95% confidence interval for the three-year average. The 

black bracket for CY 2015 is the 95% confidence interval around the CY 2015 point 

estimate. Overlap of this interval with the gray dashed line indicates no statistically 

significant difference between CY 2015 and the average of the three previous CYs. 

20 
Suicide Rates Calendar Year 2015 Annual Report 

All Services, Active All Services, Reserve 

0 5 10 15 20 25 

2012 2013 2014 2015 

0 5 10 15 20 25 

2012 2013 2014 2015 

15 20 25 30

Air Force and Army, Guard 

Rate per 100,000 

0 5 10 30

30 

2012 2013 2014 2015 

Calendar year 

Figure 3. Rates of suicide in the Active Component and the Reserve and Guard 

Components of the SELRES (color), irrespective of duty status, accounting for the age 

and sex distribution of the U.S. general population in each year. Note: The solid gray 

line is the suicide rate in the U.S. general population, age 17 – 59, for each CY. The 

line is dashed between CY 2014 and CY 2015 to reflect that the data from CY 2014 are 

carried forward to CY 2015 since CY 2014 is the most recently available data. The 

black brackets for each CY are the 95% confidence intervals for the rates; those 

brackets that cross the gray line are not significantly different from the U.S. general 

population. 

21 
- ~ -

:~ } ___ J :1 p,--1 1 

Suicide Rates Calendar Year 2015 Annual Report 

Army, Active Air Force, Active 

0 5 10 15 20 25 

2012 2013 2014 2015 

0 5 10 15 20 25 

2012 2013 2014 2015 

10 15 20 25 30

Marine Corps, Active 

10 15 20 25 30

Navy, Active 

Rate per 100,000 

3030 

0 5 0 5 

2012 2013 2014 2015 2012 2013 2014 2015 

Calendar year 

Figure 4. Rates of suicide in the Active Component of each of the Services (color), 

accounting for the age and sex distribution of the U.S. general population in each year. 

Note: The solid gray line is the suicide rate in the U.S. general population, age 17 – 59, 

for each CY. The line is dashed between CY 2014 and CY 2015 to reflect that the data 

from CY 2014 are carried forward to CY 2015 since CY 2014 is the most recently 

available data. The black brackets for each CY are the 95% confidence intervals for the 

rates; those brackets that cross the gray line are not significantly different from the U.S. 

general population. 

22 
Suicide Rates Calendar Year 2015 Annual Report 

Table 4. Rates of suicide among Service members in the Active Component, all Services, CY 2013 – 

CY 2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 256 18.5 276 20.4 266 20.2 

Sex 

Male 241 20.5 256 22.3 252 22.7 

Female 15 - 20 9.8 14 -

Race 

American Indian/Alaska Native 8 - 3 - 4 -

Asian/Pacific Islander 8 - 8 - 12 -

Black/African American 32 13.7 42 18.2 45 19.9 

White/Caucasian 192 20.1 199 21.5 186 20.7 

Other/Unknown 16 - 24 22.3 19 -

Ethnicity 

Hispanic 21 13.3 34 21.4 29 18.2 

Non-Hispanic 232 19.5 240 20.8 229 20.6 

Unknown 3 - 2 - 8 -

Age 

17-19 13 - 6 - 12 -

20-24 95 21.9 96 22.4 97 23.1 

25-29 72 21.5 73 22.7 61 19.7 

30-34 31 14.0 52 23.8 44 20.6 

35-39 26 16.8 30 19.8 32 21.7 

40-44 11 - 15 - 15 -

45-49 8 - 1 - 4 -

50-54 0 - 3 - 1 -

55-59 0 - 0 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 2 -

E1-E4 125 21.0 122 21.2 127 22.5 

E5-E9 108 20.1 120 22.8 114 22.5 

Officer 23 10.5 31 14.3 18 -

Warrant officer 0 - 3 - 5 -

Education 

Some high school 1 - 1 - 1 -

Alternative high school certification 15 - 20 49.3 18 -

High school graduate 171 19.9 177 21.4 179 22.4 

Some college, no degree 18 - 20 32.6 19 -

Associate's degree or technical certification 15 - 19 - 21 19.9 

Four-year college degree 23 13.9 28 16.8 17 -

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

Unknown 7 - 4 - 5 -

Marital status 

Never married 106 18.9 105 19.0 116 21.1 

Married 126 16.6 145 19.5 132 18.6 

Legally separated 2 - 0 - 0 -

Divorced 22 36.7 25 44.8 17 -

Widowed 0 - 1 - 1 - 1

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

instability. 

23 
Suicide Rates Calendar Year 2015 Annual Report 

Table 5. Rates of suicide among Service members in the Reserve Component of the Selected Reserve 

irrespective of duty status, all Services, CY 2013 – CY 2015, overall and by demographic 

characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 85 22.8 79 21.6 90 24.7 

Sex 

Male 78 26.6 72 25.1 78 27.3 

Female 7 - 7 - 12 -

Race 

American Indian/Alaska Native 1 - 2 - 0 -

Asian/Pacific Islander 6 - 4 - 6 -

Black/African American 8 - 9 - 10 -

White/Caucasian 68 26.5 59 23.6 72 29.0 

Other/Unknown 2 - 5 - 2 -

Ethnicity 

Hispanic 5 - 9 - 14 -

Non-Hispanic 79 25.0 67 21.7 75 24.5 

Unknown 1 - 3 - 1 -

Age 

17-19 6 - 3 - 2 -

20-24 22 26.7 30 38.0 25 33.0 

25-29 18 - 13 - 26 35.0 

30-34 14 - 10 - 20 33.0 

35-39 9 - 9 - 4 -

40-44 7 - 3 - 7 -

45-49 6 - 8 - 3 -

50-54 2 - 1 - 3 -

55-59 1 - 2 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 0 -

E1-E4 46 29.0 46 29.7 47 31.2 

E5-E9 25 17.1 24 16.8 33 22.9 

Officer 13 - 9 - 8 -

Warrant officer 1 - 0 - 2 -

Education 

Some high school 4 - 1 - 4 -

Alternative high school certification 5 - 6 - 5 -

High school graduate 45 20.9 54 26.0 60 29.4 

Some college, no degree 5 - 2 - 3 -

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

Four-year college degree 17 - 8 - 7 -

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

Unknown 0 - 0 - 1 -

Marital status 

Never married 37 22.1 45 27.3 49 29.6 

Married 38 21.7 28 16.3 32 18.8 

Legally separated 0 - 0 - 0 -

Divorced 10 - 6 - 8 -

Widowed 0 - 0 - 1 - 1

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

instability. 

24 
Suicide Rates Calendar Year 2015 Annual Report 

Table 6. Rates of suicide among Service members in the Guard Component of the SELRES, Air Force 

and Army, CY 2013 – CY 2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 133 28.9 91 19.8 123 27.1 

Sex 

Male 127 32.9 87 22.7 116 27.1 

Female 6 - 4 - 7 -

Race 

American Indian/Alaska Native 1 - 2 - 1 -

Asian/Pacific Islander 3 - 5 - 4 -

Black/African American 18 - 11 - 10 -

White/Caucasian 106 30.7 73 20.0 103 28.7 

Other/Unknown 5 - 0 - 5 -

Ethnicity 

Hispanic 2 - 5 9 -

Non-Hispanic 131 31.0 86 20.4 114 27.4 

Unknown 0 - 0 - 0 -

Age 

17-19 8 - 9 - 8 -

20-24 41 36.1 34 30.4 45 40.5 

25-29 34 37.6 20 21.9 23 24.9 

30-34 18 - 12 - 22 31.2 

35-39 10 - 8 - 11 -

40-44 14 - 3 - 5 -

45-49 3 - 3 - 6 -

50-54 4 - 1 - 2 -

55-59 1 - 1 - 1 -

Rank/grade 

Cadet/midshipman 0 - 0 - 0 -

E1-E4 68 33.4 51 25.1 67 33.5 

E5-E9 63 31.8 34 17.3 46 23.7 

Officer 2 - 6 - 10 -

Warrant officer 0 - 0 - 0 -

Education 

Some high school 3 - 4 - 2 -

Alternative high school certification 21 68.6 5 - 12 -

High school graduate 71 38.0 48 25.9 64 34.7 

Some college, no degree 17 - 15 - 25 22.6 

Associate's degree or technical certification 7 - 3 - 5 -

Four-year college degree 7 - 7 - 12 -

Master's degree or greater 1 - 2 - 3 -

Unknown 6 - 7 - 0 -

Marital status 

Never married 69 31.1 58 25.5 67 29.0 

Married 53 25.5 26 12.9 50 25.7 

Legally separated 0 - 0 - 0 -

Divorced 11 - 7 - 6 -

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. 

25 
Suicide Rates Calendar Year 2015 Annual Report 

Table 7. Rates of suicide among Service members in the Active Component, Air Force, CY 2013 – CY 

2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 48 14.4 62 19.1 64 20.5 

Sex 

Male 44 16.3 53 20.2 62 24.6 

Female 4 - 9 - 2 -

Race 

American Indian/Alaska Native 2 - 0 - 0 -

Asian/Pacific Islander 0 - 1 - 5 -

Black/African American 8 - 9 - 7 -

White/Caucasian 35 14.6 45 19.3 48 21.5 

Other/Unknown 3 - 7 - 4 -

Ethnicity 

Hispanic 2 - 4 - 2 -

Non-Hispanic 46 14.8 58 19.2 59 20.4 

Unknown 0 - 0 - 3 -

Age 

17-19 0 - 3 - 1 -

20-24 18 - 27 30.1 26 30.3 

25-29 17 - 11 - 15 -

30-34 5 - 11 - 10 -

35-39 5 - 8 - 5 -

40-44 3 - 2 - 5 -

45-49 0 - 0 - 2 -

50-54 0 - 0 - 0 -

55-59 0 - 0 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 1 -

E1-E4 23 19.2 29 24.7 30 25.9 

E5-E9 22 15.3 28 20.1 29 22.2 

Officer 3 - 5 - 4 -

Warrant officer 0 - 0 - 0 -

Education 

Some high school 0 - 0 - 0 -

Alternative high school certification 0 - 0 - 0 -

High school graduate 40 21.7 50 28.7 43 26.6 

Some college, no degree 0 - 0 - 0 -

Associate's degree or technical certification 5 - 6 - 16 -

Four-year college degree 2 - 5 - 2 -

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

Unknown 0 - 0 - 2 -

Marital status 

Never married 21 17.7 26 22.4 37 32.6 

Married 19 - 29 15.5 22 12.4 

Legally separated 0 - 0 - 0 -

Divorced 8 - 6 - 5 -

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. 

26 
Suicide Rates Calendar Year 2015 Annual Report 

Table 8. Rates of suicide among Service members in the Active Component, Army, CY 2013 – CY 

2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 121 22.7 126 24.6 120 24.4 

Sex 

Male 117 25.4 118 26.7 113 26.8 

Female 4 - 8 - 7 -

Race 

American Indian/Alaska Native 4 - 1 - 3 -

Asian/Pacific Islander 5 - 4 - 4 -

Black/African American 16 - 27 24.6 27 25.2 

White/Caucasian 94 25.6 88 25.3 78 23.6 

Other/Unknown 2 - 6 - 8 -

Ethnicity 

Hispanic 11 - 18 - 14 -

Non-Hispanic 110 23.8 108 24.4 104 24.7 

Unknown 0 - 0 - 2 -

Age 

17-19 5 - 1 - 4 -

20-24 44 28.4 38 25.5 32 22.3 

25-29 36 28.0 36 30.2 30 27.0 

30-34 15 - 24 27.5 29 35.1 

35-39 13 - 13 - 19 -

40-44 3 - 11 - 4 -

45-49 5 - 1 - 2 -

50-54 0 - 2 - 0 -

55-59 0 - 0 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 1 -

E1-E4 65 28.0 56 25.6 45 21.4 

E5-E9 44 22.1 56 29.2 59 32.5 

Officer 12 - 12 - 10 -

Warrant officer 0 - 2 - 5 -

Education 

Some high school 1 - 1 - 1 -

Alternative high school certification 12 - 14 - 15 -

High school graduate 69 23.1 68 24.1 68 25.4 

Some college, no degree 14 - 18 - 17 -

Associate's degree or technical certification 5 - 8 - 4 -

Four-year college degree 16 - 12 - 9 -

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

Unknown 2 - 1 - 2 -

Marital status 

Never married 43 22.7 35 19.2 39 21.8 

Married 66 21.1 73 24.2 71 24.9 

Legally separated 2 - 0 - 0 -

Divorced 10 - 18 - 9 -

Widowed 0 - 0 - 1 - 1

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

instability. 

27 
Suicide Rates Calendar Year 2015 Annual Report 

Table 9. Rates of suicide among Service members in the Active Component, Marine Corps, CY 2013 – 

CY 2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 46 23.6 34 17.9 39 21.2 

Sex 

Male 43 23.8 32 18.3 37 21.8 

Female 3 - 2 - 2 -

Race 

American Indian/Alaska Native 0 - 0 - 1 -

Asian/Pacific Islander 1 - 0 - 1 -

Black/African American 3 - 1 - 3 -

White/Caucasian 36 23.4 28 18.6 34 23.3 

Other/Unknown 6 - 5 - 0 -

Ethnicity 

Hispanic 5 - 2 - 5 -

Non-Hispanic 41 25.0 32 20.3 34 22.6 

Unknown 0 - 0 - 0 -

Age 

17-19 6 - 2 - 5 -

20-24 21 24.6 13 - 22 25.5 

25-29 10 - 11 - 5 -

30-34 5 - 8 - 2 -

35-39 1 - 0 - 4 -

40-44 2 - 0 - 1 -

45-49 1 - 0 - 0 -

50-54 0 - 0 - 0 -

55-59 0 - 0 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 0 -

E1-E4 28 24.3 17 - 28 25.8 

E5-E9 15 - 13 - 9 -

Officer 3 - 4 - 2 -

Warrant officer 0 - 0 - 0 -

Education 

Some high school 0 - 0 - 0 -

Alternative high school certification 2 - 1 - 0 -

High school graduate 36 22.5 25 16.1 36 23.8 

Some college, no degree 2 - 2 - 0 -

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

Four-year college degree 4 - 4 - 2 -

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

Unknown 0 - 0 - 0 -

Marital status 

Never married 19 - 14 - 19 -

Married 23 25.2 19 - 17 -

Legally separated 0 - 0 - 0 -

Divorced 4 - 1 - 3 -

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. 

28 
Suicide Rates Calendar Year 2015 Annual Report 

Table 10. Rates of suicide among Service members in the Active Component, Navy, CY 2013 – CY 

2015, overall and by demographic characteristics 

2013 2014 2015 

Group Count Rate1 Count Rate1 Count Rate1 

Total 41 12.7 54 16.6 43 13.1 

Sex 

Male 37 13.9 53 19.8 40 14.9 

Female 4 - 1 - 3 

Race 

American Indian/Alaska Native 2 - 2 - 0 -

Asian/Pacific Islander 2 - 3 - 2 -

Black/African American 5 - 5 - 8 -

White/Caucasian 27 14.0 38 19.4 26 13.1 

Other/Unknown 5 - 6 - 7 -

Ethnicity 

Hispanic 3 - 10 - 8 -

Non-Hispanic 35 14.0 42 16.5 32 12.7 

Unknown 3 - 2 - 3 -

Age 

17-19 2 - 0 - 2 -

20-24 12 - 18 - 17 -

25-29 9 - 15 - 11 -

30-34 6 - 9 - 3 -

35-39 7 - 9 - 4 -

40-44 3 - 2 - 5 -

45-49 2 - 0 - 0 -

50-54 0 - 1 - 1 -

55-59 0 - 0 - 0 -

Rank/grade 

Cadet/midshipman 0 - 0 - 0 -

E1-E4 9 - 20 15.6 24 18.6 

E5-E9 27 19.9 23 16.6 17 -

Officer 5 - 10 - 2 -

Warrant officer 0 - 1 - 0 -

Education 

Some high school 0 - 0 - 0 -

Alternative high school certification 1 - 5 - 3 -

High school graduate 26 12.1 34 15.7 32 14.7 

Some college, no degree 2 - 0 - 2 -

Associate's degree or technical certification 5 - 3 - 0 -

Four-year college degree 1 - 7 - 4 -

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

Unknown 5 - 3 - 1 -

Marital status 

Never married 23 14.8 30 19.0 21 13.1 

Married 18 - 24 14.5 22 13.2 

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. 

29 
CHAPTE R 3 

COMBINED DATA: 

ALL SERVI CES 

30 
----

Combined Data: All Services Calendar Year 2015 Annual Report 

DoDSER Results Summary: All Services 

The DoDSER system collects data on demographic, contextual, behavioral health, historical and 

risk-related factors for all identified suicides and suicide attempts that occur among Active 

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

time of the event. Please refer to the DoDSER data tables that follow each population-specific 

chapter (e.g., Air Force, Army, Marine Corps, Navy) for specific variables of interest. 

Calendar Year 2015 Incidence of Death Due to Suicide 

As of March 31, 2016, the AFMES identified 266 confirmed suicides or suicides pending 

confirmation among Active Component Service members and 26 among SELRES Service 

members who were in a duty status at the time of their death. A DoDSER survey was submitted 

for 289 of these deaths. These DoDSER surveys were used in the generation of the data tables 

included in this chapter. 

Four suicide deaths were associated with one or more previous suicide attempt from CY 2008 – 

CY 2014, and three cases of suicide had previous suicide attempts during CY 2015. The 

median number of days between the most recent suicide attempt and the date of death was 

126. 

Calendar Year 2015 Incidence of Suicide Attempts 

There were 1,199 suicide attempts recorded by the Services during CY 2015. The associated 

reports provided data on 1,147 unique Service members—1,098 (95.7 percent) reporting a 

single suicide attempt during this time period and 49 (4.3 percent) that reported two or more 

suicide attempts during CY 2015. 

Eighteen DoDSER suicide attempt cases had prior events recorded in the DoDSER system 

between CY 2008 and CY 2014. The median number of days between the previous attempt and 

the DoDSER case for CY 2015 was 330 days. 

Demographic Characteristics 

Demographic and military service 

characteristics for all DoDSER 

suicide and suicide attempt cases 

are detailed in Tables 11 and 12. 

The distribution of characteristics 

among DoDSER suicide and suicide 

attempt cases was consistent with 

the general demographic 

composition of the Services. Similar 

to previous years, a demographic 

distinction between the suicide and 

suicide attempt DoDSER cases was 

the sex distribution, with females 

comprising 5.5 percent of DoDSER 

suicide cases and 29.4 percent of 

DoDSER suicide attempt cases. 

Figure 5. Percent of DoDSER suicide cases indicating 

distinct methods of injury, CY 2012 – CY 2015 0 20 40 60 80 1 0 0 P e r c e n t 

2012 2013 2014 2015 

Year 

Firearm Hanging/asphyxiation 

31 
---+--

--+--

Combined Data: All Services Calendar Year 2015 Annual Report 

Compared to DoDSER suicide 

attempt cases, DoDSER suicide 

cases also described an older 

population and one with a greater 

proportion of parents of minor 

children (21.8 percent). There was a 

similar pattern in the distribution of 

rank/grade, with DoDSER suicide 

cases having a greater proportion of 

more senior enlisted Service 

members, also compared to 

DoDSER suicide attempt cases. 

Event Information 

2012 2013 2014 2015 

P e r c e n t 

The data presented in Table 13 Year 0 20 40 60 8 0 1 0 0 

provide a descriptive overview of the Drugs/alcohol Hanging/asphyxiation 

settings and circumstances Sharp/blunt object 

surrounding suicides and suicide 

attempts that occurred across the Figure 6. Percent of DoDSER suicide attempt cases 

DoD in CY15. Figure 5 shows that indicating distinct methods of injury, CY 2012 – CY 2015 

the use of firearms and 

hanging/asphyxiation were the most 

commonly used methods of suicide, which is consistent with the data from CY 2012 – CY 2014. 

Among suicide cases that involved a firearm, the majority of firearms were personal 

possessions (95 percent) and not military-issued weapons (5 percent). 

Figure 6 identifies drug and/or alcohol overdose as the most frequently reported mechanism of 

injury among DoDSER suicide attempt cases. The other two most common methods of 

attempting suicide involved hanging/asphyxiation and the use of a sharp or blunt object. The 

prevalence of all three mechanisms of injury for CY 2015 was consistent with the data from CY 

2012 – CY 2014. 

Behavioral Health History 

Table 14 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Substance abuse and adjustment disorders were the most frequently 

identified diagnoses in DoDSER suicide cases for CY 2015. Figure 7 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. All indicators for CY 2015 were consistent with the data from the 

previous three calendar years. One notable exception was a decrease in the active use of 

psychotropic medications in the 90 days preceding a death caused by suicide. 

Figure 8 displays the prevalence of the same factors among DoDSER suicide attempt cases. 

The prevalence of variables related to an individual’s behavioral health history were higher for 

DoDSER suicide attempt cases than for DoDSER suicide cases. There were no differences in 

the prevalence estimates for CY 2015 compared to the data from CY 2012 – CY 2014. 

32 
i= ·········· 1··········· .. l<: ...... ::--==: •························ .. ······················•·················=====::t 

1± I= :::·

-··~ ······ ···. 

········;.. ·· ~ = ··········;~~ -::········· ..: ~;; 

---+---

--+-- --+--

----•---- • ····•···· • 

Combined Data: All Services Calendar Year 2015 Annual Report 0 20 40 60 80 1 0 0 

P e r c e n t 

0 20 40 60 80 1 0 0 

P e r c e n t 

2012 2013 

Year 

2014 2015 2012 2013 

Year 

2014 2015 

Mood 

Adjustment 

Prior self-harm 

Anxiety 

Substance abuse 

Medication last 90 days 

Mood 

Adjustment 

Prior self-harm 

Anxiety 

Substance abuse 

Medication last 90 days 

Figure 7. Percent of DoDSE

with specific behavioral heal 

2012 – CY 2015. 

R suicide cases 

th factors, CY 

Figure 8. Percent of Do

cases with specific beh 

2012 – CY 2015. 

DSER 

aviora

 suicide attempt 

l health factors, CY 

Psychosocial Stressors 

The information collected on psychosocial stressors pertain to information collected about 

relationships, family issues, legal or administrative problems, work and financial difficulties and 

alleged abuse victimization or perpetration. Table 15 provides descriptive data for each of these 

factors. Overall, 192 DoDSER suicide cases (66.4 percent) and 910 DoDSER suicide attempt 

cases (75.9 percent) endorsed at least one of these stressors. Figures 9 (cases of suicide) and 

10 (cases of suicide attempt) display the prevalence of six stressors queried in the DoDSER 

system from CY 2012 – CY 2015. The most common individual stressors were relationship, 

administrative/legal and workplace difficulties. The prevalence estimates for CY 2015 were 

consistent with the data from previous years. 

Relationship, administrative/legal and workplace difficulties were also the most common 

stressors endorsed among DoDSER suicide attempt cases. The data were largely consistent 

with those from prior years with the exception of financial problems/debt, which was slightly 

lower in CY 2015 relative to the overall prevalence observed for CY 2012 – CY 2014. 

In addition to data collected from the DoDSER system, cases were also matched against 

records related to the filing of an unrestricted report of sexual assault. According to the analysis 

of these data, no DoDSER suicide cases and 17 DoDSER suicide attempt cases were 

associated with an unrestricted report of a sexual assault that occurred during the year prior to 

the suicide related event. Table 15 provides the number of sexual assaults recorded via 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. 

33 
--

•------ ==-- -- ---- - - ------------ --•- -- -------------------• 

----+-----

• 

:.::-~-= -- ---=:::·== ·:;:_-------------:-. - - -=·...:.: ·==·-·• 

; ... ...... ...... : 

----+-----

----+-----

• 

Combined Data: All Services Calendar Year 2015 Annual Report 0 20 40 60 80 100 Percent 

2012 2013 2014 2015 

Year 

Relationship Family/friend suicide 

Family Administrative/legal 

Work Debt 

Figure 9. Percent of DoDSER suicide cases endorsing 

specific stressors prior to the event, CY 2012 – CY 2015. 0 20 40 60 80 10 

Percent 

2012 2013 

Year 

2014 2015 

Relationship 

Family 

Work 

Family/friend suicide 

Administrative/legal 

Debt 

Figure 10. Percent of DoDSER suicide attempt cases 

endorsing specific stressors prior to the event, CY 2012 – 

CY 2015. 

34 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 11. Demographic characteristics1 of suicide and suicide attempt DoDSERs submitted 

for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Sex 

Male 273 94.5 847 70.6 

Female 16 5.5 352 29.4 

Age 

17-19 13 4.5 174 14.5 

20-24 98 33.9 574 47.9 

25-29 67 23.2 254 21.2 

30-34 49 17.0 109 9.1 

35-39 33 11.4 49 4.1 

40-44 17 5.9 28 2.3 

45-59 12 4.2 11 0.9 

Race 

American Indian/Alaska Native 5 1.7 18 1.5 

Asian/Pacific Islander 13 4.5 51 4.3 

Black/African American 49 17.0 237 19.8 

White/Caucasian 212 73.4 837 69.8 

Other/Unknown 10 3.5 56 4.7 

Ethnicity 

Hispanic 29 10.0 166 13.8 

Not Hispanic 260 90.0 1,031 86.0 

Unknown 0 0.0 2 0.2 

Education 

Less than high school 1 0.3 5 0.4 

Alternative high school 20 6.9 47 3.9 

High school graduate 211 73.0 1,028 85.7 

Associate's or technical degree 24 8.3 58 4.8 

Four-year degree 23 8.0 45 3.8 

Postgraduate 8 2.8 14 1.2 

Unknown 2 0.7 2 0.2 

Marital status 

Never married 121 41.9 589 49.1 

Married 150 51.9 513 42.8 

Resides with spouse 88 312 

Separated 0 0.0 10 0.8 

Divorced 17 5.9 86 7.2 

Widowed 1 0.3 1 0.1 

Had minor children 

Yes, resided with service member 63 21.8 180 15.0 

Yes, did not reside with service member 48 16.6 150 12.5 

No 164 56.7 852 71.1 

Unknown 14 4.8 17 1.4 1

Data on demographic characteristics primarily provided by DMDC. 

35 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 12. Military characteristics1 of suicide and suicide attempt DoDSERs submitted for 

CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Component 

Active 263 91.0 1,140 95.1 

Reserve 11 3.8 35 2.9 

Guard 15 5.2 24 2.0 

Rank/grade 

Cadet/midshipman 2 0.7 

E1-E4 132 45.7 839 70.0 

E5-E9 127 43.9 287 23.9 

Enlisted, unknown grade 0 0.0 38 3.2 

Warrant 6 2.1 2 0.2 

Officer 22 7.6 33 2.8 

Enlisted occupational group 

Infantry, gun crews and seamanship specialists 62 21.5 291 24.3 

Electronic equipment repairers 14 4.8 43 3.6 

Communications and intelligence specialists 39 13.5 144 12.0 

Health care specialists 19 6.6 154 12.8 

Other technical and allied specialists 8 2.8 28 2.3 

Functional support and administration 26 9.0 164 13.7 

Electrical/mechanical equipment repairers 46 15.9 145 12.1 

Craftsworkers 9 3.1 55 4.6 

Service and supply handlers 27 9.3 96 8.0 

Non-occupational 8 2.8 42 3.5 

Unknown 1 0.3 2 0.2 

Officer occupational group 

Tactical operations officers 13 4.5 7 0.6 

Intelligence officers 1 0.3 2 0.2 

Engineering and maintenance officers 3 1.0 4 0.3 

Scientists and professionals 1 0.3 0 0.0 

Health care officers 4 1.4 10 0.8 

Administrators 2 0.7 6 0.5 

Supply, procurement and allied officers 2 0.7 0 0.0 

Non-occupational 4 1.4 6 0.5 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 166 57.4 390 32.5 

Number of deployments 

1 64 204 

2 46 91 

3 or more 56 95 

Specific deployment locations2 

Afghanistan 95 224 

Iraq 85 139 

Kuwait 90 175 

Kyrgyzstan 53 121 

No 123 42.6 806 67.2 

Unknown 0 0.0 3 0.3 1

Data on military characteristics primarily provided by DMDC.

2

Subcategories are not mutually exclusive. 

36 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 13. Event characteristics of suicide and suicide attempt DoDSERs submitted for CY 

2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Event location country 

United States 265 91.7 1,031 86.0 

Iraq 1 0.3 0 0.0 

Kuwait 1 0.3 3 0.3 

Korea 7 2.4 28 2.3 

Other Europe 3 1.0 13 1.1 

Japan 6 2.1 56 4.7 

Belgium 0 0.0 2 0.2 

Germany 3 1.0 32 2.7 

United Kingdom 0 0.0 5 0.4 

Other 3 1.0 18 1.5 

Unknown 0 0.0 11 0.9 

Event setting 

Own residence 140 48.4 502 41.9 

Barracks 53 18.3 476 39.7 

Residence of friend or family 23 8.0 39 3.3 

Work/jobsite 12 4.2 30 2.5 

Automobile 23 8.0 65 5.4 

Inpatient medical facility 0 0.0 9 0.8 

Hotel 4 1.4 10 0.8 

Other 34 11.8 58 4.8 

Unknown 0 0.0 10 0.8 

Event method1 

Drugs/alcohol 6 2.1 697 58.1 

Hanging/asphyxiation 86 29.8 154 12.8 

Poisoning 6 2.1 50 4.2 

Firearm 180 62.3 67 5.6 

Military firearm 9 6 

Non-military firearm 170 60 

Firearm of unknown origin 1 1 

Falling/jumping 1 0.3 24 2.0 

Sharp/blunt object 7 2.4 138 11.5 

Other 3 1.0 56 4.7 

Pending/unknown 0 0.0 13 1.1 

Used alcohol during event 

Yes 68 23.5 427 35.6 

No 113 39.1 721 60.1 

Unknown 108 37.4 51 4.3 

Used drugs during event 

Yes 17 5.9 630 52.5 

Illegal drugs 

Used, overdose 2 45 

Used, no overdose 4 19 

Prescription drugs 

Used, overdose 1 357 

Used, no overdose 8 101 

Non-prescription drugs 

Used, overdose 4 189 

Used, no overdose 3 52 

No 153 52.9 527 44.0 

Unknown 119 41.2 42 3.5 

37 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 13 (cont). Event characteristics of suicide and suicide attempt DoDSERs submitted 

for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Death-risk gambling 

Yes 3 1.0 25 2.1 

No 266 92.0 1,146 95.6 

Unknown 20 6.9 28 2.3 

Planned/premeditated 

Yes 116 40.1 276 23.0 

No 107 37.0 808 67.4 

Unknown 66 22.8 115 9.6 

Observable 

Yes 80 27.7 483 40.3 

No 185 64.0 656 54.7 

Unknown 24 8.3 60 5.0 

Suicide note left 

Yes 65 22.5 123 10.3 

No 176 60.9 1,028 85.7 

Unknown 48 16.6 48 4.0 

Communicated potential for self-harm (other than suicide 

note) 

Yes 81 28.0 259 21.6 

How communicated2 

Written 10 15 

Verbal 49 163 

Text 30 107 

Other 0 2 

Number of people to whom communicated 

1 65 193 

2 13 46 

3 3 12 

4 or more 0 3 

Unknown 0 5 

To whom communicated2 

Supervisor 9 30 

Chaplain 0 4 

Mental health staff 11 50 

Friend 24 97 

Spouse 36 88 

Family 8 35 

Other 12 29 

No 177 61.2 874 72.9 

Unknown 31 10.7 66 5.5 

Residence at time of event 

Barracks 74 25.6 505 42.1 

BEQ/BOQ 11 3.8 25 2.1 

On-base family housing 27 9.3 124 10.3 

Off-base 166 57.4 481 40.1 

Ship 2 0.7 11 0.9 

Other 8 2.8 34 2.8 

Unknown 1 0.3 19 1.6 

Reside alone at time of event 

Yes 89 30.8 413 34.4 

No 190 65.7 751 62.6 

Unknown 10 3.5 35 2.9 

38 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 13 (cont). Event characteristics of suicide and suicide attempt DoDSERs submitted 

for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Gun in home/immediate environment 

Yes 171 59.2 135 11.3 

No 90 31.1 960 80.1 

Unknown 28 9.7 104 8.7 

Duty environment2 

Garrison/permanent duty station 236 81.7 982 81.9 

Leave 25 8.7 36 3.0 

Temporary duty 2 0.7 20 1.7 

Training (excluding basic) 15 5.2 49 4.1 

Basic training 5 1.7 29 2.4 

Psychiatric hospitalization 0 0.0 7 0.6 

Medical 6 2.1 28 2.3 

Correctional facility 1 0.3 3 0.3 

Command observation 3 1.0 10 0.8 

Underway 1 0.3 4 0.3 

Other 1 0.3 23 1.9 

Unknown 4 1.4 35 12.1 

Deployed at time of event 

Yes 8 2.8 17 1.4 

Location 

Bahrain 2 1 

Djibouti 0 2 

Iraq 1 0 

Kuwait 2 5 

Other/Unknown 2 9 

No 281 97.2 1,182 98.6 1

Data on the cause of the death were provided by AFMES. 

2

Subcategories are not mutually exclusive. 

39 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 14. Medical and behavioral characteristics of suicide and suicide attempt DoDSER 

reports submitted for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Any mental health diagnosis 

Yes1 142 49.1 793 66.1 

Number of mental health diagnoses 

1 65 299 

2 37 268 

More than 2 40 226 

Mood disorder1 57 417 

Bipolar 4 23 

Major depression 36 279 

Dysthymic 5 37 

Other mood disorder 23 108 

Anxiety disorder1 55 326 

Posttraumatic stress 24 155 

Panic 3 29 

Generalized anxiety disorder 13 69 

Acute stress 2 12 

Other anxiety disorder 28 118 

Personality disorder 7 80 

Psychotic disorder 5 8 

Adjustment disorder 67 352 

Substance abuse disorder 71 342 

No 145 50.2 390 32.5 

Unknown 2 0.7 16 1.3 

Sleep disorder 

Yes 32 11.1 149 12.4 

No 252 87.2 1,015 84.7 

Unknown 5 1.7 35 2.9 

History of traumatic brain injury 

Yes 16 5.5 53 4.4 

No 266 92.0 1,113 92.8 

Unknown 7 2.4 33 2.8 

Family history of mental illness 

Yes 24 8.3 340 28.4 

No 174 60.2 742 61.9 

Unknown 91 31.5 117 9.8 

Prior self-injury 

Yes 34 11.8 338 28.2 

Number of prior self-injuries 

One 18 170 

More than one 16 163 

Unknown 0 5 

Current event similar to prior 11 173 

No 229 79.2 818 68.2 

Unknown 26 9.0 43 3.6 

Ever taken psychotropic medications 

Yes 63 21.8 520 43.4 

No 204 70.6 632 52.7 

Unknown 22 7.6 47 3.9 

40 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 14 (cont). Medical and behavioral characteristics of suicide and suicide attempt 

DoDSERs submitted for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Pain medication, last 90 days 

Yes 37 12.8 216 18.0 

No 220 76.1 921 76.8 

Unknown 32 11.1 62 5.2 

Use of opioid medications, last 90 days 

Yes 17 5.9 72 6.0 

No 238 82.4 1,058 88.2 

Unknown 34 11.8 69 5.8 

Polypharmacy at time of event 

Yes 12 4.2 96 8.0 

No 252 87.2 1,021 85.2 

Unknown 25 8.7 82 6.8 

Health/social services, last 90 days 

Yes1 185 64.0 833 69.5 

Medical Treatment Facility 165 666 

Substance Abuse Services 25 158 

Family Assistance Program 11 71 

Outpatient mental health 76 591 

Inpatient mental health 13 184 

No 102 35.3 355 29.6 

Unknown 2 0.7 11 0.9 1

Subcategories are not mutually exclusive. 

41 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 15. Psychosocial determinants described in suicide and suicide attempt DoDSER 

reports submitted for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 119 41.2 504 42.0 

Intimate relationship 110 439 

Other relationship 27 141 

No 146 50.5 669 55.8 

Unknown 24 8.3 26 2.2 

Friend and family stressors, last 90 days 

Yes1 14 4.8 116 9.7 

Death of spouse or other family member (not 

suicide) 5 26 

Death of friend (not suicide) 3 25 

Serious illness of friend or family member 6 75 

No 253 87.5 1,058 88.2 

Unknown 22 7.6 25 2.1 

History of friend or family death by suicide 

Yes1

 17 5.9 175 14.6 

Spouse 1 3 

Family other than spouse 8 68 

Friend 8 119 

No 261 90.3 1,001 83.5 

Unknown 11 3.8 23 1.9 

Administrative/legal problems, last 90 days 

Yes1 91 31.5 364 30.4 

Courts martial proceedings 9 18 

Article 15/Non-judicial punishment 24 110 

Administrative separation proceedings 17 111 

Away without leave/deserter status 10 22 

Medical evaluation board proceedings 14 108 

Civil legal proceedings 25 64 

Non-selection for promotion 20 37 

Under investigation 46 107 

No 197 68.2 815 68.0 

Unknown 1 0.3 20 1.7 

Excessive debt/bankruptcy, last 90 days 

Yes 19 6.6 61 5.1 

No 228 78.9 1,076 89.7 

Unknown 42 14.5 62 5.2 

Workplace, last 90 days 

Yes1 64 22.1 420 35.0 

Job problems 50 335 

Supervisor/coworker issues 20 225 

Poor performance review 17 119 

Unit/workplace hazing 1 36 

No 211 73.0 752 62.7 

Unknown 14 4.8 27 2.3 

Abuse, assault, or harassment victimization, last year 

Yes1 8 2.8 119 9.9 

Physical abuse or assault 3 36 

Sexual abuse or assault 0 48 

Emotional abuse 5 64 

Sexual harassment 0 26 

No 259 89.6 1,049 87.5 

Unknown 22 7.6 31 2.6 

42 
Combined Data: All Services Calendar Year 2015 Annual Report 

Table 15 (cont). Psychosocial determinants described in suicide and suicide attempt 

DoDSER reports submitted for CY 2015, all Services 

Suicide 

Suicide attempt 

(n = 289) (n = 1,199) 

No. % No. % 

Abuse, assault, or harassment perpetration, last year 

Yes1

 32 11.1 76 6.3 

Physical abuse or assault 15 42 

Sexual abuse or assault 16 18 

Emotional abuse 8 23 

Sexual harassment 3 6 

No 240 83.0 1,089 90.8 

Unknown 17 5.9 34 2.8 1

Subcategories are not mutually exclusive. 

43 
CHAPT ER 4 

U.S. AIR FORCE 

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44 
U.S. Air Force Calendar Year 2015 Annual Report 

DoDSER Results Summary: Air Force 

The DoDSER system collects data on demographic, contextual, behavioral health, historical and 

risk-related factors for all identified suicides and suicide attempts that occur among Active 

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

time of the event. Please refer to the DoDSER data tables that follow this chapter for specific 

variables of interest. The findings in this chapter pertain specifically to the United States Air 

Force. There were no statistical comparisons for data over time within the Air Force. See 

Chapter 3 for data relevant to all Services combined. 

Calendar Year 2015 Incidence of Death Due to Suicide 

As of March 31, 2016, the AFMES identified 63 confirmed suicides or suicides pending 

confirmation among Air Force Active Component Service members and 1 among SELRES 

Service members who were in a duty status at the time of death. A DoDSER survey was 

submitted for 62 of these deaths. These DoDSER surveys were used in the generation of the 

data tables included in this chapter. Two suicide deaths were associated with one or more 

suicide attempts from CY 2008 – CY 2014. No suicides were associated with a separate 

DoDSER suicide attempt case in CY 2015. 

Calendar Year 2015 Incidence of Suicide Attempts 

There were 276 suicide attempts recorded by the Air Force during CY 2015. The reports 

provided data on 259 unique Service members—245 cases (94.6 percent) reported a single 

suicide attempt during this time period and 14 cases (5.4 percent) reported two or more suicide 

attempts. Five DoDSER suicide attempt cases were associated with one or more previous 

suicide attempt records in the DoDSER system from 2008 – 2014. The median number of days 

between the last attempt and the CY 2015 attempt report was 444 days. 

Demographic Characteristics 

Aggregated demographic and military service characteristics for all DoDSER suicide and suicide 

attempt cases are detailed in Tables 16 and 17. Similar to the summary for all Services, Air 

Force DoDSER suicide cases were predominantly associated with young, male Service 

members. This demographic profile is representative of the broader, overall composition of the 

Air Force. The demographic profile of DoDSER suicide attempt cases were generally younger 

and had a higher proportion of females compared to DoDSER suicide cases. 

Event Information 

The data presented in Table 18 provide a descriptive overview of the settings and 

circumstances surrounding suicides and suicide attempts that occurred within the U.S. Air Force 

in CY 2015. The use of firearms and hanging/asphyxiation were the most common methods of 

suicide. Among suicide cases that involved a firearm, the majority of firearms were personal 

possessions and not military-issued weapons. 

Drug and/or alcohol overdose was the most frequently reported mechanism of injury among 

DoDSER suicide attempt cases. The other two most common mechanisms of injury were 

hanging/asphyxiation and the use of a sharp or blunt object. 

45 
U.S. Air Force Calendar Year 2015 Annual Report 

Behavioral Health History 

Table 19 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Substance abuse and adjustment disorders were the most frequently 

identified diagnoses in DoDSER suicide cases. Mood disorders were the most prevalent 

diagnosis among DoDSER suicide attempt cases. 

Psychosocial Stressors 

The information collected on psychosocial stressors pertain to information collected about 

relationships, family issues, legal or administrative problems, work and financial difficulties and 

alleged abuse victimization or perpetration. Table 20 provides descriptive data for each of these 

factors. Overall, 41 DoDSER suicide cases reports (66.1 percent) and 222 DoDSER suicide 

attempt cases (80.4 percent) endorsed at least one of these stressors. The most common 

individual stressors were relationship, administrative/legal and workplace difficulties. These 

were also the most frequently endorsed stressors among DoDSER suicide attempt reports. 

In addition to data collected from the DoDSER system, cases were matched against records 

related to the filing of an unrestricted report of sexual assault. According to the analysis of these 

data, no DoDSER suicide cases or DoDSER suicide attempt cases were associated with an 

unrestricted report of sexual assault that occurred during the year prior to the suicide related 

event. Table 20 provides the number of sexual assaults recorded via 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. 

46 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 16. Demographic characteristics1 of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Air Force 

Suicide Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Sex 

Male 60 96.8 180 65.2 

Female 2 3.2 96 34.8 

Age 

17-19 1 1.6 27 9.8 

20-24 24 38.7 128 46.4 

25-29 15 24.2 60 21.7 

30-34 10 16.1 29 10.5 

35-39 5 8.1 18 6.5 

40-44 5 8.1 10 3.6 

45-59 2 3.2 4 1.4 

Race 

American Indian/Alaska Native 0 0.0 5 1.8 

Asian/Pacific Islander 6 9.7 12 4.3 

Black/African American 7 11.3 48 17.4 

White/Caucasian 47 75.8 191 69.2 

Other/Unknown 2 3.2 20 7.2 

Ethnicity 

Hispanic 2 3.2 16 5.8 

Not Hispanic 60 96.8 259 93.8 

Unknown 0 0.0 1 0.4 

Education 

Less than high school 0 0.0 0 0.0 

Alternative high school 0 0.0 1 0.4 

High school graduate 41 66.1 221 80.1 

Associate's or technical degree 16 25.8 34 12.3 

Four-year degree 3 4.8 11 4.0 

Postgraduate 1 1.6 8 2.9 

Unknown 1 1.6 1 0.4 

Marital status 

Never married 35 56.5 130 47.1 

Married 22 35.5 115 41.7 

Resides with spouse 16 68 

Separated 0 0.0 3 1.1 

Divorced 5 8.1 28 10.1 

Widowed 0 0.0 0 0.0 

Had minor children 

Yes, resided with service member 10 16.1 48 17.4 

Yes, did not reside with service member 8 12.9 37 13.4 

No 44 71.0 188 68.1 

Unknown 0 0.0 3 1.1 1 Data on demographic characteristics primarily provided by DMDC. 

47 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 17. Military characteristics1 of suicide and suicide attempt DoDSERs submitted for CY 

2015, Air Force 

Suicide Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Component 

Active 61 98.4 266 96.4 

Reserve 1 1.6 5 1.8 

Guard 0 0.0 5 1.8 

Rank/grade 

Cadet/midshipman 1 1.6 1 0.4 

E1-E4 29 46.8 178 64.5 

E5-E9 28 45.2 78 28.3 

Enlisted, unknown grade 0 0.0 5 1.8 

Warrant 0 0.0 0 0.0 

Officer 4 6.5 14 5.1 

Occupational group 

Enlisted 

Infantry, gun crews and seamanship specialists 5 8.1 28 10.1 

Electronic equipment repairers 3 4.8 17 6.2 

Communications and intelligence specialists 11 17.7 23 8.3 

Health care specialists 4 6.5 39 14.1 

Other technical and allied specialists 1 1.6 10 3.6 

Functional support and administration 5 8.1 50 18.1 

Electrical/mechanical equipment repairers 16 25.8 44 15.9 

Craftsworkers 3 4.8 14 5.1 

Service and supply handlers 7 11.3 20 7.2 

Non-occupational 2 3.2 14 5.1 

Unknown 0 0.0 2 0.7 

Warrant and commissioned officers 

Tactical operations officers 1 1.6 1 0.4 

Intelligence officers 0 0.0 1 0.4 

Engineering and maintenance officers 0 0.0 0 0.0 

Scientists and professionals 0 0.0 0 0.0 

Health care officers 1 1.6 7 2.5 

Administrators 0 0.0 4 1.4 

Supply, procurement and allied officers 0 0.0 0 0.0 

Non-occupational 3 4.8 2 0.7 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 33 53.2 88 31.9 

Number of deployments 

1 14 46 

2 11 24 

3 or more 8 18 

Specific deployment locations2 

Afghanistan 12 27 

Iraq 13 25 

Kuwait 3 19 

Kyrgyzstan 9 14 

No 29 46.8 187 67.8 

Unknown 0 0.0 1 0.4 1Data on Military Characteristics provided primarily by DMDC. 

2

Subcategories are not mutually exclusive. 

48 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 18. Event characteristics of suicide and suicide attempt DoDSER reports submitted 

for CY 2015, Air Force 

Suicide 

Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Event location country 

United States 58 93.5 220 79.7 

Iraq 0 0.0 0 0.0 

Kuwait 0 0.0 1 0.4 

Korea 2 3.2 8 2.9 

Other Europe 1 1.6 8 2.9 

Japan 1 1.6 13 4.7 

Belgium 0 0.0 1 0.4 

Germany 0 0.0 14 5.1 

United Kingdom 0 0.0 5 1.8 

Other 0 0.0 4 1.4 

Unknown 0 0.0 2 0.7 

Event setting 

Own residence 29 46.8 131 47.5 

Barracks 11 17.7 81 29.3 

Residence of friend or family 4 6.5 12 4.3 

Work/jobsite 1 1.6 6 2.2 

Automobile 6 9.7 19 6.9 

Inpatient medical facility 0 0.0 5 1.8 

Hotel 2 3.2 6 2.2 

Other 9 14.5 14 5.1 

Unknown 0 0.0 2 0.7 

Event method1 

Drugs/alcohol 0 0.0 160 58.0 

Hanging/asphyxiation 17 27.4 33 12.0 

Poisoning 0 0.0 15 5.4 

Firearm 43 69.4 9 3.3 

Military firearm 2 1 

Non-military firearm 41 8 

Firearm of unknown provenance 0 0 

Falling/jumping 0 0.0 4 1.4 

Sharp/blunt object 2 3.2 41 14.9 

Other 0 0.0 12 4.3 

Pending/unknown 0 0.0 2 0.7 

Used alcohol during event 

Yes 19 30.6 100 36.2 

No 20 32.3 162 58.7 

Unknown 23 37.1 14 5.1 

Used drugs during event 

Yes2

 3 4.8 152 55.1 

Illegal drugs 

Used, overdose 0 6 

Used, no overdose 1 5 

Prescription drugs 

Used, overdose 0 85 

Used, no overdose 2 22 

Non-prescription drugs 

Used, overdose 0 47 

Used, no overdose 0 11 

No 33 53.2 112 40.6 

Unknown 26 41.9 12 4.3 

49 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 18 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Air Force 

Suicide 

Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Death-risk gambling 

Yes 1 1.6 8 2.9 

No 56 90.3 264 95.7 

Unknown 5 8.1 4 

Planned/premeditated 

Yes 26 41.9 60 21.7 

No 21 33.9 175 63.4 

Unknown 15 24.2 41 14.9 

Observable 

Yes 12 19.4 103 37.3 

No 43 69.4 159 57.6 

Unknown 7 11.3 14 5.1 

Suicide note left 

Yes 20 32.3 38 13.8 

No 33 53.2 223 80.8 

Unknown 9 14.5 15 5.4 

Communicated potential for self-harm 

Yes 18 29.0 75 27.2 

How communicated2 

Written 3 7 

Verbal 8 47 

Text 10 31 

Other 0 0 

Number of people to whom communicated 

1 11 57 

2 4 13 

3 3 3 

4 or more 0 1 

Unknown 0 1 

To whom communicated2 

Supervisor 4 7 

Chaplain 0 2 

Mental health staff 2 21 

Friend 9 28 

Spouse 6 17 

Family 3 10 

Other 4 11 

No 41 66.1 185 67.0 

Unknown 3 4.8 16 5.8 

Residence at time of event 

Barracks 13 21.0 83 30.1 

BEQ/BOQ 2 3.2 8 2.9 

On-base family housing 4 6.5 42 15.2 

Off-base 40 64.5 130 47.1 

Ship 0 0.0 0 0.0 

Other 3 4.8 12 4.3 

Unknown 0 0.0 1 0.4 

Reside alone at time of event 

Yes 22 35.5 143 51.8 

No 39 62.9 128 46.4 

Unknown 1 1.6 5 1.8 

50 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 18 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Air Force 

Suicide 

Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Gun in home/immediate environment 

Yes 41 66.1 35 12.7 

No 18 29.0 225 81.5 

Unknown 3 4.8 16 5.8 

Duty environment2 

Garrison/permanent duty station 52 83.9 229 83.0 

Leave 4 6.5 15 5.4 

Temporary duty 2 3.2 8 2.9 

Training (excluding basic) 4 6.5 10 3.6 

Basic training 1 1.6 3 1.1 

Psychiatric hospitalization 0 0.0 5 1.8 

Medical 1 1.6 3 1.1 

Correctional facility 1 1.6 1 0.4 

Command observation 0 0.0 1 0.4 

Underway 0 0.0 0 0.0 

Other 0 0.0 7 2.5 

Unknown 1 1.6 6 2.2 

Deployed at time of event 

Yes 0 0.0 2 0.7 

Location1 

Bahrain 0 0 

Djibouti 0 1 

Kuwait 0 1 

Other/Unknown 0 0 

No 62 100.0 274 99.3 1

Data on the cause of the death were provided by AFMES.

2

Subcategories are not mutually exclusive. 

51 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 19. Medical and behavioral characteristics of suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Air Force 

Suicide Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Any mental health diagnosis 

Yes1 27 43.5 174 63.0 

Number of mental health diagnoses 

1 17 68 

2 6 58 

More than 2 4 48 

Mood disorder1 8 98 

Bipolar 1 4 

Major depression 2 62 

Dysthymic 0 12 

Other mood disorder 5 29 

Anxiety disorder1 8 76 

Posttraumatic stress 1 32 

Panic 0 0 

Generalized anxiety disorder 1 14 

Acute stress 1 2 

Other anxiety disorder 4 30 

Personality disorder 1 21 

Psychotic disorder 0 2 

Adjustment disorder 16 63 

Substance abuse disorder 10 65 

No 35 56.5 99 35.9 

Unknown 0 0.0 3 1.1 

Sleep disorder 

Yes 8 12.9 32 11.6 

No 53 85.5 241 87.3 

Unknown 1 1.6 3 1.1 

History of traumatic brain injury 

Yes 2 3.2 3 1.1 

No 59 95.2 269 97.5 

Unknown 1 1.6 4 1.4 

Family history of mental illness 

Yes 6 9.7 88 31.9 

No 37 59.7 165 59.8 

Unknown 19 30.6 23 8.3 

Prior self-injury 

Yes 5 8.1 81 29.3 

Number of prior self-injuries 

One 3 40 

More than one 2 41 

Current event similar to prior 0 41 

No 54 87.1 191 69.2 

Unknown 3 4.8 4 1.4 

Ever taken psychotropic medications 

Yes 14 22.6 121 43.8 

No 44 71.0 149 54.0 

Unknown 4 6.5 6 2.2 

52 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 19 (cont). Medical and behavioral characteristics of suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Air Force 

Suicide Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Use of psychotropic medications, last 90 days 

Yes1

 6 9.7 105 38.0 

Antidepressants 4 84 

Antianxiety 1 51 

Antimanics 0 4 

Anticonvulsants 0 4 

Antipsychotics 2 18 

Sleep medication 4 52 

No 52 83.9 165 59.8 

Unknown 4 6.5 6 2.2 

Pain medication, last 90 days 

Yes 11 17.7 59 21.4 

No 42 67.7 207 75.0 

Unknown 9 14.5 10 3.6 

Use of opioid medications, last 90 days 

Yes 5 8.1 21 7.6 

No 48 77.4 242 87.7 

Unknown 9 14.5 13 4.7 

Polypharmacy at time of event 

Yes 1 1.6 28 10.1 

No 58 93.5 229 83.0 

Unknown 3 4.8 19 6.9 

Health/social services, last 90 days 

Yes1

 46 74.2 209 75.7 

Medical Treatment Facility 46 198 

Substance Abuse Services 5 44 

Family Assistance Program 3 18 

Outpatient mental health 10 132 

Inpatient mental health 2 40 

No 16 25.8 65 23.6 

Unknown 0 0.0 2 0.7 1Subcategories are not mutually exclusive. 

53 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 20. Psychosocial determinants described in suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Air Force 

Suicide 

Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 23 37.1 136 49.3 

Intimate relationship 21 115 

Other relationship 3 46 

No 35 56.5 136 49.3 

Unknown 4 6.5 4 1.4 

Friend and family stressors, last 90 days 

Yes1 6 9.7 27 9.8 

Death of spouse or other family member (manner 

other than suicide) 3 5 

Death of friend (manner other than suicide) 1 6 

Serious illness of friend or family member 2 19 

No 54 87.1 245 88.8 

Unknown 2 3.2 4 1.4 

History of friend or family death by suicide 

Yes1

 6 9.7 49 17.8 

Spouse 0 2 

Family other than spouse 2 24 

Friend 4 26 

No 56 90.3 223 80.8 

Unknown 0 0.0 4 1.4 

Administrative/legal problems, last 90 days 

Yes1 15 24.2 76 27.5 

Courts martial proceedings 4 5 

Article 15/Non-judicial punishment 5 23 

Administrative separation proceedings 2 18 

Away without leave/deserter status 1 4 

Medical evaluation board proceedings 1 25 

Civil legal proceedings 5 15 

Non-selection for promotion 1 7 

Under investigation 12 28 

No 47 75.8 196 71.0 

Unknown 0 0.0 4 1.4 

Excessive debt/bankruptcy, last 90 days 

Yes 9 14.5 19 6.9 

No 46 74.2 250 90.6 

Unknown 7 11.3 7 2.5 

Workplace, last 90 days 

Yes1 12 19.4 109 39.5 

Job problems 9 90 

Supervisor/coworker issues 4 57 

Poor performance review 3 30 

Unit/workplace hazing 1 6 

No 49 79.0 164 59.4 

Unknown 1 1.6 3 1.1 

Abuse, assault, or harassment victimization, last year 

Yes1 2 3.2 26 9.4 

Physical abuse or assault 0 6 

Sexual abuse or assault 0 12 

Emotional abuse 2 18 

Sexual harassment 0 2 

No 55 88.7 247 89.5 

Unknown 5 8.1 3 1.1 

54 
U.S. Air Force Calendar Year 2015 Annual Report 

Table 20 (cont). Psychosocial determinants described in suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Air Force 

Suicide 

Suicide attempt 

(n = 62) (n = 276) 

No. % No. % 

Abuse, assault, or harassment perpetration, last year 

Yes1

 8 12.9 21 7.6 

Physical abuse or assault 4 9 

Sexual abuse or assault 4 5 

Emotional abuse 3 10 

Sexual harassment 0 2 

No 50 80.6 251 90.9 

Unknown 4 6.5 4 1.4 1

Subcategories are not mutually exclusive. 

55 
CHAPT ERS 

U.S. A RMY 

56 
U.S. Army Calendar Year 2015 Annual Report 

DoDSER Results Summary: Army 

The DoDSER system collects data on demographic, contextual, behavioral health, historical and 

risk-related factors for all identified suicides and suicide attempts that occur among Active 

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

time of the event. Please refer to the DoDSER data tables that follow this chapter for specific 

variables of interest. The findings in this chapter pertain specifically to the United States Army. 

There were no statistical comparisons for data over time within the Army. See Chapter 3 for 

data relevant to all Services combined. 

Calendar Year 2015 Incidence of Death Due to Suicide 

As of March 31, 2016, the AFMES identified 120 confirmed suicides or suicides pending 

confirmation among Army Active Component Service members and 23 among SELRES Service 

members who were in a duty status at the time of death. A DoDSER survey was submitted for 

all 143 of these deaths. These DoDSER surveys were used in the generation of the data tables 

included in this chapter. One suicide death was associated with one or more DoDSER suicide 

attempt cases from CY 2008 to CY 2014. No suicides were associated with a separate 

DoDSER suicide attempt case in CY 2015. 

Calendar Year 2015 Incidence of Suicide Attempts 

There were 478 suicide attempts recorded by the Army during CY 2015. The reports provided 

data on 467 unique Service members—456 (97.6 percent) reporting a single suicide attempt 

during the time period and 11 (2.3 percent) with two reported attempts. Eight DoDSER suicide 

attempt cases had one or more previous suicide attempt records in the DoDSER system from 

2008 – 2014. The median number of days between the last attempt and the CY 2015 attempt 

report was 251 days. 

Demographic Characteristics 

Aggregated demographic and military service characteristics for all DoDSER suicide and suicide 

attempt cases are detailed in Tables 21 and 22. Similar to the summary for all Services, Army 

DoDSER suicide cases were predominantly associated with young, male Service members. 

This is consistent with what would be expected given the overall demographics of the Army 

population. The cases described in the DoDSER suicide attempt cases were also generally 

younger, but involved a higher proportion of female Service members compared to the DoDSER 

suicide cases. 

Event Information 

The data presented in Table 23 provide a descriptive overview of the settings and 

circumstances surrounding suicides and suicide attempts that occurred within the U.S. Army in 

CY 2015. Consistent with the data from CY 2012 – CY 2014, the use of firearms and 

hanging/asphyxiation were the most common methods of suicide. Among suicide cases that 

involved a firearm, the majority of firearms were personal possessions and not military-issued 

weapons. 

57 
U.S. Army Calendar Year 2015 Annual Report 

Drug and/or alcohol overdose continues to be the most frequently reported mechanism of injury 

among DoDSER suicide attempt cases. The other two most common mechanisms of injury 

were hanging/asphyxiation and the use of a sharp or blunt object. 

Behavioral Health History 

Table 24 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Substance abuse and adjustment disorders were the most frequently 

identified diagnoses in DoDSER suicide cases. Mood disorders were the most prevalent 

diagnosis among DoDSER suicide attempt cases. 

Psychosocial Stressors 

The data collected on psychosocial stressors pertain to information collected about 

relationships, family issues, legal or administrative problems, work and financial difficulties and 

alleged abuse victimization or perpetration. Table 25 provides descriptive data for each of these 

factors. Overall, 93 DoDSER suicide cases (65.0 percent) and 363 DoDSER suicide attempt 

cases (75.9 percent) endorsed at least one of these stressors. The most common individual 

stressors were relationship, administrative/legal problems and workplace difficulties. These 

were also the most frequently endorsed stressors among DoDSER suicide attempt cases. 

In addition to data collected from the DoDSER system, cases were also matched against 

records related to the filing of an unrestricted report of sexual assault. According to the analysis 

of these data, no DoDSER suicide cases and 6 DoDSER suicide attempt cases were 

associated with an unrestricted report of sexual assault that occurred during the year prior to the 

suicide related event. Table 25 provides the number of sexual assaults recorded via 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. 

58 
U.S. Army Calendar Year 2015 Annual Report 

Table 21. Demographic characteristics1 of suicide and suicide attempt DoDSERs submitted 

for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n= 478) 

No. % No. % 

Sex 

Male 134 93.7 341 71.3 

Female 9 6.3 137 28.7 

Age 

17-19 5 3.5 60 12.6 

20-24 35 24.5 222 46.4 

25-29 34 23.8 104 21.8 

30-34 34 23.8 53 11.1 

35-39 20 14.0 20 4.2 

40-44 6 4.2 12 2.5 

45-59 9 6.3 7 1.5 

Race 

American Indian/Alaska Native 4 2.8 5 1.0 

Asian/Pacific Islander 4 2.8 16 3.3 

Black/African American 30 21.0 117 24.5 

White/Caucasian 102 71.3 334 69.9 

Other/Unknown 3 2.1 6 1.3 

Ethnicity 

Hispanic 14 9.8 58 12.1 

Not Hispanic 129 90.2 420 87.9 

Unknown 0 0.0 0 0.0 

Education 

Less than high school 1 0.7 2 0.4 

Alternative high school 17 11.9 30 6.3 

High school graduate 98 68.5 407 85.1 

Associate's or technical degree 6 4.2 16 3.3 

Four-year degree 14 9.8 20 4.2 

Postgraduate 6 4.2 3 0.6 

Unknown 1 0.7 0 0.0 

Marital status 

Never married 44 30.8 218 45.6 

Married 89 62.2 219 45.8 

Resides with spouse 53 151 

Separated 0 0.0 3 0.6 

Divorced 9 6.3 38 7.9 

Widowed 1 0.7 0 0.0 

Had minor children 

Yes, resided with service member 38 26.6 88 18.4 

Yes, did not reside with service member 27 18.9 70 14.6 

No 66 46.2 313 65.5 

Unknown 12 8.4 7 1.5 1

Data on demographic characteristics primarily provided by DMDC. 

59 
U.S. Army Calendar Year 2015 Annual Report 

Table 22. Military characteristics1 of suicide and suicide attempt DoDSERs submitted for 

CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n= 478) 

No. % No. % 

Component 

Active 120 83.9 440 92.1 

Reserve 8 5.6 19 4.0 

Guard 15 10.5 19 4.0 

Rank/grade 

Cadet/midshipman 1 0.7 0 0.0 

E1-E4 51 35.7 326 68.2 

E5-E9 71 49.7 116 24.3 

Enlisted, unknown grade 0 0.0 26 5.4 

Warrant 6 4.2 2 0.4 

Officer 14 9.8 8 1.7 

Occupational group 

Enlisted 

Infantry, gun crews and seamanship specialists 48 33.6 168 35.1 

Electronic equipment repairers 2 1.4 5 1.0 

Communications and intelligence specialists 19 13.3 90 18.8 

Health care specialists 9 6.3 77 16.1 

Other technical and allied specialists 5 3.5 11 2.3 

Functional support and administration 15 10.5 58 12.1 

Electrical/mechanical equipment repairers 15 10.5 36 7.5 

Craftsworkers 2 1.4 2 0.4 

Service and supply handlers 6 4.2 15 3.1 

Non-occupational 1 0.7 6 1.3 

Unknown 0 0.0 0 0.0 

Warrant and commissioned officers 

Tactical operations officers 9 6.3 6 1.3 

Intelligence officers 1 0.7 1 0.2 

Engineering and maintenance officers 2 1.4 1 0.2 

Scientists and professionals 1 0.7 0 0.0 

Health care officers 3 2.1 1 0.2 

Administrators 2 1.4 1 0.2 

Supply, procurement and allied officers 2 1.4 0 0.0 

Non-occupational 1 0.7 0 0.0 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 100 69.9 197 41.2 

Number of deployments 

1 39 103 

2 23 42 

3 or more 38 52 

Specific deployment locations2 

Afghanistan 69 138 

Iraq 59 86 

Kuwait 76 132 

Kyrgyzstan 37 70 

No 43 30.1 281 58.8 

Unknown 0 0.0 0 0.0 1

Data on military characteristics provided primarily by DMDC. 

2

Subcategories are not mutually exclusive. 

60 
U.S. Army Calendar Year 2015 Annual Report 

Table 23. Event characteristics of suicide and suicide attempt DoDSER reports submitted 

for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Event location country 

United States 134 93.7 430 90.0 

Iraq 1 0.7 0 0.0 

Kuwait 1 0.7 2 0.4 

Korea 5 3.5 19 4.0 

Other Europe 0 0.0 0 0.0 

Japan 0 0.0 1 0.2 

Belgium 0 0.0 1 0.2 

Germany 2 1.4 18 3.8 

United Kingdom 0 0.0 0 0.0 

Other 0 0.0 4 0.8 

Unknown 0 0.0 3 0.6 

Event setting 

Own residence 76 53.1 222 46.4 

Barracks 23 16.1 190 39.7 

Residence of friend or family 11 7.7 9 1.9 

Work/jobsite 6 4.2 13 2.7 

Automobile 12 8.4 21 4.4 

Inpatient medical facility 0 0.0 2 0.4 

Hotel 1 0.7 2 0.4 

Other 14 9.8 16 3.3 

Unknown 0 0.0 3 0.6 

Event method1 

Drugs/alcohol 5 3.5 287 60.0 

Hanging/asphyxiation 37 25.9 57 11.9 

Poisoning 4 2.8 22 4.6 

Firearm 93 65.0 31 6.5 

Military firearm 3 2 

Non-military firearm 89 28 

Firearm of unknown provenance 1 1 

Falling/jumping 0 0.0 11 2.3 

Sharp/blunt object 2 1.4 45 9.4 

Other 2 1.4 20 4.2 

Pending/unknown 0 0.0 5 1.0 

Used alcohol during event 

Yes 29 20.3 167 34.9 

No 67 46.9 301 63.0 

Unknown 47 32.9 10 2.1 

Used drugs during event 

Yes 9 6.3 269 56.3 

Illegal drugs 

Used, overdose 2 21 

Used, no overdose 2 8 

Prescription drugs 

Used, overdose 1 146 

Used, no overdose 2 63 

Non-prescription drugs 

Used, overdose 4 64 

Used, no overdose 1 30 

No 84 58.7 196 41.0 

Unknown 50 35.0 13 2.7 

61 
U.S. Army Calendar Year 2015 Annual Report 

Table 23 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Death-risk gambling 

Yes 2 1.4 13 2.7 

No 128 89.5 456 95.4 

Unknown 13 9.1 9 1.9 

Planned/premeditated 

Yes 57 39.9 102 21.3 

No 52 36.4 347 72.6 

Unknown 34 23.8 29 6.1 

Observable 

Yes 47 32.9 186 38.9 

No 82 57.3 278 58.2 

Unknown 14 9.8 14 2.9 

Suicide note left 

Yes 29 20.3 54 11.3 

No 90 62.9 412 86.2 

Unknown 24 16.8 12 2.5 

Communicated potential for self-harm 

Yes 38 26.6 117 24.5 

How communicated2 

Written 6 7 

Verbal 24 79 

Text 13 47 

Other 0 2 

Number of people to whom communicated 

1 33 89 

2 5 18 

3 0 7 

4 or more 0 2 

Unknown 0 1 

To whom communicated2 

Supervisor 4 17 

Chaplain 0 1 

Mental health staff 2 22 

Friend 7 39 

Spouse 22 48 

Family 3 14 

Other 5 13 

No 84 58.7 338 70.7 

Unknown 21 14.7 23 4.8 

Residence at time of event 

Barracks 33 23.1 199 41.6 

BEQ/BOQ 2 1.4 6 1.3 

On-base family housing 13 9.1 58 12.1 

Off-base 91 63.6 196 41.0 

Ship 0 0.0 0 0.0 

Other 3 2.1 12 2.5 

Unknown 1 0.7 7 1.5 

Reside alone at time of event 

Yes 40 28.0 167 34.9 

No 95 66.4 306 64.0 

Unknown 8 5.6 5 1.0 

62 
U.S. Army Calendar Year 2015 Annual Report 

Table 23 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Gun in home/immediate environment 

Yes 88 61.5 58 12.1 

No 34 23.8 386 80.8 

Unknown 21 14.7 34 7.1 

Duty environment2 

Garrison/permanent duty station 117 81.8 401 83.9 

Leave 15 10.5 9 1.9 

Temporary duty 0 0.0 2 0.4 

Training (excluding basic) 6 4.2 17 3.6 

Basic training 0 0.0 16 3.3 

Psychiatric hospitalization 0 0.0 2 0.4 

Medical 2 1.4 9 1.9 

Correctional facility 0 0.0 0 0.0 

Command observation 0 0.0 0 0.0 

Underway 0 0.0 0 0.0 

Other 0 0.0 7 1.5 

Unknown 1 0.7 15 3.1 

Deployed at time of event 

Yes 4 2.8 6 1.3 

Location1 

Bahrain 0 1 

Djibouti 0 1 

Kuwait 2 3 

Other/Unknown 0 1 

No 139 97.2 472 98.7 1

Data on the cause of the death were provided by AFMES. 

2

Subcategories are not mutually exclusive. 

63 
U.S. Army Calendar Year 2015 Annual Report 

Table 24. Medical and behavioral characteristics of suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Any mental health diagnosis 

Yes1 81 56.6 349 73.0 

Number of mental health diagnoses 

1 33 125 

2 23 120 

More than 2 25 104 

Mood disorder1 34 189 

Bipolar 1 16 

Major depression 24 146 

Dysthymic 4 16 

Other mood disorder 14 32 

Anxiety disorder1 33 153 

Posttraumatic stress 19 74 

Panic 3 21 

Generalized anxiety disorder 7 41 

Acute stress 0 7 

Other anxiety disorder 19 54 

Personality disorder 4 24 

Psychotic disorder 5 4 

Adjustment disorder 36 178 

Substance abuse disorder 41 140 

No 60 42.0 124 25.9 

Unknown 2 1.4 5 1.0 

Sleep disorder 

Yes 16 11.2 75 15.7 

No 123 86.0 388 81.2 

Unknown 4 2.8 15 3.1 

History of traumatic brain injury 

Yes 12 8.4 35 7.3 

No 127 88.8 432 90.4 

Unknown 4 2.8 11 2.3 

Family history of mental illness 

Yes 12 8.4 133 27.8 

No 86 60.1 303 63.4 

Unknown 45 31.5 42 8.8 

Prior self-injury 

Yes 21 14.7 140 29.3 

Number of prior self-injuries 

One 10 72 

More than one 11 65 

Unknown 0 3 

Current event similar to prior 7 78 

No 104 72.7 317 66.3 

Unknown 18 12.6 21 4.4 

Ever taken psychotropic medications 

Yes 37 25.9 226 47.3 

No 96 67.1 225 47.1 

Unknown 10 7.0 27 5.6 

64 
U.S. Army Calendar Year 2015 Annual Report 

Table 24 (cont). Medical and behavioral characteristics of suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Use of psychotropic medications, last 90 days 

Yes1 25 17.5 163 34.1 

Antidepressants 23 140 

Antianxiety 13 80 

Antimanics 2 7 

Anticonvulsants 1 5 

Antipsychotics 1 14 

Sleep medication 15 96 

No 108 75.5 287 60.0 

Unknown 10 7.0 28 5.9 

Pain medication, last 90 days 

Yes 17 11.9 95 19.9 

No 110 76.9 357 74.7 

Unknown 16 11.2 26 5.4 

Use of opioid medications, last 90 days 

Yes 9 6.3 32 6.7 

No 117 81.8 419 87.7 

Unknown 17 11.9 27 5.6 

Polypharmacy at time of event 

Yes 7 4.9 39 8.2 

No 122 85.3 407 85.1 

Unknown 14 9.8 32 6.7 

Health/social services, last 90 days 

Yes1 88 61.5 333 69.7 

Medical Treatment Facility 76 239 

Substance Abuse Services 12 60 

Family Assistance Program 6 32 

Outpatient mental health 44 258 

Inpatient mental health 7 78 

No 53 37.1 142 29.7 

Unknown 2 1.4 3 0.6 1

Subcategories are not mutually exclusive. 

65 
U.S. Army Calendar Year 2015 Annual Report 

Table 25. Psychosocial determinants described in suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 64 44.8 182 38.1 

Intimate relationship 60 156 

Other relationship 18 51 

No 62 43.4 286 59.8 

Unknown 17 11.9 10 2.1 

Friend and family stressors, last 90 days 

Yes1

 5 3.5 61 12.8 

Death of spouse or other family member (manner 

other than suicide) 2 15 

Death of friend (manner other than suicide) 2 12 

Serious illness of friend or family member 1 40 

No 123 86.0 409 85.6 

Unknown 15 10.5 8 1.7 

History of friend or family death by suicide 

Yes1

 5 3.5 86 18.0 

Spouse 0 1 

Family other than spouse 2 27 

Friend 3 67 

No 128 89.5 384 80.3 

Unknown 10 7.0 8 1.7 

Administrative/legal problems, last 90 days 

Yes1 47 32.9 164 34.3 

Courts martial proceedings 5 5 

Article 15/Non-judicial punishment 11 47 

Administrative separation proceedings 10 54 

Away without leave/deserter status 4 8 

Medical evaluation board proceedings 10 53 

Civil legal proceedings 16 26 

Non-selection for promotion 8 19 

Under investigation 24 43 

No 95 66.4 309 64.6 

Unknown 1 0.7 5 1.0 

Excessive debt/bankruptcy, last 90 days 

Yes 6 4.2 26 5.4 

No 113 79.0 435 91.0 

Unknown 24 16.8 17 3.6 

Workplace, last 90 days 

Yes1 35 24.5 190 39.7 

Job problems 27 142 

Supervisor/coworker issues 12 114 

Poor performance review 9 61 

Unit/workplace hazing 0 23 

No 96 67.1 280 58.6 

Unknown 12 8.4 8 1.7 

Abuse, assault, or harassment victimization, last year 

Yes1

 2 1.4 64 13.4 

Physical abuse or assault 1 19 

Sexual abuse or assault 0 20 

Emotional abuse 1 32 

Sexual harassment 0 16 

No 128 89.5 405 84.7 

Unknown 13 9.1 9 1.9 

66 
U.S. Army Calendar Year 2015 Annual Report 

Table 25 (cont). Psychosocial determinants described in suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Army 

Suicide 

Suicide attempt 

(n = 143) (n = 478) 

No. % No. % 

Abuse, assault, or harassment perpetration, last year 

Yes1

 16 11.2 30 6.3 

Physical abuse or assault 8 16 

Sexual abuse or assault 8 9 

Emotional abuse 4 8 

Sexual harassment 2 2 

No 118 82.5 439 91.8 

Unknown 9 6.3 9 1.9 1

Subcategories are not mutually exclusive. 

67 
CHAPTER 6 

U.S. MARINE C ORPS 

68 
U.S. Marine Corps Calendar Year 2015 Annual Report 

DoDSER Results Summary: Marine Corps 

The DoDSER system collects data on demographic, contextual, behavioral health, historical and 

risk-related factors for all identified suicides and suicide attempts that occur among Active 

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

time of the event. Please refer to the DoDSER data tables that follow this chapter for specific 

variables of interest. The findings in this chapter pertain specifically to the United State Marine 

Corps. There were no statistical comparisons for data over time within the Marine Corps. See 

Chapter 3 for data relevant to all Services combined. 

Calendar Year 2015 Incidence of Death Due to Suicide 

As of March 31, 2016, the AFMES identified 39 confirmed suicides or suicides pending 

confirmation among Marine Corps Active Component Service members and 0 among SELRES 

Service members who were in a duty status at the time of death. A DoDSER survey was 

submitted for all 39 of these deaths. These DoDSER surveys were used in the generation of the 

data tables included in this chapter. One suicide death was associated with one or more suicide 

attempts from CY 2008 to CY 2014 and one suicide was associated with a previous DoDSER 

suicide attempt case in CY 2015. 

Calendar Year 2015 Incidence of Suicide Attempts 

There were 308 suicide attempts recorded by the Marine Corps during CY 2015. The reports 

provided data on 287 unique Service members—266 (92.7 percent) reporting a single suicide 

attempt during this time period and 21 Service members (7.3 percent) with two reported 

attempts. Two DoDSER suicide attempt cases were associated with one or more previous 

suicide attempt records in the DoDSER system from CY 2008 – CY 2014. 

Demographic Characteristics 

Aggregated demographic and military service characteristics for all suicide and suicide attempt 

DoDSER cases are detailed in Tables 26 and 27. Similar to the summary for all Services, 

Marine Corps DoDSER suicide cases were predominantly associated with young, male Service 

members. The distribution of characteristics among DoDSER suicide and suicide attempt cases 

was consistent with the general demographic composition of the U.S. Marine Corps. The cases 

described in the DoDSER suicide attempt cases were generally younger and included a higher 

proportion of females compared to DoDSER suicide reports. 

Event Information 

The data presented in Table 28 provide a descriptive overview of the settings and 

circumstances surrounding suicides and suicide attempts that occurred within the U.S. Marine 

Corps in CY 2015. The use of firearms and hanging/asphyxiation were the most common 

methods of suicide. Among suicide cases that involved a firearm, the majority of firearms were 

personal possessions and not military-issued weapons. 

Drug and/or alcohol overdose was the most frequently reported mechanism of injury among 

DoDSER suicide attempt cases. The other two most common mechanisms of injury were 

hanging/asphyxiation and the use of a sharp or blunt object. 

69 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Behavioral Health History 

Table 29 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Substance abuse was the most frequently identified diagnosis in DoDSER 

suicide cases. It was also the most frequently identified diagnosis in DoDSER suicide attempt 

cases. 

Psychosocial Stressors 

The information collected on psychosocial stressors pertain to information about relationships, 

family issues, legal or administrative problems, work and financial difficulties and alleged abuse 

victimization or perpetration. Table 30 provides descriptive data for each of these factors. 

Overall, 27 DoDSER suicide cases (69.2 percent) and 227 DoDSER suicide attempt cases 

(73.7 percent) reported at least one of these stressors. The most common individual stressors 

were relationship, administrative/legal and workplace difficulties. These were also the most 

frequently endorsed stressors among DoDSER suicide attempt cases. 

In addition to data collected from the DoDSER system, cases were also matched against 

records related to the filing of an unrestricted report of sexual assault. According to the analysis 

of these data, no DoDSER suicide cases and 9 DoDSER suicide attempt cases were 

associated with an unrestricted report of sexual assault that occurred during the year prior to the 

suicide related event. Table 30 provides the number of sexual assaults recorded via 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. 

70 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 26. Demographic characteristics1 of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Sex 

Male 37 94.9 241 78.2 

Female 2 5.1 67 21.8 

Age 

17-19 5 12.8 72 23.4 

20-24 22 56.4 165 53.6 

25-29 5 12.8 51 16.6 

30-34 2 5.1 14 4.6 

35-39 4 10.3 4 1.3 

40-44 1 2.6 2 0.7 

45-59 0 0.0 0 0.0 

Race 

American Indian/Alaska Native 1 2.6 5 1.6 

Asian/Pacific Islander 1 2.6 14 4.5 

Black/African American 3 7.7 46 14.9 

White/Caucasian 34 87.2 237 76.9 

Other/Unknown 0 0.0 6 1.9 

Ethnicity 

Hispanic 5 12.8 69 22.4 

Not Hispanic 34 87.2 239 77.6 

Unknown 0 0.0 0 0.0 

Education 

Less than high school 0 0.0 1 0.3 

Alternative high school 0 0.0 10 3.2 

High school graduate 36 92.3 290 94.2 

Associate's or technical degree 1 2.6 2 0.6 

Four-year degree 2 5.1 5 1.6 

Postgraduate 0 0.0 0 0.0 

Unknown 0 0.0 0 0.0 

Marital status 

Never married 19 48.7 169 54.9 

Married 17 43.6 116 37.7 

Resides with spouse 7 65 

Separated 0 0.0 3 1.0 

Divorced 3 7.7 19 6.2 

Widowed 0 0.0 1 0.3 

Had minor children 

Yes, resided with service member 6 15.4 30 9.7 

Yes, did not reside with service member 6 15.4 28 9.1 

No 25 64.1 248 80.5 

Unknown 2 5.1 2 0.6 1

Data on demographic characteristics primarily provided by DMDC. 

71 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 27. Military characteristics1 of suicide and suicide attempt DoDSERs submitted for 

CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Component 

Active 39 100.0 303 98.4 

Reserve 0 0.0 5 1.6 

Guard 0 0.0 0 0.0 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

E1-E4 28 71.8 248 80.5 

E5-E9 9 23.1 52 16.9 

Enlisted, unknown grade 0 0.0 6 1.9 

Warrant 0 0.0 0 0.0 

Officer 2 5.1 2 0.6 

Occupational group 

Enlisted 

Infantry, gun crews and seamanship specialists 6 15.4 85 27.6 

Electronic equipment repairers 3 7.7 9 2.9 

Communications and intelligence specialists 7 17.9 24 7.8 

Health care specialists 0 0.0 0 0.0 

Other technical and allied specialists 2 5.1 7 2.3 

Functional support and administration 3 7.7 46 14.9 

Electrical/mechanical equipment repairers 5 12.8 34 11.0 

Craftsworkers 3 7.7 33 10.7 

Service and supply handlers 5 12.8 50 16.2 

Non-occupational 3 7.7 18 5.8 

Unknown 0 0.0 0 0.0 

Warrant and commissioned officers 

Tactical operations officers 1 2.6 0 0.0 

Intelligence officers 0 0.0 0 0.0 

Engineering and maintenance officers 1 2.6 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 1 0.3 

Supply, procurement and allied officers 0 0.0 0 0.0 

Non-occupational 0 0.0 1 0.3 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 11 28.2 56 18.2 

Number of deployments 

1 5 32 

2 4 9 

3 or more 2 15 

Specific deployment locations2 

Afghanistan 7 44 

Iraq 9 21 

Kuwait 7 28 

Kyrgyzstan 5 14 

No 28 71.8 251 81.5 

Unknown 0 0.0 1 0.3 1

Data on military characteristics provided primarily by DMDC. 

2

Subcategories are not mutually exclusive. 

72 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 28. Event characteristics of suicide and suicide attempt DoDSER reports submitted 

for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Event location country 

United States 35 89.7 265 86.0 

Iraq 0 0.0 0 0.0 

Kuwait 0 0.0 0 0.0 

Korea 0 0.0 1 0.3 

Other Europe 0 0.0 1 0.3 

Japan 3 7.7 38 12.3 

Belgium 0 0.0 0 0.0 

Germany 1 2.6 0 0.0 

United Kingdom 0 0.0 0 0.0 

Other 0 0.0 2 0.6 

Unknown 0 0.0 1 0.3 

Event setting 

Own residence 11 28.2 87 28.2 

Barracks 14 35.9 165 53.6 

Residence of friend or family 6 15.4 10 3.2 

Work/jobsite 0 0.0 8 2.6 

Automobile 1 2.6 17 5.5 

Inpatient medical facility 0 0.0 2 0.6 

Hotel 1 2.6 2 0.6 

Other 6 15.4 17 5.5 

Unknown 0 0.0 0 0.0 

Event method1 

Drugs/alcohol 0 0.0 162 52.6 

Hanging/asphyxiation 18 46.2 50 16.2 

Poisoning 0 0.0 8 2.6 

Firearm 18 46.2 23 7.5 

Military firearm 2 3 

Non-military firearm 16 20 

Firearm of unknown provenance 0 0 

Falling/jumping 1 2.6 7 2.3 

Sharp/blunt object 2 5.1 41 13.3 

Other 0 0.0 16 5.2 

Pending/unknown 1 0.3 

Used alcohol during event 

Yes 8 20.5 115 37.3 

No 9 23.1 180 58.4 

Unknown 22 56.4 13 4.2 

Used drugs during event 

Yes1

 2 5.1 139 45.1 

Illegal drugs 

Used, overdose 0 9 

Used, no overdose 0 6 

Prescription drugs 

Used, overdose 0 84 

Used, no overdose 2 9 

Non-prescription drugs 

Used, overdose 0 50 

Used, no overdose 0 8 

No 9 23.1 161 52.3 

Unknown 28 71.8 8 2.6 

73 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 28 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Death-risk gambling 

Yes 0 0.0 4 1.3 

No 37 94.9 302 98.1 

Unknown 2 5.1 2 0.6 

Planned/premeditated 

Yes 11 28.2 81 26.3 

No 14 35.9 202 65.6 

Unknown 14 35.9 25 8.1 

Observable 

Yes 9 23.1 147 47.7 

No 27 69.2 148 48.1 

Unknown 3 7.7 13 4.2 

Suicide note left 

Yes 5 12.8 19 6.2 

No 21 53.8 282 91.6 

Unknown 13 33.3 7 2.3 

Communicated potential for self-harm 

Yes 12 30.8 47 15.3 

How communicated2 

Written 0 0 

Verbal 9 29 

Text 3 20 

Other 0 0 

Number of people to whom communicated 

1 9 35 

2 3 9 

3 0 1 

4 or more 0 0 

Unknown 0 2 

To whom communicated2 

Supervisor 0 4 

Chaplain 0 1 

Mental health staff 4 6 

Friend 5 21 

Spouse 3 16 

Family 1 5 

Other 2 3 

No 22 56.4 249 80.8 

Unknown 5 12.8 12 3.9 

Residence at time of event 

Barracks 19 48.7 180 58.4 

BEQ/BOQ 5 12.8 8 2.6 

On-base family housing 5 12.8 16 5.2 

Off-base 9 23.1 90 29.2 

Ship 0 0.0 0 0.0 

Other 1 2.6 8 2.6 

Unknown 0 0.0 6 1.9 

Reside alone at time of event 

Yes 12 30.8 57 18.5 

No 26 66.7 233 75.6 

Unknown 1 2.6 18 5.8 

74 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 28 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Gun in home/immediate environment 

Yes 17 43.6 33 10.7 

No 20 51.3 244 79.2 

Unknown 2 5.1 31 10.1 

Duty environment2 

Garrison/permanent duty station 33 84.6 256 83.1 

Leave 2 5.1 5 1.6 

Temporary duty 0 0.0 7 2.3 

Training (excluding basic) 6 15.4 14 4.5 

Basic training 4 10.3 9 2.9 

Psychiatric hospitalization 0 0.0 0 0.0 

Medical 2 5.1 9 2.9 

Correctional facility 0 0.0 1 0.3 

Command observation 2 5.1 8 2.6 

Underway 0 0.0 0 0.0 

Other 0 0.0 6 1.9 

Unknown 0 0.0 5 1.6 

Deployed at time of event 

Yes 0 0.0 6 1.9 

Location1 

Bahrain 0 0 

Djibouti 0 0 

Kuwait 0 0 

Other/Unknown 0 6 

No 39 100.0 302 98.1 1

Data on the cause of the death were provided by AFMES. 

2

Subcategories are not mutually exclusive. 

75 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 29. Medical and behavioral characteristics of suicide and suicide attempt DoDSERs 

submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Any mental health diagnosis 

Yes1 19 48.7 182 59.1 

Number of mental health diagnoses 

1 7 72 

2 5 66 

More than 2 7 44 

Mood disorder1 8 82 

Bipolar 2 2 

Major depression 4 41 

Dysthymic 1 4 

Other mood disorder 4 33 

Anxiety disorder1 9 66 

Posttraumatic stress 2 34 

Panic 0 6 

Generalized anxiety disorder 2 9 

Acute stress 1 2 

Other anxiety disorder 3 25 

Personality disorder 1 18 

Psychotic disorder 0 1 

Adjustment disorder 8 74 

Substance abuse disorder 14 94 

No 20 51.3 126 40.9 

Unknown 0 0.0 0 0.0 

Sleep disorder 

Yes 3 7.7 28 9.1 

No 36 92.3 276 89.6 

Unknown 0 0.0 4 1.3 

History of traumatic brain injury 

Yes 0 0.0 13 4.2 

No 38 97.4 289 93.8 

Unknown 1 2.6 6 1.9 

Family history of mental illness 

Yes 5 12.8 75 24.4 

No 21 53.8 203 65.9 

Unknown 13 33.3 30 9.7 

Prior self-injury 

Yes 5 12.8 80 26.0 

Number of prior self-injuries 

One 4 39 

More than one 1 39 

Unknown 0 2 

Current event similar to prior 3 44 

No 29 74.4 222 72.1 

Unknown 5 12.8 6 1.9 

Ever taken psychotropic medications 

Yes 6 15.4 114 37.0 

No 26 66.7 192 62.3 

Unknown 7 17.9 2 0.6 

76 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 29. Medical and behavioral characteristics of suicide and suicide attempt DoDSERs 

submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Use of psychotropic medications, last 90 days 

Yes1

 3 7.7 94 30.5 

Antidepressants 3 82 

Antianxiety 2 30 

Antimanics 0 2 

Anticonvulsants 0 9 

Antipsychotics 1 6 

Sleep medication 2 47 

No 28 71.8 210 68.2 

Unknown 8 20.5 4 1.3 

Pain medication, last 90 days 

Yes 5 12.8 41 13.3 

No 29 74.4 257 83.4 

Unknown 5 12.8 10 3.2 

Use of opioid medications, last 90 days 

Yes 3 7.7 16 5.2 

No 31 79.5 280 90.9 

Unknown 5 12.8 12 3.9 

Polypharmacy at time of event 

Yes 3 7.7 22 7.1 

No 30 76.9 272 88.3 

Unknown 6 15.4 14 4.5 

Health/social services, last 90 days 

Yes1 25 64.1 208 67.5 

Medical Treatment Facility 20 169 

Substance Abuse Services 7 37 

Family Assistance Program 2 14 

Outpatient mental health 13 135 

Inpatient mental health 2 45 

No 14 35.9 100 32.5 

Unknown 0 0.0 0 0.0 1

Subcategories are not mutually exclusive. 

77 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 30. Psychosocial determinants described in suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 14 35.9 130 42.2 

Intimate relationship 13 121 

Other relationship 2 25 

No 22 56.4 176 57.1 

Unknown 3 7.7 2 0.6 

Friend and family stressors, last 90 days 

Yes1 3 7.7 21 6.8 

Death of spouse or other family member (manner 

other than suicide) 0 4 

Death of friend (manner other than suicide) 0 5 

Serious illness of friend or family member 3 12 

No 32 82.1 284 92.2 

Unknown 4 10.3 3 1.0 

History of friend or family death by suicide 

Yes1 3 7.7 24 7.8 

Spouse 1 0 

Family other than spouse 2 9 

Friend 0 18 

No 35 89.7 284 92.2 

Unknown 1 2.6 0 0.0 

Administrative/legal problems, last 90 days 

Yes1 15 38.5 84 27.3 

Courts martial proceedings 0 7 

Article 15/Non-judicial punishment 3 24 

Administrative separation proceedings 2 26 

Away without leave/deserter status 3 8 

Medical evaluation board proceedings 3 22 

Civil legal proceedings 3 13 

Non-selection for promotion 4 5 

Under investigation 5 21 

No 24 61.5 224 72.7 

Unknown 0 0.0 0 0.0 

Excessive debt/bankruptcy, last 90 days 

Yes 2 5.1 11 3.6 

No 29 74.4 277 89.9 

Unknown 8 20.5 20 6.5 

Workplace, last 90 days 

Yes1 9 23.1 78 25.3 

Job problems 6 62 

Supervisor/coworker issues 2 39 

Poor performance review 4 17 

Unit/workplace hazing 0 6 

No 29 74.4 226 73.4 

Unknown 1 2.6 4 1.3 

Abuse, assault, or harassment victimization, last year 

Yes1 2 5.1 16 5.2 

Physical abuse or assault 1 6 

Sexual abuse or assault 0 12 

Emotional abuse 1 4 

Sexual harassment 0 6 

No 34 87.2 285 92.5 

Unknown 3 7.7 7 2.3 

78 
U.S. Marine Corps Calendar Year 2015 Annual Report 

Table 30 (cont). Psychosocial determinants described in suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Marine Corps 

Suicide 

Suicide attempt 

(n = 39) (n = 308) 

No. % No. % 

Abuse, assault, or harassment perpetration, last year 

Yes1

 4 10.3 16 5.2 

Physical abuse or assault 1 10 

Sexual abuse or assault 2 4 

Emotional abuse 1 3 

Sexual harassment 0 1 

No 32 82.1 285 92.5 

Unknown 3 7.7 7 2.3 1

Subcategories are not mutually exclusive. 

79 
CHAPTER 7 

U.S. NA VY 

80 
U.S. Navy Calendar Year 2015 Annual Report 

DoDSER Results Summary: Navy 

The DoDSER system collects data on demographic, contextual, behavioral health, historical and 

risk-related factors for all identified suicides and suicide attempts that occur among Active 

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

time of the event. Please refer to the DoDSER data tables that follow this chapter for specific 

variables of interest. The findings in this chapter pertain specifically to the United State Navy. 

There were no statistical comparisons for data over time within the Navy. See Chapter 3 for 

data relevant to all Services combined. 

Calendar Year 2015 Incidence of Death Due to Suicide 

As of March 31, 2016, the AFMES identified 43 confirmed suicides or suicides pending 

confirmation among Navy Active Component Service members and 2 among SELRES Service 

members who were in a duty status at the time of death. A DoDSER survey was submitted for 

all 45 of these deaths. These DoDSER surveys were used in the generation of the data tables 

included in this chapter. No suicide deaths were associated with suicide attempts from CY 2008 

– CY 2014 and one suicide was associated with a previous DoDSER suicide attempt case in CY 

2015. 

Calendar Year 2015 Incidence of Suicide Attempt 

There were 137 suicide attempts recorded by the Navy during CY 2015. The reports provided 

data on 134 unique Service members—131 (97.7 percent) with one reported attempt and 3 (2.2 

percent) with two reported attempts. Three DoDSER suicide attempt cases had one or more 

previous suicide attempt records in the DoDSER system from CY 2008 – CY 2014. 

Demographic Characteristics 

Aggregated demographic and military service characteristics for all suicide and suicide attempt 

DoDSER cases are detailed in Tables 31 and 32. Similar to the summary for all Services, Navy 

DoDSER suicide cases were predominantly associated with young, male Service members. The 

distribution of characteristics among DoDSER suicide and suicide attempt cases was consistent 

with the general demographic composition of the U.S. Navy. The cases described in the 

DoDSER suicide attempt cases were generally younger and included a higher proportion of 

females compared to DoDSER suicide cases. 

Event Information 

The data presented in Table 33 provide a descriptive overview of the settings and 

circumstances surrounding suicides and suicide attempts that occurred within the U.S. Navy in 

CY 2015. The use of firearms and hanging/asphyxiation were the most common methods of 

suicide. Among suicide cases that involved a firearm, the majority of firearms were personal 

possessions and not military-issued weapons. 

Drug and/or alcohol overdose was the most frequently reported mechanism of injury among 

DoDSER suicide attempt cases. The other two most common mechanisms of injury were 

hanging/asphyxiation and the use of a sharp or blunt object. 

81 
U.S. Navy Calendar Year 2015 Annual Report 

Behavioral Health History 

Table 34 provides data on behavioral health variables related to both common diagnoses and 

treatment utilization. Mood disorders were the most frequently identified diagnoses in DoDSER 

suicide cases. It was also the most frequently identified diagnosis in DoDSER suicide attempt 

cases. 

Psychosocial Stressors 

The information collected on psychosocial stressors pertains to information collected about 

relationships, family issues, legal or administrative problems, work and financial difficulties and 

alleged abuse victimization or perpetration. Table 35 provides descriptive data for each of these 

factors. Overall, 31 DoDSER suicide cases (68.9 percent) and 98 DoDSER suicide attempt 

cases (71.53 percent) endorsed at least one of these stressors. The most common individual 

stressors were relationship, administrative/legal problems and workplace difficulties. These 

were also the most frequently endorsed stressors among DoDSER suicide attempt cases. 

In addition to data collected from the DoDSER system, cases were also matched against 

records related to the filing of an unrestricted report of sexual assault. According to the analysis 

of these data, no DoDSER suicide cases and 2 DoDSER suicide attempt cases were 

associated with an unrestricted report of sexual assault that occurred during the year prior to the 

suicide related event. Table 35 provides the number of sexual assaults recorded via 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. 

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U.S. Navy Calendar Year 2015 Annual Report 

Table 31. Demographic characteristics1 of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Sex 

Male 42 93.3 85 62.0 

Female 3 6.7 52 38.0 

Age 

17-19 2 4.4 15 11.0 

20-24 17 37.8 59 43.1 

25-29 13 28.9 39 28.5 

30-34 3 6.7 13 9.5 

35-39 4 8.9 7 5.1 

40-44 5 11.1 4 2.9 

45-49 1 2.2 0 0.0 

Race 

American Indian/Alaska Native 0 0.0 3 2.2 

Asian/Pacific Islander 2 4.4 9 6.6 

Black/African American 9 20.0 26 19.0 

White/Caucasian 29 64.4 75 54.7 

Other/Unknown 5 11.1 24 17.5 

Ethnicity 

Hispanic 8 17.8 23 16.8 

Not Hispanic 37 82.2 113 82.5 

Unknown 0 0.0 1 0.7 

Education 

Less than high school 0 0.0 2 1.5 

Alternative high school 3 6.7 6 4.4 

High school graduate 36 80.0 110 80.3 

Associate's or technical degree 1 2.2 6 4.4 

Four-year degree 4 8.9 9 6.6 

Postgraduate 1 2.2 3 2.2 

Unknown 0 0.0 1 0.7 

Marital status 

Never married 23 51.1 72 52.6 

Married 22 48.9 63 46.0 

Resides with spouse 12 28 

Separated 0 0.0 1 0.7 

Divorced 0 0.0 1 0.7 

Widowed 0 0.0 0 0.0 

Had minor children 

Yes, resided with service member 9 20.0 14 10.2 

Yes, did not reside with service member 7 15.6 15 10.9 

No 29 64.4 103 75.2 

Unknown 0 0.0 5 3.6 1

Data on demographic characteristics primarily provided by DMDC. 

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U.S. Navy Calendar Year 2015 Annual Report 

Table 32. Military characteristics1 of suicide and suicide attempt DoDSER reports submitted 

for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Component 

Active 43 95.6 131 95.6 

Reserve 2 4.4 6 4.4 

Guard 0 0.0 0 0.0 

Rank/grade 

Cadet/midshipman 0 0.0 0 0.0 

E1-E4 24 53.3 87 63.5 

E5-E9 19 42.2 41 29.9 

Enlisted, unknown grade 0 0.0 1 0.7 

Warrant 0 0.0 0 0.0 

Officer 2 4.4 8 5.8 

Occupational group 

Enlisted 

Infantry, gun crews and seamanship specialists 3 6.7 10 7.3 

Electronic equipment repairers 6 13.3 12 8.8 

Communications and intelligence specialists 2 4.4 7 5.1 

Health care specialists 6 13.3 38 27.7 

Other technical and allied specialists 0 0.0 0 0.0 

Functional support and administration 3 6.7 10 7.3 

Electrical/mechanical equipment repairers 10 22.2 31 22.6 

Craftsworkers 1 2.2 6 4.4 

Service and supply handlers 9 20.0 11 8.0 

Non-occupational 2 4.4 4 2.9 

Unknown 1 2.2 0 0.0 

Warrant and commissioned officers 

Tactical operations officers 2 4.4 0 0.0 

Intelligence officers 0 0.0 0 0.0 

Engineering and maintenance officers 0 0.0 3 2.2 

Scientists and professionals 0 0.0 0 0.0 

Health care officers 0 0.0 2 1.5 

Administrators 0 0.0 0 0.0 

Supply, procurement and allied officers 0 0.0 0 0.0 

Non-occupational 0 0.0 3 2.2 

Unknown 0 0.0 0 0.0 

History of deployment 

Yes 22 48.9 49 35.8 

Number of deployments 

1 6 23 

2 8 16 

3 or more 8 10 

Specific deployment locations2 

Afghanistan 7 15 

Iraq 4 7 

Kuwait 4 10 

Kyrgyzstan 2 9 

No 23 51.1 87 63.5 

Unknown 0 0 1 0.7 1

Data on military characteristics provided primarily by DMDC.

2

Subcategories are not mutually exclusive. 

84 
U.S. Navy Calendar Year 2015 Annual Report 

Table 33. Event characteristics of suicide and suicide attempt DoDSER reports submitted 

for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Event location country 

United States 38 84.4 116 84.7 

Iraq 0 0.0 0 0.0 

Kuwait 0 0.0 0 0.0 

Korea 0 0.0 0 0.0 

Other Europe 2 4.4 4 2.9 

Japan 2 4.4 4 2.9 

Belgium 0 0.0 0 0.0 

Germany 0 0.0 0 0.0 

United Kingdom 0 0.0 0 0.0 

Other 3 6.7 8 5.8 

Unknown 0 0.0 5 3.6 

Event setting 

Own residence 24 53.3 62 45.3 

Barracks 5 11.1 40 29.2 

Residence of friend or family 2 4.4 8 5.8 

Work/jobsite 5 11.1 3 2.2 

Automobile 4 8.9 8 5.8 

Inpatient medical facility 0 0.0 0 0.0 

Hotel 0 0.0 0 0.0 

Other 5 11.1 11 8.0 

Unknown 0 0.0 5 3.6 

Event method1 

Drugs/alcohol 1 2.2 88 64.2 

Hanging/asphyxiation 14 31.1 14 10.2 

Poisoning 2 4.4 5 3.6 

Firearm 26 57.8 4 2.9 

Military firearm 2 0 

Non-military firearm 24 4 

Firearm of unknown provenance 0 0 

Falling/jumping 0 0.0 2 1.5 

Sharp/blunt object 1 2.2 11 8.0 

Other 1 2.2 8 5.8 

Pending/unknown 0 0.0 5 3.6 

Used alcohol during event 

Yes 12 26.7 45 32.8 

No 17 37.8 78 56.9 

Unknown 16 35.6 14 10.2 

Used drugs during event 

Yes1

 3 6.7 70 51.1 

Illegal drugs 

Used, overdose 0 9 

Used, no overdose 1 0 

Prescription drugs 

Used, overdose 0 42 

Used, no overdose 2 7 

Non-prescription drugs 

Used, overdose 0 28 

Used, no overdose 2 3 

No 27 60.0 58 42.3 

Unknown 15 33.3 9 6.6 

85 
U.S. Navy Calendar Year 2015 Annual Report 

Table 33 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Death-risk gambling 

Yes 0 0.0 0 0.0 

No 45 100.0 124 90.5 

Unknown 0 0.0 13 9.4 

Planned/premeditated 

Yes 22 48.9 33 24.1 

No 20 44.4 84 61.3 

Unknown 3 6.7 20 14.5 

Observable 

Yes 12 26.7 47 34.3 

No 33 73.3 71 51.8 

Unknown 0 0.0 19 13.9 

Suicide note left 

Yes 11 24.4 12 8.8 

No 32 71.1 111 81.0 

Unknown 2 4.4 14 10.2 

Communicated potential for self-harm 

Yes 13 28.9 20 14.6 

How communicated2 

Written 1 1 

Verbal 8 8 

Text 4 9 

Other 0 0 

Number of people to whom communicated 

1 12 12 

2 1 6 

3 or more 0 1 

Unknown 0 1 

To whom communicated2 

Supervisor 1 2 

Chaplain 0 0 

Mental health staff 3 1 

Friend 3 9 

Spouse 5 7 

Family 1 6 

Other 1 2 

No 30 66.7 102 74.5 

Unknown 2 4.4 15 10.9 

Residence at time of event 

Barracks 9 20.0 43 31.4 

BEQ/BOQ 2 4.4 3 2.2 

On-base family housing 5 11.1 8 5.8 

Off-base 26 57.8 65 47.4 

Ship 2 4.4 11 8.0 

Other 1 2.2 2 1.5 

Unknown 0 0.0 5 3.6 

Reside alone at time of event 

Yes 15 33.3 46 33.6 

No 30 66.7 84 61.3 

Unknown 0 0.0 7 5.1 

86 
U.S. Navy Calendar Year 2015 Annual Report 

Table 33 (cont). Event characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Gun in home/immediate environment 

Yes 25 55.6 9 6.6 

No 18 40.0 105 76.6 

Unknown 2 4.4 23 16.8 

Duty environment2 

Garrison/permanent duty station 34 75.6 96 70.1 

Leave 4 8.9 7 5.1 

Temporary duty 0 0.0 3 2.2 

Training (excluding basic) 3 6.7 8 5.8 

Basic training 0 0.0 1 0.7 

Psychiatric hospitalization 0 0.0 0 0.0 

Medical 1 2.2 7 5.1 

Correctional facility 0 0.0 1 0.7 

Command observation 1 2.2 1 0.7 

Underway 1 2.2 4 2.9 

Other 1 2.2 3 2.2 

Unknown 2 4.4 9 6.6 

Deployed at time of event 

Yes 4 8.9 3 2.2 

Location1 

Bahrain 2 0 

Djibouti 0 0 

Kuwait 0 0 

Other/Unknown 2 3 

No 41 91.1 134 97.8 1

Data on the cause of the death were provided by AFMES.

2

Subcategories are not mutually exclusive. 

87 
U.S. Navy Calendar Year 2015 Annual Report 

Table 34. Medical and behavioral characteristics of suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Any mental health diagnosis 

Yes1 15 33.3 88 64.2 

Number of mental health diagnoses 

1 8 34 

2 3 24 

More than 2 4 30 

Mood disorder1 7 48 

Bipolar 0 1 

Major depression 6 30 

Dysthymic 0 5 

Other mood disorder 0 14 

Anxiety disorder1 5 31 

Posttraumatic stress 2 15 

Panic 0 2 

Generalized anxiety disorder 3 5 

Acute stress 0 1 

Other anxiety disorder 2 9 

Personality disorder 1 17 

Psychotic disorder 0 1 

Adjustment disorder 7 37 

Substance abuse disorder 6 43 

No 30 66.7 41 29.9 

Unknown 0 0.0 8 5.8 

Sleep disorder 

Yes 5 11.1 14 10.2 

No 40 88.9 110 80.3 

Unknown 0 0.0 13 9.5 

History of traumatic brain injury 

Yes 2 4.4 2 1.5 

No 42 93.3 123 89.8 

Unknown 1 2.2 12 8.8 

Family history of mental illness 

Yes 1 2.2 44 32.1 

No 30 66.7 71 51.8 

Unknown 14 31.1 22 16.1 

Prior self-injury 

Yes 3 6.7 37 27.0 

Number of prior self-injuries 

One 1 2.2 19 13.9 

More than one 2 4.4 18 13.1 

Current event similar to prior 1 2.2 10 7.3 

No 42 93.3 88 64.2 

Unknown 0 0.0 12 8.8 

Ever taken psychotropic medications 

Yes 6 13.3 59 43.1 

No 38 84.4 66 48.2 

Unknown 1 2.2 12 8.8 

88 
U.S. Navy Calendar Year 2015 Annual Report 

Table 34 (cont). Medical and behavioral characteristics of suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Use of psychotropic medications, last 90 days 

Yes1

 3 6.7 51 37.2 

Antidepressants 3 38 

Antianxiety 1 25 

Antimanics 0 2 

Anticonvulsants 0 1 

Antipsychotics 0 3 

Sleep medication 0 26 

No 41 91.1 73 53.3 

Unknown 1 2.2 13 9.5 

Pain medication, last 90 days 

Yes 4 8.9 21 15.3 

No 39 86.7 100 73.0 

Unknown 2 4.4 16 11.7 

Use of opioid medications, last 90 days 

Yes 0 0.0 3 2.2 

No 42 93.3 117 85.4 

Unknown 3 6.7 17 12.4 

Polypharmacy at time of event 

Yes 1 2.2 7 5.1 

No 42 93.3 113 82.5 

Unknown 2 4.4 17 12.4 

Health/social services, last 90 days 

Yes1 26 57.8 83 60.6 

Medical Treatment Facility 23 60 

Substance Abuse Services 1 17 

Family Assistance Program 0 7 

Outpatient mental health 9 66 

Inpatient mental health 2 21 

No 19 42.2 48 35.0 

Unknown 0 0.0 6 4.4 1

Subcategories are not mutually exclusive. 

89 
U.S. Navy Calendar Year 2015 Annual Report 

Table 35. Psychosocial determinants described in suicide and suicide attempt DoDSER 

reports submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Failed or failing relationship, last 90 days 

Yes1 18 40.0 56 40.9 

Intimate relationship 16 47 

Other relationship 4 19 

No 27 60.0 71 51.8 

Unknown 0 0.0 10 7.3 

Friend and family stressors, last 90 days 

Yes1 0 0.0 7 5.1 

Death of spouse or other family member (manner 

other than suicide) 0 2 

Death of friend (manner other than suicide) 0 2 

Serious illness of friend or family member 0 4 

No 44 97.8 120 87.6 

Unknown 1 2.2 10 7.3 

History of friend or family death by suicide 

Yes1

 3 6.7 16 11.7 

Spouse 0 0 

Family other than spouse 2 8 

Friend 1 8 

No 42 93.3 110 80.3 

Unknown 0 0.0 11 8.0 

Administrative/legal problems, last 90 days 

Yes1 14 31.1 40 29.2 

Courts martial proceedings 0 1 

Article 15/Non-judicial punishment 5 16 

Administrative separation proceedings 3 13 

Away without leave/deserter status 2 2 

Medical evaluation board proceedings 0 8 

Civil legal proceedings 1 10 

Non-selection for promotion 7 6 

Under investigation 5 15 

No 31 68.9 86 62.8 

Unknown 0 0.0 11 8.0 

Excessive debt/bankruptcy, last 90 days 

Yes 2 4.4 5 3.6 

No 40 88.9 114 83.2 

Unknown 3 6.7 18 13.1 

Workplace, last 90 days 

Yes1 8 17.8 43 31.4 

Job problems 8 41 

Supervisor/coworker issues 2 15 

Poor performance review 1 11 

Unit/workplace hazing 0 1 

No 37 82.2 82 59.9 

Unknown 0 0.0 12 8.8 

Abuse, assault, or harassment victimization, last year 

Yes1 2 4.4 13 9.5 

Physical abuse or assault 1 5 

Sexual abuse or assault 0 4 

Emotional abuse 1 10 

Sexual harassment 0 2 

No 42 93.3 112 81.8 

Unknown 1 2.2 12 8.8 

90 
U.S. Navy Calendar Year 2015 Annual Report 

Table 35 (cont). Psychosocial determinants described in suicide and suicide attempt 

DoDSER reports submitted for CY 2015, Navy 

Suicide 

Suicide attempt 

(n = 45) (n = 137) 

No. % No. % 

Abuse, assault, or harassment perpetration, last year 

Yes1 4 8.9 9 6.6 

Physical abuse or assault 2 7 

Sexual abuse or assault 2 0 

Emotional abuse 0 2 

Sexual harassment 1 1 

No 40 88.9 114 83.2 

Unknown 1 2.2 14 10.2 1

Subcategories are not mutually exclusive. 

91 
CHAPTE R S 

SELECTED RE SERVE 

NON DUTY STATUS 

92 
Selected Reserve: Non Duty Status Calendar Year 2015 Annual Report 

The DoDSER system collects 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, policies related to suicide are evolving to incorporate surveillance and 

reporting of suicide events that occur among members of the Reserve Component who are not 

in a duty status at the time of their death. Pursuant to that goal, this report presents information 

on suicide-related deaths among the sub-population of the SELRES Service members who 

were not in a duty status at the time of their death. 

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 2015, 187 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 36 displays the demographic and Service 

characteristics of these Service members who died by suicide. These distributions were 

qualitatively similar to those for Service members who died by suicide in an active duty status 

(Tables 11 and 12). 

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Selected Reserve: Non Duty Status Calendar Year 2015 Annual Report 

Table 36. 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 % 

Service 

Air Force 30 16.0 

Army 134 71.7 

Marine Corps 11 5.9 

Navy 12 6.4 

Component 

Reserve 79 42.2 

Guard 108 57.8 

Sex 

Male 170 90.9 

Female 17 9.1 

Age 

17-19 9 4.8 

20-24 67 35.8 

25-29 42 22.5 

30-34 37 19.8 

35-39 14 7.5 

40-44 10 5.3 

45-59 8 4.3 

Education 

Less than high school 6 3.2 

Alternative high school 15 8.0 

High school graduate 137 73.3 

Associate's or technical degree 8 4.3 

Four-year degree 14 7.5 

Postgraduate 6 3.2 

Unknown 1 0.5 

Ethnicity 

Hispanic 23 12.3 

Not Hispanic 163 87.2 

Unknown 1 0.5 

Race 

American Indian/Alaska Native 0 0.0 

Asian/Pacific Islander 10 5.3 

Black/African American 17 9.1 

White/Caucasian 153 81.8 

Other/Unknown 7 3.7 

Marital status 

Never married 108 57.8 

Married 64 34.2 

Legally separated 0 0.0 

Divorced 14 7.5 

Widowed 1 0.5 

Rank/grade 

E1-E4 107 57.2 

E5-E9 65 34.8 

Officer 14 7.5 

Warrant officer 1 0.5 1

Demographic and Service characteristics provided by the DMDC. 

94 
APPENDI X A 

GLOSS ARY 

95 
Glossary Calendar Year 2015 Annual Report 

Active Component 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.” 

Article 15 A provision under the Uniform Code of Military Justice that gives 

commanding officers the ability to impose non-judicial punishment upon 

soldiers who commit minor offenses within their units. 

death-risk gambling Any game of chance with death or serious injury as a potential 

outcome. Examples include “Russian roulette.” 

deployment 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. 

DoDSER Annual 

Report 

A yearly summary providing a descriptive report of data from the United 

States (U.S.) Armed Forces on the incidence of suicides and suicide 

attempts between January 1, 2015 and December 31, 2015. This 

report is prepared and published by the National Center for Telehealth 

and Technology. 

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 Service 

specific 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 

96 
Glossary Calendar Year 2015 Annual Report 

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/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 the event was planned and/or premeditated includes verbal 

discussion of plan, written notes, email/chat-room discussion or other 

evidence of plan such as preparatory behaviors (e.g., giving 

possessions away, purchase of materials to facilitate suicide, etc.). 

polypharmacy Being prescribed any four or more medications taken concurrently with 

any one of them being a psychotropic or central-nervous-system 

depressant. 

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. 

Selected Reserve 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. 

self-harm (without 

intent to die) 

A self-inflicted, potentially injurious behavior for which there is evidence 

(either implicit or explicit) that the person did not intend to kill 

himself/herself (i.e., had no intent to die). 

sexual assault 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 

97 
Glossary Calendar Year 2015 Annual Report 

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). 

suicidal ideation Any self-reported thoughts of engaging in suicide-related behaviors. 

suicide Self-inflicted death with evidence (either explicit or implicit) of intent to 

die. 

suicide attempt A self-inflicted potentially injurious behavior with a non-fatal outcome for 

which there is evidence (either explicit or implicit) of intent to die. 

traumatic brain injury 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 the 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. 

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/SHARP Specialist assistance and an official 

investigation of the crime. 

98 
APPENDI X B 

ACRONY MS 

99 
Acronyms Calendar Year 2015 Annual Report 

AFMES 

AWOL 

BEQ 

BOQ 

CDC 

CI 

CTS 

CY 

DCIPS 

DHA 

DMDC 

DEERS 

DoDSER 

DSPO 

OEF 

OIF 

OND 

SAPRO 

SELRES 

SMR 

SPARRC 

SPPM 

T2 

WISQARS 

Armed Forces Medical Examiner System 

absent without official leave 

Bachelor Enlisted Quarters 

Bachelor Officer Quarters 

Centers for Disease Control and Prevention 

confidence interval 

contingency tracking system 

calendar year 

Defense Casualty Information Processing System 

Defense Health Agency 

Defense Manpower Data Center 

Defense Enrollment Eligibility Reporting System 

Department of Defense Suicide Event Report 

Defense Suicide Prevention Office 

Operation Enduring Freedom 

Operation Iraqi Freedom 

Operation New Dawn 

Sexual Assault Prevention and Response Office 

 Selected Reserve 

standardized mortality ratio 

Suicide Prevention and Risk Reduction Committee 

Suicide Prevention Program Manager 

National Center for Telehealth & Technology 

Web-based Injury Statistics Query and Reporting System 

100 
APPENDIX C 

LIST OF TAB LE S 

101 
List of Tables Calendar Year 2015 Annual Report 

Table 1. DoDSER survey content areas..........................................................................Page 7 

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 12 

Table 3. Frequency and unadjusted rate of suicide, by Component and Service, for CY 2013 – CY 

2015..........................................................................................................Page 17 

Table 4. Rates of suicide among Service members in the Active Component, all Services, CY 2013 – 

CY 2015, overall and by demographic characteristics..........................................Page 23 

Table 5. Rates of suicide among Service members in the Reserve Component of the Selected 

Reserve irrespective of duty status, all Services, CY 2013 – CY 2015, overall and by 

demographic characteristics...........................................................................Page 24 

Table 6. Rates of suicide among Service members in the Guard Component of the SELRES, Air 

Force and Army, CY 2013 – CY 2015, overall and by demographic characteristics....Page 25 

Table 7. Rates of suicide among Service members in the Active Component, Air Force, CY 2013 – 

CY 2015, overall and by demographic characteristics..........................................Page 26 

Table 8. Rates of suicide among Service members in the Active Component, Army, CY 2013 – CY 

2015, overall and by demographic characteristics...............................................Page 27 

Table 9. Rates of suicide among Service members in the Active Component, Marine Corps, CY 2013 

– CY 2015, overall and by demographic characteristics.......................................Page 28 

Table 10. Rates of suicide among Service members in the Active Component, Navy, CY 2013 – CY 

2015, overall and by demographic characteristics...............................................Page 29 

Table 11. Demographic characteristics of suicide and suicide attempt DoDSERs submitted for CY 

2015, all Services.........................................................................................Page 35 

Table 12. Military characteristics of suicide and suicide attempt DoDSERs submitted for CY 2015, all 

Services.....................................................................................................Page 36 

Table 13. Event characteristics of suicide and suicide attempt DoDSERs submitted for CY 2015, all 

Services.....................................................................................................Page 37 

Table 14. Medical and behavioral characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, all Services..................................................................Page 40 

Table 15. Psychosocial determinants described in suicide and suicide attempt DoDSER reports 

submitted for CY 2015, all Services..................................................................Page 42 

Table 16. Demographic characteristics of suicide and suicide attempt DoDSER reports submitted for 

CY 2015, Air Force.......................................................................................Page 47 

Table 17. Military characteristics of suicide and suicide attempt DoDSERs submitted for CY 2015, Air 

Force.........................................................................................................Page 48 

Table 18. Event characteristics of suicide and suicide attempt DoDSER reports submitted for CY 

2015, Air Force............................................................................................Page 49 

Table 19. Medical and behavioral characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Air Force.....................................................................Page 52 

Table 20. Psychosocial determinants described in suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Air Force.....................................................................Page 54 

Table 21. Demographic characteristics of suicide and suicide attempt DoDSERs submitted for CY 

2015, Army.................................................................................................Page 59 

Table 22. Military characteristics of suicide and suicide attempt DoDSERs submitted for CY 2015, 

Army..........................................................................................................Page 60 

102 
List of Tables Calendar Year 2015 Annual Report 

Table 23. Event characteristics of suicide and suicide attempt DoDSER reports submitted for CY 

2015, Army.................................................................................................Page 61 

Table 24. Medical and behavioral characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Army..........................................................................Page 64 

Table 25. Psychosocial determinants described in suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Army..........................................................................Page 66 

Table 26. Demographic characteristics of suicide and suicide attempt DoDSER reports submitted for 

CY 2015, Marine Corps.................................................................................Page 71 

Table 27. Military characteristics of suicide and suicide attempt DoDSERs submitted for CY 2015, 

Marine Corps..............................................................................................Page 72 

Table 28. Event characteristics of suicide and suicide attempt DoDSER reports submitted for CY 

2015, Marine Corps......................................................................................Page 73 

Table 29. Medical and behavioral characteristics of suicide and suicide attempt DoDSERs submitted 

for CY 2015, Marine Corps.............................................................................Page 76 

Table 30. Psychosocial determinants described in suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Marine Corps...............................................................Page 78 

Table 31. Demographic characteristics of suicide and suicide attempt DoDSER reports submitted for 

CY 2015, Navy............................................................................................Page 83 

Table 32. Military characteristics of suicide and suicide attempt DoDSER reports submitted for CY 

2015, Navy.................................................................................................Page 84 

Table 33. Event characteristics of suicide and suicide attempt DoDSER reports submitted for CY 

2015, Navy.................................................................................................Page 85 

Table 34. Medical and behavioral characteristics of suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Navy..........................................................................Page 88 

Table 35. Psychosocial determinants described in suicide and suicide attempt DoDSER reports 

submitted for CY 2015, Navy..........................................................................Page 90 

Table 36. 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 94 

103 
APPENDI X D 

FEEDBAC K & 

SUGGESTI ONS 

104 
Feedback & Suggestions Calendar Year 2015 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 we could make the DoDSER Annual Report more useful. 

Please return your completed survey by mail, fax or email to: 

Dr. Larry D. Pruitt 

National Center for Telehealth & Technology (T2) 

9933 West Hayes, Joint Base Lewis-McChord, WA 98431 

Fax: 253.968.4192 

Email: Click here for e-mail contact

 Strongly 

Disagree 

Disagree Neutral Agree Strongly 

Agree 

I found the information in the 2015 

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, etc.)? 

Do you have any other feedback or suggestions? 

Optional: 

Name: _______________________________ Title: _________________________________ 

Organization: _________________________________________________________________ 

Email: ________________________________ Phone: _______________________________ 

105 
National Center fo'rTelehealth :& Technology {T2) 

Defense Centers of Excellence for Psychological 

Health &Traumatic Brainlnjury (DCoE) 

T2health.dcoe.mil