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DoDSER 2009 Annual Report

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ACKNOWLEDGMENTS

Preparation of this report was supported by the National Center for Telehealth & Technology (T2) 

Suicide Risk Management & Surveillance Office (SRMSO) research team, including Debi Harris. SRMSO 

acknowledges the contributions of several individuals to the development and refinement of the DoD 

Suicide Event Report (DoDSER). Commander Aaron Werbel, Ph.D. (Marine Corps Suicide Prevention 

Program Manager [SPPM]), Lieutenant Colonel Michael Kindt, Ph.D. (Air Force SPPM), Lieutenant 

Commander Bonnie Chavez, Ph.D. (Navy SPPM) and Mr. Walter Morales (Army SPPM) were 

instrumental in the development of the Service’s DoDSER program. In addition, we thank Major Lisa 

Hull, DVM, MPH, DACVPM, the Army DoDSER Project Officer in the Behavioral & Social Health Outcomes 

Program for her leadership in the Army’s DoDSER program. T2 is especially grateful to Lynne OetjenGerdes and Captain Joyce Cantrell, M.D., MPH, of the Mortality Surveillance Division of the Armed 

Forces Medical Examiner System. Their notification of confirmed suicides, provision of the demographic 

data presented in this report, and general support for the DoDSER project have been key to the project’s 

success. DoDSER data would not be available without the hard work of the providers and Command 

appointees across the Services.

Authors: David D. Luxton, Ph.D., Nancy A. Skopp, Ph.D., Julie T. Kinn, Ph.D., Nigel E. Bush, Ph.D., Mark A. 

Reger, Ph.D., Gregory A. Gahm, Ph.D.
DoDSER 2009 Annual Report

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CONTENTS

ACKNOWLEDGMENTS.............................................................................................................................................i

LIST OF TABLES ..................................................................................................................................................... iv

LIST OF FIGURES.................................................................................................................................................. viii

EXECUTIVE SUMMARY........................................................................................................................................... 1

Background ...........................................................................................................................................................1

Results...................................................................................................................................................................1

Conclusion.............................................................................................................................................................3

Chapter 1 INTRODUCTION .....................................................................................................................................4

Background ...........................................................................................................................................................4

Method .................................................................................................................................................................5

Chapter 2 DoD-WIDE RESULTS FOR COMPLETED SUICIDES .................................................................................. 10

DoDSER Submissions...........................................................................................................................................10

Dispositional/Personal Factors ...........................................................................................................................11

Contextual Factors..............................................................................................................................................22

Historical/Developmental Factors......................................................................................................................31

Deployment Factors............................................................................................................................................37

Summary .............................................................................................................................................................39

Chapter 3 DoD-WIDE RESULTS FOR COMPLETED SUICIDES IN OEF/OIF AND NON-OEF/OIF LOCATIONS .............. 40

Dispositional/Personal Factors ...........................................................................................................................40

Contextual Factors..............................................................................................................................................51

Clinical/Symptom Factors...................................................................................................................................52

Historical/Developmental Factors......................................................................................................................60

Deployment Factors............................................................................................................................................68

Summary .............................................................................................................................................................71

Chapter 4 AIR FORCE RESULTS FOR COMPLETED SUICIDES .................................................................................. 72

Air Force DoDSER Submissions and POC Compliance.........................................................................................72

Dispositional/Personal Factors ...........................................................................................................................72

Contextual Factors..............................................................................................................................................79

Clinical/Symptom Factors...................................................................................................................................81

Historical/Developmental Factors......................................................................................................................87

Deployment Factors............................................................................................................................................91

Summary .............................................................................................................................................................93

Chapter 5 ARMY RESULTS .................................................................................................................................... 94

Army Results for Completed Suicides .............................................................................................................. 94

Army DoDSER Submissions for Completed Suicides, and POC Compliance........................................................94
DoDSER 2009 Annual Report

Contents

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Dispositional/Personal Factors ...........................................................................................................................94

Contextual Factors............................................................................................................................................102

Clinical/Symptom Factors.................................................................................................................................105

Historical/Developmental Factors....................................................................................................................110

Deployment Factors..........................................................................................................................................115

Army Results for Non-Fatal Events ................................................................................................................ 117

Army DoDSERs Submitted for Non-Fatal Events...............................................................................................118

Dispositional/Personal Factors .........................................................................................................................118

Contextual Factors............................................................................................................................................131

Clinical/Symptom Factors.................................................................................................................................134

Historical/Developmental Factors....................................................................................................................143

Deployment Factors..........................................................................................................................................151

Summary ...........................................................................................................................................................153

Chapter 6 MARINE CORPS RESULTS FOR COMPLETED SUICIDES ........................................................................ 154

DoDSER Submissions and POC Compliance ......................................................................................................154

Dispositional/Personal Factors .........................................................................................................................154

Contextual Factors............................................................................................................................................160

Clinical/Symptom Factors.................................................................................................................................162

Historical/Developmental Factors....................................................................................................................168

Deployment Factors..........................................................................................................................................172

Summary ...........................................................................................................................................................174

Chapter 7 NAVY RESULTS FOR COMPLETED SUICIDES........................................................................................ 175

Navy DoDSER Submissions and POC Compliance .............................................................................................175

Dispositional/Personal Factors .........................................................................................................................175

Contextual Factors............................................................................................................................................181

Clinical/Symptom Factors.................................................................................................................................184

Historical/Developmental Factors....................................................................................................................189

Deployment Factors..........................................................................................................................................193

Summary ...........................................................................................................................................................195

REFERENCES....................................................................................................................................................... 196

ABBREVIATION, ACRONYM, AND INITIALISM LIST ............................................................................................. 197

FEEDBACK AND SUGGESTIONS........................................................................................................................... 198
DoDSER 2009 Annual Report

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LIST OF TABLES

Chapter 2 DOD-WIDE RESULTS FOR COMPLETED SUICIDES

TABLE 2.1 2009 AFMES CONFIRMED AND PENDING SUICIDES AND DODSERS SUBMITTED........................................................................................10

TABLE 2.2 2009 AND 2008 AFMES DEMOGRAPHICS AND SUICIDE RATES..................................................................................................................12

TABLE 2.3 2009 DMDC DEMOGRAPHICS BY SERVICE.................................................................................................................................................14

TABLE 2.4 2009 AND 2008 DODSER EVENT COUNTRY................................................................................................................................................16

TABLE 2.5 2009 AND 2008 DODSER EVENT SETTING..................................................................................................................................................16

TABLE 2.6 2009 AND 2008 DODSER EVENT METHOD.................................................................................................................................................17

TABLE 2.7 2009 AND 2008 DODSER SUBSTANCE(S) USED DURING EVENT .................................................................................................................18

TABLE 2.8 2009 AND 2008 DODSER OTHER EVENT INFORMATION............................................................................................................................20

TABLE 2.9 2009 AND 2008 DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT ......................................................................21

TABLE 2.10 2009 AND 2008 DODSER RECIPIENTS OF COMMUNICATED INTENT ........................................................................................................21

TABLE 2.11 2009 AND 2008 DODSER MODE OF COMMUNICATED INTENT ................................................................................................................22

TABLE 2.12 2009 AND 2008 DODSER HOME ENVIRONMENT.....................................................................................................................................22

TABLE 2.13 2009 AND 2008 DODSER DUTY ENVIRONMENT.......................................................................................................................................23

TABLE 2.14 2009 AND 2008 DODSER SUICIDE EVENTS BY MONTH.............................................................................................................................24

TABLE 2.15 2009 AND 2008 DODSER PRIOR SELF-INJURY ..........................................................................................................................................25

TABLE 2.16 2009 AND 2008 DODSER COMORBIDITY RATES.......................................................................................................................................26

TABLE 2.17 2009 AND 2008 DODSER MOOD DISORDERS...........................................................................................................................................27

TABLE 2.18 2009 AND 2008 DODSER ANXIETY DISORDERS ........................................................................................................................................27

TABLE 2.19 2009 AND 2008 DODSER OTHER BEHAVIORAL HEALTH DISORDERS ........................................................................................................28

TABLE 2.20 2009 AND 2008 DODSER TREATMENT HISTORY ......................................................................................................................................30

TABLE 2.21 2009 AND 2008 DODSER PSYCHOTROPIC MEDICATION USE ...................................................................................................................31

TABLE 2.22 2009 AND 2008 DODSER RELATIONSHIP HISTORY...................................................................................................................................33

TABLE 2.23 2009 AND 2008 DODSER FAMILY HISTORY ..............................................................................................................................................33

TABLE 2.24 2009 AND 2008 DODSER ADMIN/LEGAL HISTORY ...................................................................................................................................35

TABLE 2.25 2009 AND 2008 DODSER ABUSE HISTORY................................................................................................................................................36

TABLE 2.26 2009 AND 2008 DODSER FINANCIAL AND WORKPLACE DIFFICULTIES .....................................................................................................37

TABLE 2.27 2009 AND 2008 DODSER EVER DEPLOYED TO OEF/OIF............................................................................................................................38

TABLE 2.28 2009 AND 2008 DODSER COMBAT HISTORY............................................................................................................................................38

Chapter 3 DOD-WIDE RESULTS FOR COMPLETED SUICIDES IN OEF/OIF AND NON-OEF/OIF LOCATIONS

TABLE 3.1 2009 AND 2008 SUICIDES INOEF/OIF AND NON-OEF/OIF EVENTS .............................................................................................................40

TABLE 3.2 2009 AND 2008 DODSER DEMOGRAPHICS FOR OEF/OIF AND NON-OEF/OIF EVENTS ...............................................................................42

TABLE 3.3 2009 AND 2008 DODSER EVENT SETTING FOR OEF/OIF AND NON-OEF/OIF EVENTS.................................................................................44

TABLE 3.4 2009 AND 2008 DODSER EVENT METHOD FOR OEF/OIF AND NON-OEF/OIF EVENTS................................................................................46

TABLE 3.5 2009 AND 2008 DODSER SUBSTANCE(S) USED DURING EVENT FOROEF/OIF AND NON-OEF/OIF EVENTS ................................................47

TABLE 3.6 2009 AND 2008 DODSER RECIPIENTS OF COMMUNICATED INTENT FOR OEF/OIF AND NON-OEF/OIF EVENTS .........................................48

TABLE 3.7 2009 AND 2008 DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT FOR OEF/OIF AND NON-OEF/OIF EVENTS .....49

TABLE 3.8 2009 AND 2008 DODSER MODE OF COMMUNICATED INTENT FOROEF/OIF AND NON-OEF/OIF EVENTS .................................................49

TABLE 3.9 2009 AND 2008 DODSER OTHER EVENT INFORMATION FOR OEF/OIF AND NON-OEF/OIF EVENTS ...........................................................50

TABLE 3.10 2009 AND 2008 DODSER HOME ENVIRONMENT FOR OEF/OIF AND NON-OEF/OIF EVENTS ....................................................................51

TABLE 3.11 2009 AND 2008 DODSER SUICIDE EVENTS BY MONTH FOR OEF/OIF AND NON-OEF/OIF EVENTS............................................................52

TABLE 3.12 2009 AND 2008 DODSER PRIOR SELF-INJURY FOR OEF/OIF AND NON-OEF/OIF EVENTS .........................................................................53

TABLE 3.13 2009 AND 2008 DODSER COMORBIDITY RATES FOR OEF/OIF AND NON-OEF/OIF EVENTS......................................................................54

TABLE 3.14 2009 AND 2008 DODSER MOOD DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS..........................................................................54

TABLE 3.15 2009 AND 2008 DODSER ANXIETY DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS .......................................................................56

TABLE 3.16 2009 AND 2008 DODSER OTHER BEHAVIORAL HEALTH DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS .......................................57
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TABLE 3.17 2009 AND 2008 DODSER TREATMENT HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS .....................................................................58

TABLE 3.18 2009 AND 2008 DODSER PSYCHOTROPIC MEDICATION USE FOR OEF/OIF AND NON-OEF/OIF EVENTS ..................................................60

Chapter 3 DoD-WIDE RESULTS FOR COMPLETED SUICIDES IN OEF/OIF AND-NON OEF/OIF LOCATIONS (cont.)

TABLE 3.19 2009 AND 2008 DODSER RELATIONSHIP HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS..................................................................61

TABLE 3.20 2009 AND 2008 DODSER FAMILY HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS .............................................................................62

TABLE 3.21 2009 AND 2008 DODSER ADMIN/LEGAL HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS ..................................................................63

TABLE 3.22 2009 AND 2008 DODSER ABUSE HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS..............................................................................65

TABLE 3.23 2009 AND 2008 DODSER FINANCIAL AND WORKPLACE DIFFICULTIES FOR OEF/OIF AND NON-OEF/OIF EVENTS ....................................67

TABLE 3.24 2009 AND 2008 DODSER NUMBER OF DEPLOYMENTS FOR OEF/OIF AND NON-OEF/OIF EVENTS ...........................................................69

TABLE 3.25 2009 AND 2008 DODSER COMBAT HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS...........................................................................70

Chapter 4 AIR FORCE RESULTS FOR COMPLETED SUICIDES

TABLE 4.1 2009 AIR FORCE AFMES CONFIRMED AND PENDING SUICIDES AND DODSERS SUBMITTED ......................................................................72

TABLE 4.2 2009 AND 2008 AFMES AIR FORCE DEMOGRAPHICS ................................................................................................................................72

TABLE 4.3 2009 AND 2008 AIR FORCE DODSER EVENT SETTING.................................................................................................................................74

TABLE 4.4 2009 AND 2008 AIR FORCE DODSER EVENT COUNTRY ..............................................................................................................................74

TABLE 4.5 2009 AND 2008 AIR FORCE DODSER EVENT METHOD ...............................................................................................................................75

TABLE 4.6 2009 AIR FORCE DODSER EVENT MOTIVATION .........................................................................................................................................76

TABLE 4.7 2009 AND 2008 AIR FORCE DODSER SUBSTANCE(S) USED DURING EVENT................................................................................................76

TABLE 4.8 2009 AND 2008 AIR FORCE DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT.....................................................77

TABLE 4.9 2009 AND 2008 AIR FORCE DODSER MODE OF COMMUNICATED INTENT.................................................................................................77

TABLE 4.10 2009 AND 2008 AIR FORCE DODSER RECIPIENTS OF COMMUNICATED INTENT.......................................................................................78

TABLE 4.11 2009 AND 2008 AIR FORCE DODSER OTHER EVENT INFORMATION.........................................................................................................78

TABLE 4.12 2009 AND 2008 AIR FORCE DODSER HOME ENVIRONMENT....................................................................................................................79

TABLE 4.13 2009 AND 2008 AIR FORCE DODSER DUTY ENVIRONMENT .....................................................................................................................80

TABLE 4.14 2009 AND 2008 AIR FORCE DODSER SUICIDE EVENTS BY MONTH ...........................................................................................................81

TABLE 4.15 2009 AND 2008 AIR FORCE DODSER PRIOR SELF-INJURY .........................................................................................................................82

TABLE 4.16 2009 AND 2008 AIR FORCE DODSER COMORBIDITY RATES .....................................................................................................................83

TABLE 4.17 2009 AND 2008 AIR FORCE DODSER MOOD DISORDERS .........................................................................................................................83

TABLE 4.18 2009 AND 2008 AIR FORCE DODSER ANXIETY DISORDERS.......................................................................................................................84

TABLE 4.19 2009 AND 2008 AIR FORCE DODSER OTHER BEHAVIORAL HEALTH DISORDERS.......................................................................................84

TABLE 4.20 2009 AND 2008 AIR FORCE DODSER TREATMENT HISTORY.....................................................................................................................85

TABLE 4.21 2009 AND 2008 AIR FORCE DODSER PSYCHOTROPIC MEDICATIONUSE..................................................................................................86

TABLE 4.22 2009 AND 2008 AIR FORCE DODSER RELATIONSHIP HISTORY..................................................................................................................88

TABLE 4.23 2009 AND 2008 AIR FORCE DODSER FAMILY HISTORY.............................................................................................................................88

TABLE 4.24 2009 AND 2008 AIR FORCE DODSER ADMIN/LEGAL HISTORY..................................................................................................................89

TABLE 4.25 2009 AND 2008 AIR FORCE DODSER ABUSE HISTORY ..............................................................................................................................90

TABLE 4.26 2009 AND 2008 AIR FORCE DODSER FINANCIAL AND WORKPLACE DIFFICULTIES....................................................................................91

TABLE 4.27 2009 AND 2008 AIR FORCE DODSER EVER DEPLOYED TO OEF/OIF ..........................................................................................................92

TABLE 4.28 2009 AND 2008 AIR FORCE DODSER COMBAT HISTORY ..........................................................................................................................92

Chapter 5 ARMY RESULTS

TABLE 5.1 2009 ARMY AFMES CONFIRMED AND PENDING SUICIDES AND DODSERS SUBMITTED .............................................................................94

TABLE 5.2 2009 AND 2008 AFMES ARMY DEMOGRAPHICS .......................................................................................................................................95

TABLE 5.3 2009 AND 2008 ARMY DODSER EVENT COUNTRY FOR COMPLETED SUICIDES ..........................................................................................96

TABLE 5.4 2009 AND 2008 ARMY DODSER EVENT SETTING FOR COMPLETED SUICIDES ............................................................................................97

TABLE 5.5 2009 AND 2008 ARMY DODSER EVENT METHOD FOR COMPLETED SUICIDES ...........................................................................................98

TABLE 5.6 2009 AND 2008 ARMY DODSER EVENT MOTIVATION FOR COMPLETED SUICIDES.....................................................................................99

TABLE 5.7 2009 AND 2008 ARMY DODSER SUBSTANCE(S) USED DURING EVENT FOR COMPLETED SUICIDES............................................................99

TABLE 5.8 2009 AND 2008 ARMY DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT FOR COMPLETED SUICIDES............... 100

TABLE 5.9 2009 AND 2008 ARMY DODSER RECIPIENTS OF COMMUNICATED INTENT FOR COMPLETED SUICIDES................................................... 101

TABLE 5.10 2009 AND 2008 ARMY DODSER MODE OF COMMUNICATED INTENT FOR COMPLETED SUICIDES......................................................... 101

TABLE 5.11 2009 AND 2008 ARMY DODSER OTHER EVENT INFORMATION FOR COMPLETED SUICIDES................................................................... 102

TABLE 5.12 2009 AND 2008 ARMY DODSER HOME ENVIRONMENT FOR COMPLETED SUICIDES.............................................................................. 103
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TABLE 5.13 2009 AND 2008 ARMY DODSER DUTY ENVIRONMENT FOR COMPLETED SUICIDES ............................................................................... 104

TABLE 5.14 2009 AND 2008 ARMY DODSER SUICIDE EVENTS BY MONTH FOR COMPLETED SUICIDES ..................................................................... 104

Chapter 5 ARMY RESULTS (cont.)

TABLE 5.15 2009 AND 2008 ARMY DODSER PRIOR SELF-INJURY FOR COMPLETED SUICIDES................................................................................... 105

TABLE 5.16 2009 AND 2008 ARMY DODSER MOOD DISORDERS FOR COMPLETED SUICIDES ................................................................................... 106

TABLE 5.17 2009 AND 2008 ARMY DODSER ANXIETY DISORDERS FOR COMPLETED SUICIDES................................................................................. 106

TABLE 5.18 2009 AND 2008 ARMY DODSER OTHER BEHAVIORAL HEALTH DISORDERS FOR COMPLETED SUICIDES................................................. 107

TABLE 5.19 2009 AND 2008 ARMY DODSER COMORBIDITY RATES FOR COMPLETED SUICIDES ............................................................................... 108

TABLE 5.20 2009 AND 2008 ARMY DODSER TREATMENT HISTORY FOR COMPLETED SUICIDES............................................................................... 108

TABLE 5.21 2009 AND 2008 ARMY DODSER PSYCHOTROPIC MEDICATION USE FOR COMPLETED SUICIDES............................................................ 110

TABLE 5.22 2009 AND 2008 ARMY DODSER RELATIONSHIP HISTORY FOR COMPLETED SUICIDES ........................................................................... 111

TABLE 5.23 2009 AND 2008 ARMY DODSER FAMILY HISTORY FOR COMPLETED SUICIDES....................................................................................... 111

TABLE 5.24 2009 AND 2008 ARMY DODSER ADMIN/LEGAL HISTORY FOR COMPLETED SUICIDES............................................................................ 112

TABLE 5.25 2009 AND 2008 ARMY DODSER ABUSE HISTORY FOR COMPLETED SUICIDES ........................................................................................ 113

TABLE 5.26 2009 AND 2008 ARMY DODSER FINANCIAL AND WORKPLACE DIFFICULTIES FOR COMPLETED SUICIDES.............................................. 114

TABLE 5.27 2009 AND 2008 ARMY DODSER EVER DEPLOYED TO OEF/OIF FOR COMPLETED SUICIDES .................................................................... 115

TABLE 5.28 2009 AND 2008 ARMY DODSER COMBAT HISTORY FOR COMPLETED SUICIDES .................................................................................... 116

TABLE 5.29 2009 AND 2008 NON-FATAL ARMY DODSERS SUBMITTED .................................................................................................................... 118

TABLE 5.30 2009 AND 2008 NON-FATAL ARMY DODSER DEMOGRAPHICS .............................................................................................................. 119

TABLE 5.31 2009 AND 2008 NON-FATAL ARMY DODSER EVENT COUNTRY.............................................................................................................. 121

TABLE 5.32 2009 AND 2008 NON-FATAL ARMY DODSER EVENT SETTING................................................................................................................ 122

TABLE 5.33 2009 AND 2008 NON-FATAL ARMY DODSER EVENT METHOD............................................................................................................... 124

TABLE 5.34 2009 AND 2008 NON-FATAL ARMY DODSER EVENT MOTIVATION........................................................................................................ 125

TABLE 5.35 2009 AND 2008 NON-FATAL ARMY DODSER POST-EVENT ACTIONS...................................................................................................... 126

TABLE 5.36 2009 AND 2008 NON-FATAL ARMY DODSER SUBSTANCE(S) USED DURING EVENT ............................................................................... 126

TABLE 5.37 2009 AND 2008 NON-FATAL ARMY DODSER RECIPIENTS OF COMMUNICATED INTENT ........................................................................ 128

TABLE 5.38 2009 AND 2008 NON-FATAL ARMY DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT .................................... 129

TABLE 5.39 2009 AND 2008 NON-FATAL ARMY DODSER MODE OF COMMUNICATED INTENT ................................................................................ 129

TABLE 5.40 2009 AND 2008 NON-FATAL ARMY DODSER OTHER EVENT INFORMATION.......................................................................................... 130

TABLE 5.41 2009 AND 2008 NON-FATAL ARMY DODSER HOME ENVIRONMENT ..................................................................................................... 131

TABLE 5.42 2009 AND 2008 NON-FATAL ARMY DODSER DUTY ENVIRONMENT....................................................................................................... 133

TABLE 5.43 2009 AND 2008 NON-FATAL ARMY DODSER SUICIDE EVENTS BY MONTH............................................................................................. 134

TABLE 5.44 2009 AND 2008 NON-FATAL ARMY DODSER PRIOR SELF-INJURY........................................................................................................... 135

TABLE 5.45 2009 AND 2008 NON-FATAL ARMY DODSER COMORBIDITY RATES....................................................................................................... 136

TABLE 5.46 2009 AND 2008 NON-FATAL ARMY DODSER MOOD DISORDERS........................................................................................................... 137

TABLE 5.47 2009 AND 2008 NON-FATAL ARMY DODSER ANXIETY DISORDERS ........................................................................................................ 138

TABLE 5.48 2009 AND 2008 NON-FATAL ARMY DODSER OTHER BEHAVIORAL HEALTH DISORDERS ........................................................................ 139

TABLE 5.49 2009 AND 2008 NON-FATAL ARMY DODSER TREATMENT HISTORY ...................................................................................................... 140

TABLE 5.50 2009 AND 2008 NON-FATAL ARMY DODSER PSYCHOTROPIC MEDICATION USE ................................................................................... 142

TABLE 5.51 2009 AND 2008 NON-FATAL ARMY DODSER RELATIONSHIP HISTORY ................................................................................................... 143

TABLE 5.52 2009 AND 2008 NON-FATAL ARMY DODSER FAMILY HISTORY .............................................................................................................. 144

TABLE 5.53 2009 AND 2008 NON-FATAL ARMY DODSER ADMIN/LEGAL HISTORY ................................................................................................... 146

TABLE 5.54 2009 AND 2008 NON-FATAL ARMY DODSER ABUSE HISTORY................................................................................................................ 148

TABLE 5.55 2009 AND 2008 NON-FATAL ARMY DODSER FINANCIAL AND WORKPLACE DIFFICULTIES ..................................................................... 150

TABLE 5.56 2009 AND 2008 NON-FATAL ARMY DODSER EVER DEPLOYED TOOEF/OIF............................................................................................ 151

TABLE 5.57 2009 AND 2008 NON-FATAL ARMY DODSER COMBAT HISTORY............................................................................................................ 152

Chapter 6 MARINE CORPS RESULTS FOR COMPLETED SUICIDES

TABLE 6.1 2009 MARINE CORPS AFMES CONFIRMED AND PENDING SUICIDES AND DODSERS SUBMITTED ............................................................ 154

TABLE 6.2 2009 AND 2008 AFMES MARINE CORPS DEMOGRAPHICS....................................................................................................................... 154

TABLE 6.3 2009 AND 2008 MARINE CORPS DODSER EVENT COUNTRY..................................................................................................................... 156

TABLE 6.4 2009 AND 2008 MARINE CORPS DODSER EVENT SETTING....................................................................................................................... 156

TABLE 6.5 2009 AND 2008 MARINE CORPS DODSER EVENT METHOD...................................................................................................................... 157

TABLE 6.6 2009 AND 2008 MARINE CORPS DODSER SUBSTANCE(S) USED DURING EVENT...................................................................................... 158

TABLE 6.7 2009 AND 2008 MARINE CORPS DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT........................................... 158
DoDSER 2009 Annual Report

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TABLE 6.8 2009 AND 2008 MARINE CORPS DODSER MODE OF COMMUNICATED INTENT....................................................................................... 159

TABLE 6.9 2009 AND 2008 MARINE CORPS DODSER RECIPIENTS OF COMMUNICATED INTENT............................................................................... 159

Chapter 6 MARINE CORPS RESULTS FOR COMPLETED SUICIDES (cont.)

TABLE 6.10 2009 AND 2008 MARINE CORPS DODSER OTHER EVENT INFORMATION............................................................................................... 159

TABLE 6.11 2009 AND 2008 MARINE CORPS DODSER HOME ENVIRONMENT.......................................................................................................... 160

TABLE 6.12 2009 AND 2008 MARINE CORPS DODSER DUTY ENVIRONMENT ........................................................................................................... 161

TABLE 6.13 2009 AND 2008 MARINE CORPS DODSER SUICIDE EVENTS BY MONTH ................................................................................................. 162

TABLE 6.14 2009 AND 2008 MARINE CORPS DODSER PRIOR SELF-INJURY ............................................................................................................... 163

TABLE 6.15 2009 AND 2008 MARINE CORPS DODSER MOOD DISORDERS................................................................................................................ 163

TABLE 6.16 2009 AND 2008 MARINE CORPS DODSER ANXIETY DISORDERS............................................................................................................. 164

TABLE 6.17 2009 AND 2008 MARINE CORPS DODSER OTHER BEHAVIORAL HEALTH DISORDERS............................................................................. 165

TABLE 6.18 2009 AND 2008 MARINE CORPS DODSER COMORBIDITY RATES............................................................................................................ 166

TABLE 6.19 2009 AND 2008 MARINE CORPS DODSER TREATMENT HISTORY ........................................................................................................... 166

TABLE 6.20 2009 AND 2008 MARINE CORPS DODSER PSYCHOTROPIC MEDICATION USE ........................................................................................ 167

TABLE 6.21 2009 AND 2008 MARINE CORPS DODSER RELATIONSHIP HISTORY........................................................................................................ 168

TABLE 6.22 2009 AND 2008 MARINE CORPS DODSER FAMILY HISTORY................................................................................................................... 169

TABLE 6.23 2009 AND 2008 MARINE CORPS DODSER ADMIN/LEGAL HISTORY........................................................................................................ 170

TABLE 6.24 2009 AND 2008 MARINE CORPS DODSER ABUSE HISTORY .................................................................................................................... 171

TABLE 6.25 2009 AND 2008 MARINE CORPS DODSER FINANCIAL AND WORKPLACE DIFFICULTIES.......................................................................... 172

TABLE 6.26 2009 AND 2008 MARINE CORPS DODSER EVER DEPLOYED TO OEF/OIF ................................................................................................ 173

TABLE 6.27 2009 AND 2008 MARINE CORPS DODSER COMBAT HISTORY................................................................................................................. 173

Chapter 7 NAVY RESULTS FOR COMPLETED SUICIDES

TABLE 7.1 2009 NAVY AFMES CONFIRMED AND PENDING SUICIDES AND DODSERS SUBMITTED............................................................................ 175

TABLE 7.2 2009 AND 2008 AFMES NAVY DEMOGRAPHICS ...................................................................................................................................... 176

TABLE 7.3 2009 AND 2008 NAVY DODSER EVENT SETTING ...................................................................................................................................... 177

TABLE 7.4 2009 AND 2008 NAVY DODSER EVENT COUNTRY .................................................................................................................................... 177

TABLE 7.5 2009 AND 2008 NAVY DODSER EVENT METHOD..................................................................................................................................... 178

TABLE 7.6 2009 AND 2008 NAVY DODSER SUBSTANCE(S) USED DURING EVENT ..................................................................................................... 179

TABLE 7.7 2009 AND 2008 NAVY DODSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT........................................................... 180

TABLE 7.8 2009 AND 2008 NAVY DODSER MODE OF COMMUNICATED INTENT ...................................................................................................... 180

TABLE 7.9 2009 AND 2008 NAVY DODSER RECIPIENTS OF COMMUNICATED INTENT .............................................................................................. 180

TABLE 7.10 2009 AND 2008 NAVY DODSER OTHER EVENT INFORMATION .............................................................................................................. 181

TABLE 7.11 2009 AND 2008 NAVY DODSER HOME ENVIRONMENT ......................................................................................................................... 182

TABLE 7.12 2009 AND 2008 NAVY DODSER DUTY ENVIRONMENT........................................................................................................................... 183

TABLE 7.13 2009 AND 2008 NAVY DODSER SUICIDE EVENTS BY MONTH................................................................................................................. 183

TABLE 7.14 2009 AND 2008 NAVY DODSER PRIOR SELF-INJURY............................................................................................................................... 184

TABLE 7.15 2009 AND 2008 NAVY DODSER MOOD DISORDERS ............................................................................................................................... 185

TABLE 7.16 2009 AND 2008 NAVY DODSER ANXIETY DISORDERS............................................................................................................................. 185

TABLE 7.17 2009 AND 2008 NAVY DODSER OTHER BEHAVIORAL HEALTH DISORDERS ............................................................................................ 186

TABLE 7.18 2009 AND 2008 NAVY DODSER COMORBIDITY RATES ........................................................................................................................... 187

TABLE 7.19 2009 AND 2008 NAVY DODSER TREATMENT HISTORY........................................................................................................................... 187

TABLE 7.20 2009 AND 2008 NAVY DODSER PSYCHOTROPIC MEDICATION USE........................................................................................................ 188

TABLE 7.21 2009 AND 2008 NAVY DODSER RELATIONSHIP HISTORY ....................................................................................................................... 189

TABLE 7.22 2009 AND 2008 NAVY DODSER FAMILY HISTORY................................................................................................................................... 190

TABLE 7.23 2009 AND 2008 NAVY DODSER ADMIN/LEGAL HISTORY ....................................................................................................................... 191

TABLE 7.24 2009 AND 2008 NAVY DODSER ABUSE HISTORY.................................................................................................................................... 192

TABLE 7.25 2009 AND 2008 NAVY DODSER FINANCIAL AND WORKPLACE DIFFICULTIES ......................................................................................... 193

TABLE 7.26 2009 AND 2008 NAVY DODSER EVER DEPLOYED TO OEF/OIF ................................................................................................................ 194

TABLE 7.27 2009 AND 2008 NAVY DODSER COMBAT HISTORY ................................................................................................................................ 194
DoDSER 2009 Annual Report

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LIST OF FIGURES

FIGURE 2.1 2009 DODSER SUICIDE METHODS............................................................................................................................................................17

FIGURE 2.2 2009 COMMUNICATION OF POTENTIAL FOR SELF-HARM .......................................................................................................................20

FIGURE 2.3 2009 DODSER SUICIDE COMPLETIONS BY MONTH ..................................................................................................................................24

FIGURE 2.4 2009 DODSER BEHAVIORAL HEALTH DISORDERS.....................................................................................................................................26

FIGURE 2.5 2009 DODSER TREATMENT HISTORY .......................................................................................................................................................29

FIGURE 2.6 2009 HISTORY OF FAILED RELATIONSHIPS...............................................................................................................................................32

FIGURE 2.7 2009 ADMINISTRATIVE/LEGAL HISTORY..................................................................................................................................................34

FIGURE 3.1 2009 METHODS FOR OEF/OIF AND OTHER SUICIDES...............................................................................................................................45

FIGURE 3.2 2009 OEF/OIF MONTHS DEPLOYED.........................................................................................................................................................68

FIGURE 4.1 2009 AND 2008 AIR FORCE DODSER EVENT METHODS ............................................................................................................................75

FIGURE 5.1 2009 AND 2008 ARMY DODSER EVENT METHODS ...................................................................................................................................97

FIGURE 5.2 2009 AND 2008 NON-FATAL ARMY DODSER EVENT METHODS.............................................................................................................. 123

FIGURE 6.1 2009 AND 2008 MARINE CORPS DODSER EVENT METHODS .................................................................................................................. 157

FIGURE 7.1 2009 AND 2008 NAVY DODSER EVENT METHODS.................................................................................................................................. 178
DoDSER 2009 Annual Report

Page | 1

EXECUTIVE SUMMARY

This annual report summarizes data collected on Department of Defense (DoD) suicide events for 

calendar year 2009 as reported and submitted by 1 April 2010. The report presents overall DoD suicide 

data as well as Service-specific (Air Force, Army, Marine Corps, and Navy) data. This second year of the 

program provided the opportunity to present 2009 data relative to 2008. Personally identifiable 

information has been redacted from this report.

Background

The DoD Suicide Event Report (DoDSER) was developed to standardize suicide surveillance efforts across 

the Services with the ultimate goal of facilitating DoD’s suicide prevention mission. When a death is 

ruled a suicide by the Armed Forces Medical Examiner’s System (AFMES), each Service has a professional 

review records, conduct interviews where appropriate, and respond to DoDSER items on a webform that 

collects comprehensive information about the Service Member and the suicide event.

Results

The AFMES indicates that 309 Service Members died by suicide in 2009 (Air Force = 46; Army = 164; 

Marine Corps = 52; Navy = 47). This number includes deaths strongly suspected to be suicides but 

pending final determination.

DoDSERs were received for 97% of AFMES confirmed 2009 suicides as of 1 April 2010. This represented a 

significant improvement compared to 2008 (90%).

Dispositional/Personal Factors

Demographic risk factor trends for DoD suicides in 2009 were similar to those reported in 2008 and are 

generally consistent with those of the US population.

[1]

 In general:

• Caucasians under the age of 25 who were junior enlisted (E1-E4) or had earned a GED were at 

increased risk for suicide relative to their respective demographic comparison groups in crude rate 

comparisons.

• Although the suicide rate among married persons was similar to the rate for persons who had never 

married, divorced persons were almost three times more likely to die by suicide than married 

persons in crude rate comparisons.
DoDSER 2009 Annual Report

Executive Summary

Page | 2

• The majority of suicides were completed by Regular Component Service Members (92%, n=284). The 

suicide rate for these Service Members was 120% higher than the rate for Service Members in the 

Reserve and National Guard in crude rate comparisons.

• The majority of decedents used a firearm (59%; 41% of all decedents used a non-military firearm).

The second most frequent method of suicide was hanging (23%).

• Most decedents (72%) had no known history of communicating their potential for self-harm before 

taking their lives. When potential for self-harm was communicated, this was most frequently 

disclosed to spouses (13%), followed by friends (9%).

Contextual Factors

• Forty-six percent of decedents lived in off-post housing at the time of the suicide; 31% lived in a 

shared military environment (barracks, tent, other shared environment).

• Thirty-seven percent were known to have children, and 17% lived with their children.

• Firearms were present in the home or immediate environment for 49% of decedents.

Clinical/Symptom Factors

• Seventeen percent of Service Members who died by suicide had a known history of prior selfinjurious behavior.

• The majority of suicide decedents (57%) did not have a known history of a behavioral health

disorder. Eighteen percent had been diagnosed with an anxiety disorder, including 6% diagnosed 

with PTSD; 25% had a history of a mood disorder.

• Twenty-four percent had a history of receiving psychotropic medications.

• Forty-nine percent reportedly received medical, behavioral health, substance abuse, family or 

chaplaincy services within 30 days of death.

Historical/Developmental Factors

The DoDSER data provides a description of the stressors decedents experienced prior to dying by 

suicide. Although these factors are not necessarily causal, they help characterize the circumstances of 

the decedents’ lives prior to the suicide.

• Fifty percent of decedents experienced a failed or failing spousal or intimate partner relationship

prior to their suicide; 27% of decedents experienced the relationship problem within 30 days of the 

suicide. In addition, other failed relationships (non-intimate) were reported for 13% of decedents 

(8% within 30 days).

• Legal problems were identified for a minority of individuals. The most common legal problems were 

Article 15 proceedings (15%) and civil problems (12%). Ten percent had a history of being absent 

without leave (AWOL).

• Excessive debt or bankruptcy was identified for 11% of decedents. Job problems were noted for 27% 

of decedents.
DoDSER 2009 Annual Report

Executive Summary

Page | 3

Deployment Factors

• Most suicides did not occur in theater. There were ten suicides (3%) in Operation Enduring Freedom

and 33 (11%) in Operation Iraqi Freedom. Fifty-one percent of decedents had a history of 

deployment to Operation Enduring Freedom or Operation Iraqi Freedom, and 7% had a history of 

multiple deployments to Iraq, Afghanistan, or Kuwait.

• Seventeen percent of decedents had reportedly experienced direct combat operations.

Conclusion

The DoDSER program is a key aspect of the DoD’s suicide prevention program. This second year of 

DoDSER analyses confirmed many of the patterns described in the 2008 data; there were very few 

differences between 2008 and 2009. Chapters in the report provide additional details including Servicelevel analyses. Conclusions and interpretations regarding noted patterns must be made cautiously

because it is not possible to statistically determine if a given DoDSER variable is a true risk factor for 

suicide without additional data about the rate of that variable in the population.
DoDSER 2009 Annual Report

Page | 4

Chapter 1

INTRODUCTION

Background

This report presents results from all the Department of Defense Suicide Event Reports (DoDSERs)

collected for calendar year 2009. The DoDSER is part of a suicide surveillance program that standardizes

retrospective suicide surveillance efforts across the Services. Historically, the Services collected suicide 

surveillance data through separate processes. The Army used the Army Suicide Event Report (ASER), the 

Air Force used the Suicide Event Surveillance System (SESS), and the Navy and Marine Corps used the 

Department of the Navy Suicide Incident Report (DoNSIR). A major limitation of these disparate systems 

was that aggregated DoD-level analyses were not possible since the same data points were not collected 

with standardized items. In addition, each system had its own strengths and limitations; for example, 

not all of the Services benefited from an automated, webform data collection process.

The DoD’s Suicide Prevention and Risk Reduction Committee (SPARRC) provides a venue for 

collaboration among the Services’ Suicide Prevention Program Managers (SPPMs) and other 

stakeholders in the DoD’s suicide prevention mission. The SPARRC identified a standardized DoD suicide 

surveillance system as a key goal. A collaborative plan was developed to synchronize surveillance efforts 

across Services while also seeking to maintain flexibility to address Service-specific needs. A web-based 

data collection process was identified as a key goal, and in 2007, a project plan was collaboratively 

developed by T2 with SPPMs from all of the Services (Air Force, Army, Marine Corps, and Navy).

An effort was made to develop a DoD system that built on the best characteristics from each of the 

Service-specific programs. The resulting DoDSER uses an epidemiological data collection form to collect 

standardized data on suicide behaviors among Service Members. The DoDSER program was launched 1 

January 2008. All the Services are collecting DoDSERs on military suicide deaths.

[2]

By 1 January 2010, all 

Services also started collecting DoDSERs on suicide attempts. The Army is also collecting DoDSERs on 

other non-fatal suicide behaviors (see Method below).

This report provides statistics for 2009, with detailed tables presented for DoDSER items. Supplemental 

materials will be available on the National Center for Telehealth & Technology website

(http://t2health.org) after the Report is released.
DoDSER 2009 Annual Report

Chapter 1 Introduction

Page | 5

Method

DoDSER Items

DoDSER items were developed to provide a comprehensive set of information from a variety of sources 

to facilitate suicide prevention efforts in the DoD. Development of the current DoDSER content evolved 

from structured reviews of the Services’ historical surveillance items, workgroup deliberations with 

representation from all Services (including the SPPMs), and a systematic review of the literature.

Feedback from the Services’ historical efforts to develop the best possible content informed the 

development process. Feedback on content from nationally recognized civilian and military experts was 

also integrated. In addition, suggestions from senior leaders and other stakeholders were provided by 

some workgroup members. The complete DoDSER 2009 webform can be found online 

(http://t2health.org).

Risk variables are organized into categories for a theoretically meaningful presentation. Although

alternative approaches were available and considered, a relevant model successfully implemented in 

the violence risk assessment literature[3]

was selected. Categories are organized as follows:

• Dispositional or personal factors (e.g., demographics),

• Historical or developmental factors (e.g., family history, prior suicide behaviors, life events),

• Contextual factors (e.g., access to firearms, place of residence, duty status), and

• Clinical or symptom factors (e.g., posttraumatic stress disorder, other behavioral health disorders, or 

symptoms).

These factors were combined with a section on deployment history and a comprehensive set of 

questions related to the event to form the current DoDSER.

DoDSER items are updated once a year on 1 January. The National Center for Telehealth & Technology 

(T2) leads a series of meetings with all the Services’ SPPMs and DoDSER Program Managers in 

collaboration with the SPARRC. The work group reviews feedback received during the prior year and any 

implications from the evolving scientific literature. All Service representatives concur with all item 

changes, unless the change relates to a Service-specific need. Because 2009 was only the second year of 

the program, a priority was placed on maintaining items from 2008 to ensure that comparisons could be 

made across years. Therefore, no item changes were made on 1 January 2009. Refinements to item 

content were made on 1 January 2010 and will be reflected in the 2010 annual report.

Data Collection Process

The DoDSER is a webform that is available via the Internet and submitted via a secure website. The 

DoDSER data presented here are a descriptive compilation of DoDSERs as they have been completed 

and submitted by DoDSER respondents across the DoD. Personally identifiable information has been 

redacted from this report.
DoDSER 2009 Annual Report

Chapter 1 Introduction

Page | 6

DoDSER data included in this report are for suicide events that occurred in 2009 as reported and 

submitted by 1 April 2010. This date was selected with an acknowledgement that there is a tension 

between the competing values of timely reporting and complete data collection. Extension of this date 

has been considered in order to obtain additional DoDSERs, as it may take as long as one year to confirm

suicide as the cause of death. The Centers for Disease Control (CDC) addressed this with longer 

timeframes for reporting (approximately two years).

[1]

However, the DoD represents a much smaller 

population, and the vast majority of DoD suicides are determined by 1 April of the following year. The 

April date was established to maintain consistency with guidance provided by the Under Secretary of 

Defense (Personnel and Readiness) which requires 90 days between the end of the calendar year and 

calculation of calendar year suicide data.

[4]

Data regarding suicide events from 2008 are included. Data from 2008 provided in the figures of this 

report will vary slightly from the data provided in the 2008 DoDSER Annual Report because the 2008 

data set has been updated to include 2008 events confirmed between April 2009 and April 2010.

DoDSERs are required for all Active component and activated Reserve and Guard suicides in the DoD. 

Some Services will exceed this minimum requirement in 2010 (e.g., collect DoDSERs on Selected 

Reservists (SELRES) not on active duty). In addition, consistent with requirements for standardized DoD 

suicide rate calculation,

[4]

 DoDSERs are submitted for deaths when a Service’s SPPM strongly suspects 

suicide but the case is still awaiting final determination by the AFMES. This is intended to provide 

leaders and others working to prevent suicide with the most up-to-date information possible. The risk of 

overestimation is low; variation between final confirmed and suspected suicides is generally one-to-two 

cases per year, DoD-wide.

DoDSERs are also submitted for some suicide-related behaviors, including suicide attempts, deliberate 

self-harm, and suicidal ideation. In 2009, the Army was the only Service to collect this data for the entire 

year, although all Services had implemented a similar methodology for suicide attempts by 1 January 

2010. Therefore, this 2009 report includes data on suicide-related behaviors for the Army only. The 2010 

report will include similar data for all the Services.

DoDSERs are submitted by behavioral health providers (psychologists, psychiatrists, psychiatric nurses, 

or social workers), health care providers, or a command-appointed representative. Technicians may 

submit DoDSERs under the supervision of one of these professionals.

DoDSER responses are derived from a review of all relevant records. In addition, interviews are 

conducted in some cases. Following a suicide, respondents review medical and behavioral health 

records, personnel records, investigative agency records, and records related to the manner of death.

Information is also often collected from co-workers, the responsible investigative agency officer, and 

other professionals or family members (for some Services). For non-fatal suicide behaviors (Army only 

for 2009), DoDSER respondents frequently conduct interviews with Soldiers to collect some of the 

required information.
DoDSER 2009 Annual Report

Chapter 1 Introduction

Page | 7

The process for identifying suicides and obtaining DoDSERs is similar across all Services. SPPMs 

coordinate closely with the AFMES at the Armed Forces Institute of Pathology (AFIP) to maintain an 

official list of suicides. In the Army, a DoDSER point of contact (POC) and Command POC at each medical 

treatment facility are notified when a Soldier’s death is confirmed as a suicide and requested to 

complete a DoDSER within 60 days. In the Air Force, the Office of Special Investigations is the primary 

data collection agency. In the Navy and Marine Corps, the SPPMs’ office contacts the local Command 

and requests an appropriate POC to meet the requirement.

Data Quality Control Procedures

Four primary quality control procedures are followed.

First, the data submission website minimizes the possibility of data entry errors. The software uses form 

field validation to request user clarification when data is not logically possible (e.g., impossible dates).

Radio buttons and checkboxes are used to further reduce the chances of data entry errors.

Second, data submission requires a DoDSER account in which a user’s identity is confirmed with a 

microchip-containing military ID known as a common access card (CAC). The CAC contains basic 

information about the owner and is associated with a personal identification number required for login.

Therefore, “false” submissions have not generally occurred. However, suicide event and non-fatal 

suicide behaviors can be inadvertently misclassified by respondents in the DoDSER system. For example, 

the manner of death can be ambiguous in some cases, and a well-intentioned DoDSER respondent can 

misclassify an event. Therefore, DoDSER submissions are confirmed against the official list of DoD 

suicides provided by AFMES.

Third, DoDSERs are analyzed for incorrect data entry. In rare cases, individuals can make a variety of 

data entry mistakes (such as transposing years) and these are corrected when identified. A conservative 

approach is taken to correcting errors such that only clear mistakes are corrected.

Fourth, all DoDSERs are reviewed to ensure that two or more DoDSERs were not submitted for the same 

event. Potential duplicates are automatically flagged for the Service’s DoDSER Program Manager to 

determine which submission represents the most complete data, and this DoDSER is used in analyses.

DoDSER Submission Compliance

DoDSER submission compliance rates were calculated for each Service. In the DoD, DoDSERs for suicides 

are due within 60 days of notification that a death has been confirmed as a suicide by the AFMES[4]

(although some individual Service-level policies require submission sooner). Therefore, the number of 

DoDSER submissions for each Service was compared to the number of suicides confirmed by AFMES as 

of 31 January 2010 (60 days prior to the 1 April cut-off date for analysis). As such, DoDSERs that were 

not yet overdue at the time of the analysis were not counted as being out of compliance.
DoDSER 2009 Annual Report

Chapter 1 Introduction

Page | 8

Demographic Risk Factors

The DoDSER collects data on a variety of demographic variables. However, because DoDSERs are not 

available for 100% of individuals, demographic data were obtained from the Defense Manpower Data 

Center (DMDC) with assistance from the AFMES. This provided the opportunity to analyze demographic 

variables as suicide risk factors with the use of DMDC population data. The demographic categories 

presented in this report are those provided by DMDC.

Procedures for calculating rates followed standard DoD reporting procedures.

[4]

 DMDC rates were 

based on September quarter-end strength reports from DMDC and were obtained by the Mortality 

Surveillance Division of the AFMES.

Race data in the DMDC report is obtained from a self-report source. This report reflects the most 

current data available at the time of writing, but some data is subject to variation over time due to 

updates from the various sources used to populate the database. In most cases, DMDC data is used in 

this report for demographic analyses. In a few analyses where DMDC data were not available (e.g., nonfatal suicide-related behaviors in the Army Chapter), DoDSER demographics were used. Suicide rates 

based on fewer than 20 individuals may be unstable and are therefore suppressed. Suicide rate ratios 

(RR), based on population rates provided by DMDC data, are calculated to compare groups based on 

demographic characteristics.

Interpretive Considerations

The purpose of this report is to provide a broad presentation of DoDSER items to support a wide variety 

of possible needs. Given the very large number of possible comparisons between 2008 and 2009, and 

the fact that we did not approach the data with a priori hypotheses, we did not compute statistical 

analyses to compare years. The probability of finding statistically significant results by chance, even 

when no real difference exists, would be high. Enough data is presented in most cases to permit readers 

to conduct such analyses, if of interest. Further, data analyses and descriptive information of small 

sample sizes should always be interpreted with caution due to random error or potential outlier biases 

inherent in small samples.

DoDSER data is useful to help characterize the nature of suicide events. With a few exceptions (e.g., 

demographic characteristics), it is not possible to statistically determine if a given DoDSER variable is a 

risk factor for suicide. In order to determine risk, additional data is required about the rate of the 

variable in the population. For example, it is not possible to determine if owning a firearm is a risk factor 

for suicide without examining the rate of owning a firearm in the military population. A pilot study to 

collect control DoDSER data is underway, and other efforts to improve the interpretive value of the 

DoDSER data are being pursued.

It is also important to note how the “don’t know” option that is provided for many DoDSER items can 

influence the interpretation of results. The information required to answer some DoDSER items may 

only be available for some respondents who benefited from detailed medical records or interviews with 
DoDSER 2009 Annual Report

Chapter 1 Introduction

Page | 9

knowledgeable persons familiar with the decedent’s history. Therefore, “don’t know” responses are 

expected for some items. Percentages were often calculated based on the total number of responses, 

including “don’t know” responses. If one group has a higher “don’t know” response rate than 

comparison groups, it influences the way the data appear. In some cases, percentages do not add up to 

100% due to rounding error.

The nature of the item of interest should be taken into account when results are interpreted. Some 

DoDSER items are highly objective, whereas others are more subjective. Some results are therefore very 

reliable, while others reflect the best data available on a difficult to study topic that is provided by a 

respondent who is knowledgeable about the case. Reliability and validity of DoDSER items is not known 

at this time. Standardized coding guidance was available to respondents for many DoDSER items, and a 

more detailed coding manual is currently being finalized.

Future Directions

The DoDSER program continues to evolve, largely due to feedback received from leadership in the 

Services, SPPMs, and others (see FEEDBACK AND SUGGESTIONS). By 1 January 2010, all Services began

systematically collecting DoDSERs for non-fatal events. In addition to the Army’s current section on nonfatal events, the 2010 report will include thorough data on non-fatalities for the Air Force, Marine Corps, 

and Navy. T2’s Suicide Risk Management & Surveillance Office is working with SPPMs and SPARRC to 

finalize a refined DoDSER coding manual to help ensure standardization across DoDSER respondents. T2 

also recently deployed Internet and video-based DoDSER training materials to promote consistency in 

DoDSER responses. In addition to benefitting from these changes, the 2010 report will provide an 

opportunity to capitalize on three years of data collection. As such, the next report will include 

longitudinal analyses.
DoDSER 2009 Annual Report

Page | 10

Chapter 2

DoD-WIDE RESULTS FOR COMPLETED SUICIDES

DoDSER Submissions

According to data provided by the Armed Forces Medical Examiner System (AFMES), there were 309

Service Member suicides in calendar year 2009 (Air Force = 46; Army = 164; Marine Corps = 52; Navy = 

47; Table 2.1). These include eight Reservists and 17 National Guard Members on Active Duty (Army = 

17; Air Force = 5; Navy = 2; Marine Corps = 1). The 309 suicides include decedents whose cause of death 

is currently being determined by AFMES.

Table 2.1 2009 AFMES CONFIRMED AND PENDING SUICIDES AND DoDSERs SUBMITTED

Total DoDSERs 

Received

Total AFMES 

Confirmed and 

Pending 

Suicides

AFMES 

Confirmed 

Suicides (as of 

31 JAN 2010)

DoDSER 

Submission 

Compliance 

Additional 

DoDSERs Pending 

AFMES 

Confirmation

AIR FORCE 46 46 43 43 (100%) 3

ARMY 153 164 161 153 (95%) 0

MARINE CORPS 52 52 50 50 (100%) 2

NAVY 46 47 45 45 (100%) 1

Total DoD 297 309 299 291 (97%) 6

Note: Data from 1/1/2009 through 12/31/2009 as of 4/1/2010

As noted in Chapter 1, Method, the DoD standard requires a Department of Defense Suicide Event 

Report (DoDSER) submission within 60 days of notification that a death has been confirmed as a suicide 

by AFMES[4]

(although some individual Service-level policies require faster submission). Therefore, the 

number of DoDSER submissions was compared to the number of suicides confirmed by AFMES as of 31 

January 2010 (60 days prior to the 1 April cut-off date for analysis). As of 31 January 2010, there were 

299 AFMES confirmed suicides (Air Force = 43; Army = 161; Marine Corps = 50; Navy = 45). For 2009,

there were 297 DoDSERs submitted for suicides plus six DoDSERs submitted for deaths pending AFMES 

determination (Air Force = 46; Army = 153; Marine Corps = 52; Navy = 46), for an overall DoDSER 

submission compliance rate of 97% (100% for Air Force, 95% for Army, 100% for the Marine Corps, and 

100% for Navy).

2009 Suicide Rate Data

Suicide rate data are maintained by the AFMES and are not calculated with DoDSER data. Suicide data

provided by the AFMES is included in this report to provide a context for interpreting DoDSER data.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 11

The total Active Duty crude suicide rate (including Active Duty Guard and Reserve) was 18.4. Crude rates 

for 2009 by Service were Air Force = 12.4, Army = 22.0, Marine Corps = 24.0, and Navy = 13.5.

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that 

may have been associated with or contributed to the suicidal events. These factors include decedents’ 

demographic characteristics, event setting, suicide method, substance use during the event, possible

motive and intent to die, and communication of intent with others.

Demographics

Table 2.2 summarizes 2009 suicide demographic data based on Defense Manpower Data Center (DMDC) 

data provided by AFMES, and Table 2.3 shows the data by Service. Although the DoDSER does collect 

demographic data, use of DMDC data permitted the calculation of suicide rates because the same data 

is available for the DoD population (described in Chapter 1, Method). In addition, DMDC demographic 

data were provided for the few cases in which a DoDSER had not yet been received. Thus, demographic 

data were available for all suicide cases (n=309), whereas the rest of the report utilizes DoDSER data 

(n=297).

• Ninety-seven percent (n=300) of suicides were completed by men. Although the number of 

women’s suicides was too low to calculate a stable rate, exploratory analysis suggests that the risk 

of suicide was higher for men than for women.

• The majority of suicides were completed by Caucasians (80%, n=247).

• Caucasians were 76% more likely to die by suicide compared to African Americans (RR=1.76). It was 

not possible to compare other race groups due to the small cell sizes.

• Suicide was most frequently observed among persons under age 25 (46%, n=141). This group had a 

36% higher risk of suicide compared to all other age groups combined (RR=1.36).

• Most suicides (54%, n=167) were completed by junior enlisted (E1-E4) personnel followed by middle 

to senior (E5-E9) enlisted personnel (36%, n=112). Junior enlisted (E1-E4) personnel were 48% more 

likely to die by suicide compared to more senior enlisted personnel (RR=1.48). Also, enlisted 

personnel (E1-E9) were more than twice as likely to die by suicide compared to officers (RR=2.02).

• The highest level of education achieved by the majority of decedents in 2009 was graduation from 

high school (67%, n=208). The risk for suicide for persons with less than a high school education 

(GED/below high school) was 2.4 times higher compared to persons with a high school education 

(RR=2.44).

• About half of the suicides (51%, n=159) were completed by married persons. Although the suicide 

rate among married persons did not differ from never married persons (RR=1.06), divorced persons 

were almost three times as likely to die by suicide as married persons (RR=2.91). The relative risk 

was only slightly reduced when gender-adjusted (RR=2.71).

• The majority of suicides were completed by Active Duty personnel (92%, n=284) and the risk for 

suicide for Regular Active Duty personnel was 2.1 times higher than for Reservists and National 

Guard combined (RR=2.10).
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 12

Comparisons were not conducted within individual Services because the vast majority of cell sizes were 

too small to permit calculation of stable suicide rates.

Table 2.2 2009 AND 2008 AFMES DEMOGRAPHICS AND SUICIDE RATES

2009 2008

Count %

DoD 

Total % Rate Count

DoD 

Total % Rate

GENDER

Male 300 97% 85% 21.03 255 95% 18.20

Female 9 3% 15% N/A 13 5% N/A

RACE

American Indian/Alaskan Native 10 3% 2% N/A 9 3% N/A

Asian/Pacific Islander 15 5% 4% N/A 11 4% N/A

Black/African American 33 11% 17% 11.80 33 12% 11.9

White/Caucasian 247 80% 71% 20.82 204 76% 17.4

Other/DK 4 1% 7% N/A 11 4% N/A

RANK

Unknown Enlisted 3 1% N/A N/A 1 <1% N/A

E1-E4 167 54% 42% 24.06 138 51% 20.1

E5-E9 112 36% 41% 16.26 102 38% 14.8

Officer 23 7% 15% 9.32 25 9% 10.2

Warrant Officer 4 1% 1% N/A 2 1% N/A

EDUCATION

Below HS 2 1% 1% N/A 9 3% N/A

GED 44 14% 6% 45.21 24 9% 24.1

HS graduate 208 67% 63% 19.91 170 63% 16.4

Some College/tech, no degree 16 5% 5% N/A 4 1% N/A

College degree/tech cert < 4 yrs 9 3% 6% N/A 25 9% 25.1

Four-year degree 17 6% 12% N/A 20 7% 9.8

Masters degree or greater 10 3% 6% N/A 16 6% N/A

Don’t Know 3 1% 1% N/A 0 0% N/A

MARITAL 

STATUS

Never Married 105 34% 39% 16.05 100 37% 15.2

Divorced 37 12% 4% 49.61 21 8% 27.6

Legally Separated 0 0% 0% N/A 0 0% N/A

Married 159 51% 56% 17.05 144 54% 15.9

Widowed 1 <1% 0% N/A 0 0% N/A

Don't Know 7 2% 0% N/A 3 1% N/A

AGE*

17-24 141 46% 37% 23.04 142 53% 20.10

25-29 73 24% 23% 19.05 38 14% 13.70

30-34 43 14% 12% 21.19

53 20% 12.10

35-39 26 8% 12% 12.62

40-44 15 5% 6% N/A

35 13% 15.7

45+ 11 4% 6% N/A
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 13

Table 2.2 2009 AND 2008 AFMES DEMOGRAPHICS AND SUICIDE RATES

2009 2008

Count %

DoD 

Total % Rate Count

DoD 

Total % Rate

COMPONENT

Regular 284 92% 84% 19.80 235 88% 16.9

Reserve 8 3% 6% N/A 12 4% N/A

National Guard 17 6% 9% N/A 21 8% 14.4

TOTAL 309 100% 100% 18.50 268 100%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 

through 12/31/2009 as of 4/1/2010. Total % column reflects proportion of individuals with the demographic characteristic in the 

combined Services' Active Duty and Activated Reserve and National Guard Forces. 

* Age bands reported in 2008 DoDSER Annual Report were collapsed into 30-39 and 40+ age groups.

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 14

Table 2.3 2009 DMDC DEMOGRAPHICS BY SERVICE

AIR FORCE ARMY MARINE CORPS NAVY

Count %

Total 

AF

% Count %

Total 

Army 

% Count %

Total 

USMC 

% Count %

Total 

Navy 

%

GENDER

Male 44 96% 80% 159 97% 86% 52 100% 94% 45 96% 84%

Female 2 4% 20% 5 3% 14% 0 0% 6% 2 4% 16%

RACE

American Indian/Alaskan Native 2 4% 1% 5 3% 1% 0 0% 1% 3 7% 4%

Asian/Pacific Islander 2 4% 4% 10 6% 3% 1 2% 3% 2 4% 7%

Black/African American 5 11% 14% 19 12% 19% 3 6% 10% 6 13% 18%

White/Caucasian 35 76% 74% 130 79% 71% 48 92% 78% 34 72% 63%

Other/DK 2 4% 7% 0 0% 5% 0 0% 7% 2 4% 7%

RANK

Unknown Enlisted 0 0% <1% 2 1% 0% 0 0% 0% 1 2% <1%

E1-E4 21 46% 34% 94 57% 42% 39 75% 60% 13 28% 38%

E5-E9 20 43% 47% 51 31% 40% 11 21% 29% 30 64% 46%

Officer 5 11% 20% 15 9% 13% 1 2% 9% 2 4% 16%

Warrant Officer 0 0% 0% 2 1% 3% 1 2% 1% 1 2% <1%

EDUCATION

Below HS 0 0% <1% 2 1% 1% 0 0% <1% 0 0% 1%

GED 0 0% <1% 34 21% 10% 7 13% 4% 3 7% 3%

HS graduate 35 76% 55% 96 59% 57% 42 81% 83% 35 76% 70%

Some College/tech, no degree 1 2% 5% 11 7% 7% 2 4% 1% 2 4% 2%

College degree/tech cert < 4 yrs 4 9% 15% 3 2% 4% 0 0% 2% 2 4% 4%

Four-year degree 1 2% 14% 12 7% 13% 1 2% 9% 3 6% 12%

Masters degree or greater 5 11% 11% 4 2% 6% 0 0% 2% 1 2% 4%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 15

Table 2.3 2009 DMDC DEMOGRAPHICS BY SERVICE

AIR FORCE ARMY MARINE CORPS NAVY

Count %

Total 

AF

% Count %

Total 

Army 

% Count %

Total 

USMC 

% Count %

Total 

Navy 

%

Don’t Know 0 0% 1% 2 1% 1% 0 0% <1% 1 2% 3%

MARITAL 

STATUS

Never Married 14 30% 33% 58 35% 36% 25 48% 50% 8 17% 45%

Divorced 6 13% 7% 22 13% 6% 5 10% 1% 4 9% <1%

Legally Separated 0 0% <1% 0 0% <1% 0 0% <1% 0 0% <1%

Married 26 57% 60% 83 51% 57% 22 42% 46% 28 60% 55%

Widowed 0 0% <1% 1 1% <1% 0 0% <1% 0 0% <1%

Don't Know 0 0% <1% 0 0% <1% 0 0% <1% 7 15% <1%

AGE

17-24 17 37% 30% 71 43% 33% 40 77% 60% 13 28% 36%

25-29 11 24% 24% 49 30% 23% 5 10% 20% 8 17% 23%

30-34 8 17% 13% 19 12% 12% 3 6% 9% 13 28% 14%

35-39 2 4% 14% 14 9% 13% 3 6% 7% 7 15% 13%

40-44 4 9% 8% 9 5% 6% 0 0% 3% 2 4% 7%

45+ 4 9% 7% 2 1% 7% 1 2% 1% 4 9% 5%

COMPONENT

Regular 41 89% 88% 147 90% 75% 51 98% 94% 45 96% 93%

Reserve 3 7% 3% 3 2% 8% 1 2% 6% 2 4% 7%

National Guard 2 4% 8% 14 9% 17% 0 0% 0% 0 0% 0%

TOTAL 46 100% 100% 164 100% 100.0 52 100% 100% 47 100% 100%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 through 12/31/2009 as of 4/1/2010. Service total 

percentages reflect the proportion of individuals with the demographic characteristic in the entire Service's Active Duty and Activated Reserve and National Guard Forces. 

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 16

Event Setting

Table 2.4 indicates the countries in which the suicides occurred. The AFMES reported 33 OIF suicides 

and 10 OEF suicides as of 1 April 2010. DoDSER data provides a description of the event country, 

although DoDSERs were not received for all suicides, as noted above (DoDSER Submissions). The 

majority of suicides occurred in the United States (79%, n=234), followed by Iraq (10%, n=31), Europe 

(3%, n=8), Afghanistan (2%, n=7), and Korea (2%, n=7). Other responses included Greece, Japan, Puerto 

Rico, and shipside.

Table 2.4 2009 AND 2008 DoDSER EVENT COUNTRY

2009 2008

Count Percent Count Percent

EVENT COUNTRY United States 234 79% 192 79%

Iraq 31 10% 31 13%

Afghanistan 7 2% 7 3%

Kuwait 1 <1% 1 <1%

Korea 7 2% 0 0%

Europe 8 3% 5 2%

Canada 2 <1% 0 0%

Other 6 2% 0 0%

Don't Know 1 <1% 7 3%

Note: Data differs from AFMES OEF/OIF counts due to missing DoDSERs.

Table 2.5 shows the settings where the suicides occurred. Suicides occurred most in the decedents’ 

personal residences, including their military residences (60%, n=178). Eight percent (n=24) occurred at 

the residence of a friend or family member and 6% (n=17) occurred at work or job sites. “Other” settings 

ranged from outdoor locations to other residences and hotels.

Table 2.5 2009 AND 2008 DoDSER EVENT SETTING

2009 2008

Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 178 60% 138 57%

Residence of friend or family 24 8% 18 7%

Work/jobsite 17 6% 22 9%

Automobile (away from residence) 16 5% 16 7%

Inpatient medical facility 0 0% 1 <1%

Other 62 21% 48 20%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 17

Event Method

Figure 2.1 and Table 2.6 display the methods decedents used to die by suicide in 2009. These data were

cross checked with the AFMES data for quality control purposes. Military firearms were used more by 

decedents in the Army and Marine Corps than in the Air Force and Navy.

Figure 2.1 2009 DoDSER SUICIDE METHODS

Non-military firearms were the most reported method for completed suicides for all Services (DoD Total 

= 41%, n=121). Military firearms were used in 18% (n=52) of suicides. Twenty-four percent (n=70) of 

suicides were completed by hanging, strangulation or suffocation. Other suicide methods included 

vehicle exhaust (4%, n=11), jumping (2%, n=5), overdose (3%, n=10 for drugs; <1%, n=1 for alcohol), use 

of a sharp or blunt object (2%, n=7), and lying in front of a moving object (1%, n=2).1

Table 2.6 2009 AND 2008 DoDSER EVENT METHOD

2009 2008

Count Percent Count Percent

EVENT METHOD Drugs 10 3% 11 5%

Alcohol 1 <1% 1 <1%

Gas, vehicle exhaust 11 4% 6 2%

Gas, utility (or other) 5 2% 1 <1%

 1 4% reported “other” (n=12), and 2% reported “don’t know” (n=6).

11%

54%

19% 17% 17%

40%

21% 20%

29% 31% 31%

7% 10%

39%

24%

30%

0

10

20

30

40

50

60

70

80

90

100

Firearm, military issue Firearm, non-military 

issue

Hanging Other

Percentage

Air Force Army Marine Corps Navy
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 18

Table 2.6 2009 AND 2008 DoDSER EVENT METHOD

2009 2008

Count Percent Count Percent

Hanging 70 24% 51 21%

Drowning 0 0% 1 <1%

Firearm, military issue 52 18% 51 21%

Firearm, non-military issue 121 41% 102 42%

Fire, steam, etc. 0 0% 1 <1%

Sharp or blunt object 7 2% 2 1%

Jumping from high place 5 2% 3 1%

Lying in front of moving object 2 1% 1 <1%

Crashing a motor vehicle 0 0% 1 <1%

Other 12 4% 4 2%

Don't Know 1 <1% 7 3%

Substance Use during the Event

Twenty-two percent (n=66) of submitted DoDSERs in 2009 identified that alcohol was used during the 

suicide, and 6% (n=19) were reported to have used drugs (Table 2.7)

2

. Nine decedents reportedly used 

both drugs and alcohol during the suicide. Three percent of the individuals with reported drug-use 

represented use “without overdose” of over-the-counter medication (n=5) or prescription medication 

(n=3). These data are likely underestimates, as a significant number of respondents did not have access 

to information about decedents’ substance use, presumably because autopsy results were not available 

at the time of the DoDSER submission. The rate of “don’t know” responses suggests that DoDSER 

respondents may need access to autopsy results. After excluding “don’t know” responses in order to 

calculate a valid percentage, 43% of DoDSERs reported that alcohol or drugs had been used during the 

suicide.

Table 2.7 2009 AND 2008 DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

ALCOHOL USED Yes 66 22% 55 23%

No 115 39% 95 39%

Don't Know 116 39% 93 38%

 2 The meaning of this response is ambiguous, as the DoDSER item does not differentiate between appropriate therapeutic drug use and drug 

abuse. Because of the wording of the question (“During the event, were drugs used?”), these cases were included in the numbers reported 

above.

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 19

Table 2.7 2009 AND 2008 DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

ANY DRUGS USED Yes 19 6% 17 7%

No 140 47% 122 50%

Don't Know 138 46% 104 43%

 Illegal drugs Overdose 0 0% 1 <1%

Used, no overdose 2 1% 0 0%

Were not used 157 53% 131 54%

Don’t Know 138 46% 111 46%

 Prescription drugs Overdose 8 3% 11 5%

Used, no overdose 3 1% 4 2%

Were not used 148 50% 123 51%

Don’t Know 138 46% 105 43%

 OTC drugs Overdose 2 1% 5 2%

Used, no overdose 5 2% 2 1%

Were not used 152 51% 126 52%

Don’t Know 138 46% 110 45%

BOTH ALCOHOL AND DRUGS USED Yes 9 3% 6 2%

No 147 49% 131 54%

Don't Know 141 47% 106 44%

Additional Event Information

The information in this section includes data on whether the Service Member intended to die and 

whether the decedent communicated potential for self-harm. Additional items pertain to evidence of 

death-risk gambling such as Russian roulette or walking railroad tracks, planned or premeditated acts, 

and whether suicide events were performed in areas or under circumstances in which the behavior was

likely to be observed.

There was evidence of intent to die for 76% (n=226) of suicides. One hundred seventeen suicides were 

planned or premeditated and most took place where it was unlikely that others could observe or 

intervene (69%, n=204). A suicide note was reported to have been found for 25% (n=74) of suicides.

(Table 2.8)

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 20

Table 2.8 2009 AND 2008 DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

INTENDED TO DIE Yes 226 76% 171 70%

No 16 5% 15 6%

Don't Know 55 19% 57 23%

DEATH RISK GAMBLING Yes 4 1% 5 2%

No 252 85% 170 70%

Don't Know 41 14% 68 28%

PLANNED/PREMEDITATED Yes 117 39% 92 38%

No 86 29% 65 27%

Don't Know 94 32% 86 35%

OBSERVABLE Yes 61 21% 47 19%

No 204 69% 143 59%

Don't Know 32 11% 53 22%

SUICIDE NOTE LEFT Yes 74 25% 55 23%

No 160 54% 112 46%

Don't Know 63 21% 76 31%

Communication of Intent

Many Service Members who died by suicide in 2009 were reported to have communicated to someone 

their potential for self-harm, as shown in Figure 2.2.

Figure 2.2 2009 COMMUNICATION OF POTENTIAL FOR SELF-HARM
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 21

DoDSER respondents indicate the types of individuals with whom decedents communicate intent to 

suicide when known. Most decedents had no known history of communicating their potential for selfharm before taking their lives. As displayed in Table 2.9, 28% (n=83) had communicated their potential 

for self-harm before dying by suicide, and at least 30 Service Members who died by suicide (10%) 

reported this potential to multiple categories of people (Table 2.10). Whether individuals communicated 

their potential to harm themselves was not known for the majority of individuals (72%, n=214). As 

demonstrated in Table 2.11, of the 83 decedents known to have communicated their potential for selfharm, the majority (57%, n=47) communicated the message verbally. Service Members most commonly 

shared their potential for self-harm with spouses, friends and “others,”

3 (Table 2.10) which may be 

informative for suicide prevention efforts.

Table 2.9 2009 AND 2008 DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 214 72% 168 69%

1 53 18% 55 23%

2 21 7% 15 6%

3 5 2% 5 2%

4 3 1% 0 0%

5 1 <1% 0 0%

Note: The DoDSER asks respondents whether the potential for self-harm was communicated to a friend, spouse, or other categories. If a 

decedent communicated their potential for self-harm to multiple friends, the DoDSER item would not capture that.

Table 2.10 2009 AND 2008 DoDSER RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

COMMUNICATION Friend 28 9% 20 8%

Behavioral Health Staff 16 5% 11 5%

Supervisor 11 4% 7 3%

Spouse 38 13% 29 12%

Chaplain 4 1% 4 2%

Other 30 10% 29 12%

Made Multiple Communication 30 10% 20 8%

 3 The category “other” includes a variety of co-workers and non-spousal family members.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 22

Table 2.11 2009 AND 2008 DoDSER MODE OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 47 16% 44 18%

Written Only 7 2% 3 1%

Other 18 6% 9 4%

Multiple Modes 12 4% 11 5%

Note: Multiple Modes includes a combination of verbal, written, or other mode of communicating intent to suicide.

Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty 

environments.

Home Environment

As can be seen in Table 2.12, Service Members who died by suicide most frequently lived in off-base

family housing (46%, n=137). An additional 31% (n=92) lived in barracks or other shared military 

housing. Five percent (n=15) of decedents lived in bachelor enlisted quarters or bachelor officer quarters 

and 5% (n=14) lived in on-base family housing. Eight percent (n=24) lived in “other” housing and 1% 

(n=3) were stationed on ships. Thirty-four percent (n= 102) of decedents lived alone. Thirty-seven

percent (n=111) reportedly had minor children (the majority of whom did not live with their children at 

the time of the event). Firearms were present in the home or immediate environment for 49% (n=146) 

of decedents.

Table 2.12 2009 AND 2008 DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDENCE AT TIME OF EVENT Shared military living environment 92 31% 70 29%

Bachelor quarters 15 5% 13 5%

On-base family housing 14 5% 11 5%

Owned or leased apartment or house 137 46% 95 39%

Ship 3 1% 5 2%

Other 24 8% 18 7%

Don't Know 12 4% 31 13%

MARRIED SERVICE MEMBER 

RESIDENCE

Resides with spouse 70 24% 53 22%

Separated due to relationship issues 29 10% 31 13%

Apart for other reasons/deployed 35 12% 23 9%

Don't Know 13 4% 12 5%

Unmarried at time of event 150 51% 124 51%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 23

Table 2.12 2009 AND 2008 DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDED ALONE Yes 102 34% 59 24%

No 168 57% 147 60%

Don't Know 27 9% 37 15%

HAD MINOR CHILDREN Yes 111 37% 79 33%

No 158 53% 116 48%

Don't Know 28 9% 48 20%

CHILDREN RESIDED WITH Yes 51 17% 33 14%

No 55 19% 43 18%

Don't Know 5 2% 3 1%

No Children 186 63% 164 67%

HAD ACCESS TO FIREARM Yes 146 49% 133 55%

No 79 27% 36 15%

Don't Know 72 24% 74 30%

Duty Environment

As shown in Table 2.13, “Garrison or with Permanent Command” was the most frequently reported duty 

environment for decedents (41%, n=123), followed by “leave” (10%, n=31). Additional information 

regarding deployment status is provided in each Service chapter.

Table 2.13 2009 AND 2008 DoDSER DUTY ENVIRONMENT

2009 2008

Count Percent Count Percent

DUTY ENVIRONMENT Garrison 123 41% 90 37%

Psych Hosp 1 <1% 1 <1%

Leave 31 10% 26 11%

Medical Hold 5 2% 5 2%

TDY 7 2% 4 2%

Evacuation Chain 0 0% 1 <1%

AWOL 15 5% 7 3%

Under Command Obs 1 <1% 1 <1%

Other 26 9% 14 6%

Training 12 4% 8 3%

Multiple Duty Environments Provided 19 6% 8 3%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 24

Suicide Completions by Month

Figure 2.3 and Table 2.14 displays suicide counts by month for the combined Services.

Figure 2.3 2009 AND 2008 DoDSER SUICIDE COMPLETIONS BY MONTH

Table 2.14 2009 AND 2008 DoDSER SUICIDE EVENTS BY MONTH

2009 2008

Count Percent Count Percent

MONTH January 27 9% 22 9%

February 33 11% 15 6%

March 19 6% 18 7%

April 24 8% 21 9%

May 29 10% 20 8%

June 24 8% 19 8%

July 29 10% 23 9%

August 21 7% 20 8%

September 16 5% 20 8%

October 32 11% 20 8%

November 21 7% 26 11%

December 22 7% 19 8%

27

33

19

24

29

24

29

21

16

32

21 22 22

15

18

21 20 19

23

20 20 20

26

19

0

5

10

15

20

25

30

35

40

Count

2009

2008
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 25

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be 

associated with subsequent suicidal behavior. These factors include data on prior self-harm, previous 

diagnoses of behavioral health disorders and behavioral health issues, and relevant treatment histories, 

including prescribed medication.

Prior Self-Injury

As can be seen in Table 2.15, prior self-injury was not reported for the majority of suicide decedents 

(58%, n=173 ). Ten percent (n=30) of individuals with a history of prior self-injury had one known prior 

incidence of self-injury. Seven percent (n=21) had a known history of more than one event. Data on 

whether the latest self-injury was similar to prior self-injuries as well as the time between previous and 

latest event are also included in Table 2.15.

Table 2.15 2009 AND 2008 DoDSER PRIOR SELF-INJURY

2009 2008

Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 51 17% 33 14%

 Within 30 days 12 4% 6 2%

 Within 90 days (inclusive)* 23 8% 12 5%

No 173 58% 111 46%

Don't Know 73 25% 99 41%

 Number prior self-injuries One prior event 30 10% --- --- 

More than one prior event 21 7% --- ---

N/A 246 83% --- ---

 Event similar to prior self-injury Yes 9 3% 6 2%

No 30 10% 21 9%

Don't Know 12 4% 6 2%

N/A 246 83% 210 86%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 26

Behavioral Health Disorders

Figure 2.4 shows the behavioral health disorders reported for decedents in 2009.

Figure 2.4 2009 DoDSER BEHAVIORAL HEALTH DISORDERS

Forty-two percent (n=126) of decedents had a history of at least one behavioral health disorder (Table 

2.16). Twenty-five percent (n=75) of decedents had been diagnosed with a mood disorder, including

major depression (n=34), dysthymic disorder (n=5), bipolar disorder (n=2), and other mood disorders 

(n=15) (Table 2.17). Eighteen percent (n=53) had been diagnosed with an anxiety disorder, including 

with posttraumatic stress disorder (PTSD), 6% (n=19) (Table 2.18). Three had been diagnosed with a 

psychotic disorder (one diagnosed within 30 days of the suicide) (Table 2.19). Five percent (n=15) of 

decedents had been diagnosed with a personality disorder, and 22% (n=64) had a history of a substance 

abuse disorder.

Table 2.16 2009 AND 2008 DoDSER COMORBIDITY RATES

2009 2008

Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 171 58% 164 67%

1 DX 66 22% 55 23%

2 DX 37 12% 11 5%

3 DX 13 4% 10 4%

4 or more DX 10 3% 3 1%

25%

11%

18%

6%

21% 17%

5%

1% 0

10

20

30

40

50

60

70

80

90

100

Percentage
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 27

Table 2.17 2009 AND 2008 DoDSER MOOD DISORDERS

2009 2008

Count Percent Count Percent

DX W/ MOOD DISORDER Yes 75 25% 46 19%

No 178 60% 142 58%

Don't Know 44 15% 55 23%

 Bipolar disorder Yes 2 1% 2 1%

No 239 80% 175 72%

Don't Know 56 19% 66 27%

 Major depression Yes 34 11% 13 5%

No 211 71% 167 69%

Don't Know 52 18% 63 26%

 Dysthymic disorder Yes 5 2% 2 1%

No 234 79% 176 72%

Don't Know 58 20% 65 27%

 Other mood disorder Yes 15 5% 21 9%

No 226 76% 156 64%

Don't Know 56 19% 66 27%

 Unspecified mood disorder Yes 9 3% 6 2%

No 244 82% 182 75%

Don't Know 44 15% 55 23%

 Multiple mood DX Yes 10 3% 2 1%

No 243 82% 186 77%

Don't Know 44 15% 55 23%

Table 2.18 2009 AND 2008 DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

DX W/ ANXIETY DISORDER Yes 53 18% 25 10%

No 196 66% 165 68%

Don't Know 48 16% 53 22%

 PTSD Yes 19 6% 6 2%

No 225 76% 176 72%

Don't Know 53 18% 61 25%

 Panic disorder Yes 0 0% 1 <1%

No 243 82% 179 74%

Don't Know 54 18% 63 26%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 28

Table 2.18 2009 AND 2008 DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

 Generalized anxiety disorder Yes 3 1% 1 <1%

No 241 81% 180 74%

Don't Know 53 18% 62 26%

 Acute stress disorder Yes 0 0% 1 0%

No 243 82% 181 74%

Don't Know 54 18% 61 25%

 Other anxiety disorder Yes 15 5% 6 2%

No 229 77% 174 72%

Don't Know 53 18% 63 26%

 Unspecified anxiety DX Yes 5 2% 4 2%

No 244 82% 186 77%

Don't Know 48 16% 53 22%

 Multiple anxiety DX Yes 11 4% 6 2%

No 238 80% 184 76%

Don't Know 48 16% 53 22%

Table 2.19 2009 AND 2008 DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

2009 2008

Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 15 5% 12 5%

No 230 77% 175 72%

Don't Know 52 18% 56 23%

DX W/PSYCHOTIC DISORDER Yes 3 1% 2 1%

No 245 82% 187 77%

Don't Know 49 16% 54 22%

HX SUBSTANCE ABUSE Yes 64 22% 49 20%

No 170 57% 134 55%

Don't Know 63 21% 60 25%

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 29

Treatment

Figure 2.5 displays the history of decedents’ visits to treatment programs and clinics prior to dying by 

suicide.

Figure 2.5 2009 DoDSER TREATMENT HISTORY

Table 2.20 shows the number of Service Members who had ever been seen in a program or clinic, had 

been seen within 30 days and 90 days of suicide. DoDSER respondents were instructed to select all 

categories that applied, thus they are not mutually exclusive.

A total of 175 (59%) of decedents were seen at military treatment facilities (MTFs) within the year 

preceding suicide. Of these, 12% (n=36) of decedents had been seen in MTFs within 90 days of the 

suicide and 36% (n=107) within 30 days. Twenty-one percent (n=63) had been treated in outpatient 

behavioral health facilities within 30 days of the suicide, and an additional 4% (n=10) within 90 days. 

Table 2.20 also summarizes information about visits to the other programs and broadly-defined 

behavioral health resources (i.e., Chaplain, Family Advocacy Programs, Alcohol and Substance Abuse 

Services, and Inpatient Behavioral Health Facilities) within 30 and 90 days. Forty-nine percent reportedly 

received medical, behavioral health, substance abuse, family or chaplaincy services within 30 days of 

death.

36%

48%

22%

25%

8% 8% 11% 9%

2%

6%

1% 3%

0

10

20

30

40

50

60

70

80

90

100

Within 30 Days Within 90 Days (inclusive)*

Percentage

*Data presented for "Within 90 days" includes all cases that reported the event "Within 30 days."

Military Treatment Facility

Outpatient Mental Health

Chaplain

Substance Abuse Services

Inpatient Mental Health

Family Advocacy Program
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 30

Table 2.20 2009 AND 2008 DoDSER TREATMENT HISTORY

2009 2008

Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 175 59% 126 52%

 Within 30 days 107 36% 71 29%

 Within 90 days (inclusive)* 143 48% 96 40%

No 80 27% 65 27%

Don't Know 42 14% 52 21%

SUBSTANCE ABUSE SERVICES Yes 49 16% 27 11%

 Within 30 days 24 8% 10 4%

 Within 90 days (inclusive)* 26 9% 15 6%

No 200 67% 163 67%

Don't Know 48 16% 53 22%

FAMILY ADVOCACY PROGRAMS Yes 20 7% 15 6%

 Within 30 days 4 1% 8 3%

 Within 90 days (inclusive)* 9 3% 9 4%

No 211 71% 169 70%

Don't Know 66 22% 59 24%

CHAPLAIN SERVICES Yes 38 13% 34 14%

 Within 30 days 24 8% 18 7%

 Within 90 days (inclusive)* 32 11% 25 10%

No 125 42% 103 42%

Don't Know 134 45% 106 44%

OUTPATIENT BEHAVIORAL HEALTH Yes 121 41% 80 33%

 Within 30 days 63 21% 41 17%

 Within 90 days (inclusive)* 73 25% 54 22%

No 138 46% 124 51%

Don't Know 38 13% 39 16%

INPATIENT BEHAVIORAL HEALTH Yes 45 15% 25 10%

 Within 30 days 7 2% 10 4%

 Within 90 days (inclusive)* 19 6% 13 5%

No 207 70% 165 68%

Don't Know 45 15% 53 22%

HX PHYSICAL HEALTH PROBLEM Yes 64 22% 49 20%

 Within 30 days 37 13% 27 11%

 Within 90 days (inclusive)* 44 15% 40 16%

No 166 56% 136 56%

Don't Know 67 23% 58 24%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 31

Table 2.21 summarizes decedents’ use of prescription psychotropic medication. Similar to 2008, history 

of psychotropic medication use was reported for 24% (n = 71) of decedents. Twenty-one percent (n = 

62) had taken antidepressants; 9% (n = 27) antianxiety medications; 5% (n = 15) anti-psychotics; and 2% 

(n = 7) anticonvulsants.

Table 2.21 2009 AND 2008 DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 71 24% 51 21%

No 162 55% 127 52%

Don't Know 64 22% 65 27%

 Antidepressants Yes 62 21% 43 18%

No 170 57% 131 54%

Don't Know 65 22% 69 28%

 Antianxiety Yes 27 9% 16 7%

No 202 68% 157 65%

Don't Know 68 23% 70 29%

 Antimanics Yes 2 1% 2 1%

No 227 76% 168 69%

Don't Know 68 23% 73 30%

 Anticonvulsants Yes 7 2% 5 2%

No 223 75% 165 68%

Don't Know 67 23% 73 30%

 Antipsychotics Yes 15 5% 6 2%

No 215 72% 165 68%

Don't Know 67 23% 72 30%

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These 

data include information about family histories and interpersonal relationships, legal, financial and 

administrative difficulties, and reports of prior abuse.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 32

Family and Relationship History

Figure 2.6 shows the percentages of decedents who experienced failed intimate and non-intimate 

relationships prior to suicide.

Figure 2.6 2009 HISTORY OF FAILED RELATIONSHIPS

Table 2.22 provides data regarding relationship history factors. Failed marital or intimate relationships 

were reported for 51% (n=150) of Service Members who died by suicide. In addition, other failed 

relationships (non-intimate) were reported for 13% (n=39) of suicide decedents. Fifty-three percent 

(n=158) of decedents were reported to have experienced failure of either an intimate or non-intimate 

relationship prior to death.

Similar to 2008, most of these failed relationships occurred shortly before the suicide. Twenty-seven 

percent (n=81) of decedents had a reported intimate relationship failure within 30 days of the suicide.

Other failed relationships occurred within 30 days of the events for 8% (n=24) of suicides.

51%

13%

27%

8%

26%

48%

24%

39%

0

10

20

30

40

50

60

70

80

90

100

HX Failed Intimate 

Relationship

HX Failed Other 

Relationship

Percentage

Yes

Within 30 days

No

Don't Know
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 33

Table 2.22 2009 AND 2008 DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 150 51% 127 52%

 Within 30 days 81 27% 80 33%

 Within 90 days (inclusive)* 102 34% 105 43%

No 76 26% 58 24%

Don't Know 71 24% 58 24%

HX FAILED OTHER RELATIONSHIP Yes 39 13% 35 14%

 Within 30 days 24 8% 19 8%

 Within 90 days (inclusive)* 27 9% 26 11%

No 142 48% 106 44%

Don't Know 116 39% 102 42%

HX ANY FAILED RELATIONSHIP Yes 158 53% 137 56%

 Within 30 days 88 30% 88 36%

 Within 90 days (inclusive)* 109 37% 112 46%

No 72 24% 50 21%

Don't Know 67 23% 56 23%

As indicated in Table 2.23, there was a reported history of recent spousal or family death, other than by 

suicide, for 6% (n=18) of suicides (n=6 within three months). There was also a reported history of a 

chronic spousal or family severe illness for 6% (n=19) of suicides (n=11 within three months). A family 

history of behavioral health illness or suicide was reported for 15% (n=44) of decedents, with one 

spousal suicide occurring within 30 days. These rates are probably underestimates because “don’t 

know” responses were fairly common for all of these risk factors.

Table 2.23 2009 AND 2008 DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX SPOUSE SUICIDE Yes 1 <1% 1 <1%

No 249 84% 177 73%

Don't Know 47 16% 65 27%

HX FAMILY MEMBER SUICIDE Yes 12 4% 11 5%

No 190 64% 119 49%

Don't Know 95 32% 113 47%

HX FRIEND SUICIDE Yes 5 2% 3 1%

No 173 58% 122 50%

Don't Know 119 40% 118 49%
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 34

Table 2.23 2009 AND 2008 DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX DEATH OF FAMILY MEMBER Yes 18 6% 17 7%

No 175 59% 117 48%

Don't Know 104 35% 109 45%

HX DEATH OF FRIEND Yes 9 3% 12 5%

No 160 54% 101 42%

Don't Know 128 43% 130 53%

HX FAMILY ILLNESS Yes 19 6% 12 5%

No 180 61% 110 45%

Don't Know 98 33% 121 50%

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 44 15% 21 9%

No 90 30% 46 19%

Don't Know 163 55% 176 72%

Administrative and Legal History

Figure 2.7 shows the percentage of decedents who experienced administrative or legal difficulties prior 

to suicide.

Figure 2.7 2009 ADMINISTRATIVE/LEGAL HISTORY

A history of Article 15 proceedings were reported for 15% of decedents (n=46) and a history of civil legal 

problems were reported among 12% of completions (n=36). At some point during their service, 8% of 

decedents (n=25) were reportedly subjects of administrative separation proceedings and 10% (n=30) 

7%

10%

7%

9%

6%

10%

5%

8%

3%

5%

3%

6%

2%

4%

0

5

10

15

20

25

Within 30 days Within 90 days

Percentage

HX Article 15

HX AWOL

HX Civil Legal Problems

HXAdmin Separation

HX Courts Martial

HX Medical Board

HX Non-Selection

(cont.)
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 35

were subjects of AWOL/desertion proceedings. Further, 6% (n=19) of decedents had a history of courts 

martial proceedings. Other administrative and legal risk factors were less commonly reported. (Table 

2.24)

Table 2.24 2009 AND 2008 DoDSER ADMIN/LEGAL HISTORY

2009 2008

Count Percent Count Percent

HX COURTS MARTIAL Yes 19 6% 3 1%

No 235 79% 199 82%

Don't Know 43 14% 41 17%

HX ARTICLE 15 Yes 46 15% 26 11%

No 177 60% 92 38%

Don't Know 74 25% 125 51%

HX ADMIN SEPARATION Yes 25 8% 14 6%

No 230 77% 180 74%

Don't Know 42 14% 49 20%

HX AWOL Yes 30 10% 14 6%

No 229 77% 182 75%

Don't Know 38 13% 47 19%

HX MEDICAL BOARD Yes 24 8% 9 4%

No 235 79% 185 76%

Don't Know 38 13% 49 20%

HX CIVIL LEGAL PROBLEMS Yes 36 12% 32 13%

No 194 65% 151 62%

Don't Know 67 23% 60 25%

HX NON-SELECTION Yes 23 8% 10 4%

No 219 74% 155 64%

Don't Know 55 19% 78 32%

Abuse History

Seven percent (n=20) of decedents had a history of physical abuse, 4% (n=13) had a history of sexual 

abuse, and 7% (n=21) had a history of emotional abuse. Sexual harassment was reported for one suicide 

in 2009. Abuse in which the decedent was the perpetrator was not frequently indicated, although 

DoDSERs for 9% (n=26) of decedents reported that they had been alleged or confirmed perpetrators of 

physical abuse and that 3% (n=10) had been alleged or confirmed perpetrators of sexual abuse. Table 

2.25 provides additional 2009 DoDSER abuse history.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 36

Table 2.25 2009 AND 2008 DoDSER ABUSE HISTORY

2009 2008

Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 20 7% 10 4%

No 176 59% 115 47%

Don't Know 101 34% 118 49%

HX VICTIM SEXUAL ABUSE Yes 13 4% 6 2%

No 183 62% 122 50%

Don't Know 101 34% 115 47%

HX VICTIM EMOTIONAL ABUSE Yes 21 7% 11 5%

No 171 58% 113 47%

Don't Know 105 35% 119 49%

HX VICTIM SEXUAL HARASSMENT Yes 1 <1% 0 0%

No 188 63% 126 52%

Don't Know 108 36% 117 48%

HX PERPETRATOR PHYSICAL ABUSE Yes 26 9% 13 5%

No 173 58% 116 48%

Don't Know 98 33% 114 47%

HX PERPETRATOR SEXUAL ABUSE Yes 10 3% 9 4%

No 183 62% 124 51%

Don't Know 104 35% 110 45%

HX PERPETRATOR EMOTIONAL ABUSE Yes 9 3% 8 3%

No 179 60% 122 50%

Don't Know 109 37% 113 47%

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 5 2% 3 1%

No 185 62% 129 53%

Don't Know 107 36% 111 46%

Financial and Workplace Difficulties

Excessive debt or bankruptcy was reported for 11% (n=32) of suicides. A history of job problems was

reported for 27% (n=81) of decedents. A history of supervisor or co-worker issues was reported for 14% 

(n=42) of suicides. Additional information related to job or employment difficulties is presented in Table 

2.26.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 37

Table 2.26 2009 AND 2008 DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES

2009 2008

Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 32 11% 25 10%

No 161 54% 125 51%

Don't Know 104 35% 93 38%

HX JOB LOSS/INSTABILITY Yes 81 27% 44 18%

No 151 51% 149 61%

Don't Know 65 22% 50 21%

HX SUPERVISOR/COWORKER ISSUES Yes 42 14% 26 11%

No 179 60% 136 56%

Don't Know 76 26% 81 33%

HX POOR WORK EVALUATION Yes 50 17% 27 11%

No 185 62% 145 60%

Don't Know 62 21% 71 29%

HX UNIT/WORKPLACE HAZING Yes 5 2% 2 1%

No 208 70% 158 65%

Don't Know 84 28% 83 34%

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Member’s most recent three 

deployments. Data includes deployment location information as well as a history of direct combat 

operations. Comparisons of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) suicide 

events to non-OEF/OIF suicide events are reported in Chapter 3.

Deployment History

Table 2.27 summarizes OEF/OIF deployment history information for the most commonly reported 

deployment locations: Afghanistan, Iraq, and Kuwait. Fifty-one percent of decedents (n=152) had 

deployed at least once. Iraq was the most common deployment location reported for suicide decedents 

(37%, n=111), followed by Afghanistan (4%, n=11), and Kuwait (3%, n=9). Seven percent of decedents 

(n=21) reportedly had histories of multiple deployments to Iraq, Afghanistan, or Kuwait. See the 

individual Service chapters for additional information on suicide and deployment data.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 38

Table 2.27 2009 AND 2008 DoDSER EVER DEPLOYED TO OEF/OIF

2009 2008

Count Percent Count Percent

HX DEPLOYMENT OEF/OIF AFGHANISTAN 11 4% 10 4%

IRAQ 111 37% 83 34%

KUWAIT 9 3% 16 7%

MULTIPLE OEF/OIF LOCATIONS 21 7% 3 1%

NO HX OEF/OIF DEPLOYMENT 145 49% 131 54%

Combat History

Seventeen percent (n=51) of decedents had experienced direct combat operations, and 57% of these 

(n=29) had witnessed casualties (Table 2.28). Thirty-four (67% of those with combat experience) had 

participated in operations that resulted in combat casualty. Similar to 2008, the percentages of 

decedents who had experienced combat were generally low. These numbers reflect the response rate 

based on available data.

Table 2.28 2009 AND 2008 DoDSER COMBAT HISTORY

2009 2008

Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 51 17% 39 16%

 Combat Resulted in Injuries/Casualties 34 67% 22 56%

 Injured in Combat 10 20% 8 21%

 Witnessed in Combat 29 57% 20 51%

 Saw Dead Bodies in Combat 28 55% 17 44%

 Killed Others in Combat 12 24% 8 21%

NO DIRECT COMBAT HX 246 83% 204 84%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat.

Percentages for these items reflect proportion of those with combat experience.
DoDSER 2009 Annual Report

Chapter 2 DoD-Wide Results for Completed Suicides

Page | 39

Summary

This annual statistical report of the DoDSER provides statistics and analyses for DoD suicides that 

occurred in 2009. Data from 2008 DoDSERs are included for comparisons.

The AFMES identified 309 Service Member suicides in 2009 (Air Force = 46; Army = 164; Marine Corps = 

52; Navy = 47). A total of 297 DoDSERs were received in 2009 for a DoDSER submission compliance rate 

of 97% (based on 299 suicides confirmed as of 31 January 2010). Consistent with 2008 DoDSER data, 

individuals who were Caucasian, under the age of 25, junior enlisted (E1-E4), or had a GED or high school 

education were at increased risk for suicide relative to demographic comparison groups. Divorced 

individuals were almost three times more likely to die by suicide than were married persons.

Across Services, non-military firearms were the most frequently used method for suicide (41%, n=121). 

Military firearms were used in 18% (n=52) of suicides with a higher incidence in the Army and Marine

Corps than in the Air Force and Navy. Thirteen percent of suicides (n=39) died on deployment in 

OEF/OIF. Ten percent occurred while Service Members were on leave. Seven percent of Service 

Members who died by suicide had a history of multiple deployments to Iraq, Afghanistan, or Kuwait. A 

history of direct combat operations was reported for 17% (n=51) of decedents. Forty-eight percent of 

decedents (n=143) had been seen at a military treatment facility within three months prior to suicide 

(36% within 30 days of the suicide).

Failed marital or intimate relationships were reported for 51% (n=150) of decedents, and other failed 

relationships (non-intimate) were reported for 13% (n=39) of decedents. The most common legal 

problems were Article 15 proceedings (15%) and civil legal problems (12%). Seventeen percent of 

Service Members who died by suicide had a known history of prior self-injurious behavior. Twenty-eight

percent (n=82) had communicated their potential for self-harm prior to dying by suicide. Most 

decedents (57%) did not have a diagnosed behavioral health disorder reported. A total of 3% of 

decedents reportedly used both alcohol and drugs during the event. A history of job problems was 

reported for 27% (n=81) of decedents.
DoDSER 2009 Annual Report

Page | 40

Chapter 3

DoD-WIDE RESULTS FOR COMPLETED SUICIDES IN OEF/OIF AND NON-OEF/OIF LOCATIONS

For calendar year 2009, risk factors for suicide behaviors were reported for events that occurred during Operation Enduring Freedom/Operation 

Iraqi Freedom (OEF/OIF) deployments and for non-OEF/OIF events. Of the 43 OEF/OIF 2009 suicides reported by AFMES (as of 1 April 2010), 

Department of Defense Suicide Event Reports (DoDSERs) were submitted for 39 of the events. Complete DoDSER data tables are presented in 

this chapter and 2008 data are included for comparison. Although Table 3.1 shows all OEF/OIF suicides for 2009 (n=43), the subsequent tables in 

this chapter include only decedents for which DoDSERs were received (n=39 for 2008 and 2009). Interpretation of any relative differences 

between OEF/OIF decedents and others is complicated by the potential for cohort differences. For example, the military population that deploys 

may differ from the non-deployed cohort (which includes some who will never deploy due to health reasons or other factors). However, this 

data may be useful for forming hypotheses.

Table 3.1 2009 and 2008 SUICIDES IN OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

Count Percent Count Percent

COMPLETED SUICIDE Event occurred in OEF/OIF 43 14% 41 15%

Event occurred in other location 266 86% 225 85%

Note: Data provided by AFMES (as of 1 April 2010). Subsequent data tables in Chapter 3 include OEF/OIF events for which there are DoDSERs (n=39).

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that may have been associated with or 

contributed to the suicides. These factors include decedents’ demographic characteristics, event setting, suicide method, substance use during 

the event, possible motive and intent to die, and communication of intent with others.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 41

Demographics

Table 3.2 summarizes 2009 suicide demographic data based on DoDSER data collected on OEF/OIF events and non-OEF/OIF events. It was not 

possible to use the DMDC demographic data described in Chapter 2 because the aggregated data received did not identify the OEF/OIF cases. 

Therefore, it was not possible to calculate suicide rates by demographic characteristics. However, DoDSER data showed that:

• The majority of suicides were completed by men for both OEF/OIF events (97%, n=38) and non-OEF/OIF events (97%, n=252).

• Most OEF/OIF suicides were completed by Caucasians (64%, n=25), followed by African Americans (18%, n=7). This trend was the same for 

non-OEF/OIF events.

• Suicide was more common among persons under age 25 for both of OEF/OIF (59%, n=23) and non-OEF/OIF events (44%, n=115).

• Most suicides (72%, n=28) were completed by junior enlisted (E1-E4) personnel followed by middle to senior (E5-E9) enlisted personnel 

(23%, n=9). This trend was identical for non-OEF/OIF events.

• The highest level of education for the majority of decedents in 2009 was high school graduate for both OEF/OIF events (62%, n=24) and nonOEF/OIF events (46%, n=118).

• Approximately half of the suicides (51%, n=20) were completed by persons who were never married followed by married persons (36%, 

n=14) for OEF/OIF events, whereas for non-OEF/OIF suicides, approximately half (51%, n=133) were completed by married persons followed 

by never married persons (33%, n=85).

• Consistent with non-OEF/OIF events, the majority of suicides were completed by Regular Active Duty personnel (90%, n=35).

• Demographic base rates for the OEF/OIF population would be helpful to interpret relative differences noted. For example, it is possible that 

the deployed population is comprised of a higher rate of young, junior enlisted Service Members than the general military population.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 42

Table 3.2 2009 AND 2008 DoDSER DEMOGRAPHICS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

GENDER Male 38 97% 252 97% 35 90% 196 96%

Female 1 3% 7 3% 4 10% 9 4%

RACE Asian/Pacific Islander 1 3% 9 3% 2 5% 7 3%

African American 7 18% 25 10% 6 16% 22 11%

Caucasian 25 64% 169 65% 23 61% 140 69%

Hispanic 1 3% 9 3% 0 0% 7 3%

Other/Don’t Know/Missing 5 13% 47 18% 7 18% 27 13%

AGE RANGE Under 25 23 59% 115 44% 21 54% 100 49%

25-29 10 26% 62 24% 8 21% 41 20%

30-39 4 10% 60 23% 6 15% 41 20%

40 + 2 5% 22 8% 4 10% 23 11%

RANK E1-E4 28 72% 137 53% 28 72% 103 50%

E5-E9 9 23% 99 38% 7 18% 82 40%

Officer 2 5% 18 7% 4 10% 16 8%

Warrant Officer 0 0% 3 1% 0 0% 2 1%

Cadet/Midshipman 0 0% 2 1% 0 0% 1 <1%

Does Not Apply 0 0% 0 0% 0 0% 1 <1%

COMPONENT Regular 35 90% 245 95% 35 90% 193 94%

Reserve 1 3% 6 2% 1 3% 5 2%

National Guard 3 8% 7 3% 3 8% 7 3%

Other 0 0% 1 <1% 0 0% 0 0%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 43

Table 3.2 2009 AND 2008 DoDSER DEMOGRAPHICS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

EDUCATION Some high school, did not graduate 0 0% 2 1% 0 0% 0 0%

GED 4 10% 11 4% 2 5% 5 2%

High school graduate 24 62% 118 46% 13 33% 76 37%

Some college or technical school, no 

degree or certificate

4 10% 45 17% 5 13% 16 8%

College degree of less than four years or 

technical school certificate

1 3% 7 3% 0 0% 5 2%

Four-year college degree 2 5% 10 4% 1 3% 15 7%

Master’s degree or greater 1 3% 9 3% 2 5% 5 2%

Don’t Know 3 8% 57 22% 16 41% 83 40%

MARITAL STATUS Never Married 20 51% 85 33% 20 51% 68 33%

Married 14 36% 133 51% 16 41% 103 50%

Legally Separated 1 3% 5 2% 0 0% 8 4%

Divorced 4 10% 28 11% 0 0% 15 7%

Widowed 0 0% 1 <1% 0 0% 0 0%

Don’t Know 0 0% 7 3% 3 8% 11 5%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 44

Event Setting

Table 3.3 shows the settings in which the suicides occurred. Similar to non-OEF/OIF events, the majority of suicides occurred in decedents’ 

residences, including military residences (62%, n=24). Thirteen percent (n=5) of OEF/OIF suicides occurred at places of work or job sites

compared to 5% (n=12) for non- OEF/OIF suicides. Twenty-six percent (n=10) occurred at other settings for OEF/OIF events and 20% (n=52) for 

non-OEF/OIF events.

Table 3.3 2009 AND 2008 DoDSER EVENT SETTING FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 24 62% 154 60% 20 51% 118 58%

Residence of friend or family 0 0% 24 9% 0 0% 18 9%

Work/jobsite 5 13% 12 5% 11 28% 11 5%

Automobile (away from residence) 0 0% 16 6% 0 0% 16 8%

Inpatient medical facility 0 0% 0 0% 0 0% 1 <1%

Other 10 26% 52 20% 8 21% 40 20%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 45

Event Method

Figure 3.1 shows the methods decedents chose for suicide in 2009.

Figure 3.1 2009 METHODS FOR OEF/OIF AND OTHER SUICIDES

97%

<1% <1% 3%

6%

46%

26%

22%

0

10

20

30

40

50

60

70

80

90

100

Firearm, 

military issue

Firearm, nonmilitary issueHanging Other

Percentage

OEF/OIF

Other
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 46

Methods of suicide for OEF/OIF events in 2009 and 2008 are displayed in Table 3.4. Military firearms were the most commonly reported method 

for OEF/OIF suicides (97%, n=38). For non-OEF/OIF suicides, the most commonly reported method was non-military issue firearm 47% (n=121),

followed by hanging 27% (n=70).

Table 3.4 2009 AND 2008 DoDSER EVENT METHOD FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

EVENT METHOD Drugs 0 0% 10 4% 2 5% 9 4%

Alcohol 0 0% 1 <1% 0 0% 1 <1%

Gas, vehicle exhaust 0 0% 11 4% 0 0% 6 3%

Gas, utility (or other) 0 0% 5 2% 0 0% 1 0%

Hanging 0 0% 70 27% 0 0% 51 25%

Drowning 0 0% 0 0% 0 0% 1 <1%

Firearm, military issue 38 97% 14 5% 37 95% 14 7%

Firearm, non-military issue 0 0% 121 47% 0 0% 102 50%

Fire, steam, etc. 0 0% 0 0% 0 0% 1 <1%

Sharp or blunt object 0 0% 7 3% 0 0% 2 1%

Jumping from high place 0 0% 5 2% 0 0% 3 1%

Lying in front of moving object 0 0% 2 1% 0 0% 1 <1%

Crashing a motor vehicle 0 0% 0 0% 0 0% 1 <1%

Other 1 3% 11 4% 0 0% 4 2%

Don't Know 0 0% 1 <1% 0 0% 7 3%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 47

Substance Use during the Event

Three percent (n=1) of submitted DoDSERs for 2009 indicated that drugs were used during events that took place in OEF/OIF, compared to 7% 

(n=18) for non-OEF/OIF events (Table 3.5). The majority of DoDSERs had a “don’t know” response. Percentages of “yes” responses are likely an 

underestimate, as a significant number of cases did not have access to information about substance use, presumably because autopsy results 

were not available at the time of the DoDSER submission.

Table 3.5 2009 AND 2008 DoDSER SUBSTANCE(S) USED DURING EVENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

ALCOHOL USED Yes 0 0% 66 26% 0 0% 55 27%

No 26 67% 89 34% 25 64% 70 34%

Don’t Know 13 33% 103 40% 14 36% 79 39%

ANY DRUGS USED Yes 1 3% 18 7% 2 5% 15 7%

No 25 64% 115 45% 21 54% 101 50%

Don’t Know 13 33% 125 48% 16 41% 88 43%

 Illegal drugs Overdose 0 0% 0 0% 0 0% 1 <1%

Used, no overdose 0 0% 2 1% 0 0% 0 0%

Were not used 26 67% 131 51% 23 59% 108 53%

Don’t Know 13 33% 125 48% 16 41% 95 47%

 Prescription drugs Overdose 0 0% 8 3% 2 5% 9 4%

Used, no overdose 1 3% 2 1% 0 0% 4 2%

Were not used 25 64% 123 48% 21 54% 102 50%

Don’t Know 13 33% 125 48% 16 41% 89 44%

 OTC drugs Overdose 0 0% 2 1% 0 0% 5 2%

Used, no overdose 0 0% 5 2% 1 3% 1 <1%

Were not used 26 67% 126 49% 22 56% 104 51%

Don’t Know 13 33% 125 48% 16 41% 94 46%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 48

Table 3.5 2009 AND 2008 DoDSER SUBSTANCE(S) USED DURING EVENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

BOTH ALCOHOL AND DRUGS USED Yes 0 0% 9 3% 0 0% 6 3%

No 26 67% 121 47% 23 59% 108 53%

Don’t Know 13 33% 128 50% 16 41% 90 44%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicate their potential for self-harm. The majority of

decedents for both OEF/OIF and non-OEF/OIF events had no known history of communicating their potential for self-harm before taking their 

lives (Table 3.6). For OEF/OIF events, 13% (n=5) were known to communicate their potential for self-harm before dying by suicide, and at least 

two Service Members who died by suicide (5%) reported this potential to multiple persons in a variety of roles (Table 3.7). Of the five OEF/OIF 

event decedents known to have communicated their potential for self-harm before dying by suicide, three (8%) communicated the message 

verbally.

Table 3.6 2009 AND 2008 DoDSER RECIPIENTS OF COMMUNICATED INTENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

COMMUNICATION Friend 5 13% 23 9% 2 5% 18 9%

Behavioral Health Staff 1 3% 15 6% 1 3% 10 5%

Supervisor 2 5% 9 3% 1 3% 6 3%

Spouse 0 0% 38 15% 1 3% 28 14%

Chaplain 0 0% 4 2% 1 3% 3 1%

Other 1 3% 29 11% 1 3% 28 14%

Made Multiple Communication 2 5% 28 11% 0 0% 20 10%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 49

Table 3.7 2009 AND 2008 DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 34 87% 180 70% 32 82% 136 67%

1 3 8% 50 19% 7 18% 48 24%

2 1 3% 20 8% 0 0% 15 7%

3 0 0% 5 2% 0 0% 5 2%

4 1 3% 2 1% 0 0% 0 0%

5 0 0% 1 <1% 0 0% 0 0%

For OEF/OIF suicides, Service Members most commonly shared their potential for self-harm with friends and “others.” For non-OEF/OIF events, 

Service Members most commonly disclosed their potential for self-harm to spouses, followed by friends and “others”4 (Table 3.8).

Table 3.8 2009 AND 2008 DoDSER MODE OF COMMUNICATED INTENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 3 8% 44 17% 6 15% 38 19%

Written Only 1 3% 6 2% 1 3% 2 1%

Other 0 0% 18 7% 0 0% 9 4%

Multiple Modes 1 3% 11 4% 0 0% 11 5%

Note: Multiple Modes includes a combination of verbal, written, or other mode of communicating intent to suicide.

 4 The category “other” includes a variety of co-workers and non-spousal family members.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 50

Additional Event Information

The information in this section includes data on whether alcohol or other drugs were used during the suicide (not necessarily as a method for 

self-harm), whether there is evidence the Service Member intended to die, and whether the decedent communicated potential for self-harm.

Additional items in this section pertain to evidence of death-risk gambling such as Russian roulette or walking railroad tracks, planned or 

premeditated acts, and whether suicides were completed in areas or under circumstances in which the behavior was likely to be observed. As 

can be seen in Table 3.9, there was evidence that decedents intended to die for 90% (n=35) of OEF/OIF suicides. Fifteen OEF/OIF suicides 

appeared planned or premeditated and most took place where it was unlikely that others could observe or intervene (77%, n=30). A suicide note 

was reported to have been found for 28% (n=11) of OEF/OIF suicides.

Table 3.9 2009 AND 2008 DoDSER OTHER EVENT INFORMATION FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

INTENDED TO DIE Yes 35 90% 191 74% 29 74% 142 70%

No 2 5% 14 5% 1 3% 14 7%

Don't Know 2 5% 53 21% 9 23% 48 24%

DEATH RISK GAMBLING Yes 0 0% 4 2% 1 3% 4 2%

No 36 92% 216 84% 31 79% 139 68%

Don't Know 3 8% 38 15% 7 18% 61 30%

PLANNED/PREMEDITATED Yes 15 38% 102 40% 15 38% 77 38%

No 9 23% 77 30% 10 26% 55 27%

Don't Know 15 38% 79 31% 14 36% 72 35%

OBSERVABLE Yes 5 13% 56 22% 5 13% 42 21%

No 30 77% 174 67% 30 77% 113 55%

Don't Know 4 10% 28 11% 4 10% 49 24%

SUICIDE NOTE LEFT Yes 11 28% 63 24% 11 28% 44 22%

No 20 51% 140 54% 16 41% 96 47%

Don't Know 8 21% 55 21% 12 31% 64 31%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 51

Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty environments.

Home Environment

As can be seen in Table 3.10, Service Members most often lived with others for both OEF/OIF suicides (82%, n=32) and non-OEF/OIF suicides 

(53%, n=137). 31% (n=12) of OEF/OIF decedents were reported to have minor children. As expected, only two OEF/OIF decedents did not have 

access to firearms.

Table 3.10 2009 AND 2008 DoDSER HOME ENVIRONMENT FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

RESIDED ALONE Yes 5 13% 97 38% 5 13% 54 26%

No 32 82% 136 53% 31 79% 116 57%

Don't Know 2 5% 25 10% 3 8% 34 17%

HAD MINOR CHILDREN Yes 12 31% 99 38% 13 33% 66 32%

No 23 59% 135 52% 20 51% 96 47%

Don't Know 4 10% 24 9% 6 15% 42 21%

FIREARM IN IMMEDIATE/LIVING 

ENVIRONMENT

Yes 32 82% 114 44% 34 87% 99 49%

No 2 5% 77 30% 0 0% 36 18%

Don't Know 5 13% 67 26% 5 13% 69 34%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

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Suicide Completions by Month

Table 3.11 shows suicide counts by month for the combined Services for both OEF/OIF events and non-OEF/OIF events.

Table 3.11 2009 AND 2008 DoDSER SUICIDE EVENTS BY MONTH FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

MONTH January 4 10% 23 9% 2 5% 20 10%

February 2 5% 31 12% 3 8% 12 6%

March 4 10% 15 6% 1 3% 17 8%

April 7 18% 17 7% 4 10% 17 8%

May 5 13% 24 9% 3 8% 17 8%

June 2 5% 22 9% 5 13% 14 7%

July 1 3% 28 11% 4 10% 19 9%

August 2 5% 19 7% 5 13% 15 7%

September 1 3% 15 6% 4 10% 16 8%

October 3 8% 29 11% 2 5% 18 9%

November 5 13% 16 6% 3 8% 23 11%

December 3 8% 19 7% 3 8% 16 8%

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be associated with subsequent suicidal 

behavior. These factors include data on prior self-harm, previous diagnoses of behavioral health disorders and behavioral health issues, and 

relevant treatment histories, including prescribed medication.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 53

Prior Self-Injury

As can be seen in Table 3.12, prior self-injury was not reported for the majority of suicide decedents for both OEF/OIF events (64%, n=25) and 

non-OEF/OIF events (58%, n=148). Five percent (n=2) of OEF/OIF decedents with a history of self-injury had one prior event compared to 11% 

(n=28) for non-OEF/OIF decedents. Similar to non-OEF/OIF decedents, 8% (n=3) of OEF/OIF decedents had a history of more than one event. 

Data on whether the latest self-injury was similar to prior self-injuries and the time between previous and latest events are also shown in Table 

3.12.

Table 3.12 2009 AND 2008 DoDSER PRIOR SELF-INJURY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 5 13% 46 18% 4 10% 29 14%

 Within 30 days 1 3% 11 4% 0 0% 6 3%

 Within 90 days (inclusive)* 1 3% 22 9% 1 3% 11 5%

No 25 64% 148 57% 17 44% 94 46%

Don't Know 9 23% 64 25% 18 46% 81 40%

 Number prior self-injuries One prior event 2 5% 28 11% ---- ---- ---- ----

More than one prior event 3 8% 18 7% ---- ---- ---- ----

N/A 34 87% 212 82% ---- ---- ---- ----

 Event similar to prior self-injury Yes 0 0% 9 3% 0 0% 6 3%

No 3 8% 27 10% 4 10% 17 8%

Don't Know 2 5% 10 4% 0 0% 6 3%

N/A 34 87% 212 82% 35 90% 175 86%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

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Behavioral Health Disorders

Twenty-eight percent (n=11) of OEF/OIF decedents had a history of at least one behavioral health disorder compared to 45% (n =115) for nonOEF/OIF decedents (Table 3.13). As shown in Table 3.14, 10% (n=4) of decedents had been diagnosed with a mood disorder, including major 

depression (n=1) and unspecified mood disorders (n=2). Thirteen percent (n=5) had been diagnosed with an anxiety disorder, including 

posttraumatic stress disorder (PTSD; 3%; Table 3.15). As indicated in Table 3.16, one decedent had been diagnosed with a psychotic disorder, 

one had been diagnosed with a personality disorder, and 15% (n=6) had a history of substance abuse.

Table 3.13 2009 AND 2008 DoDSER COMORBIDITY RATES FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 28 72% 143 55% 27 69% 137 67%

1 DX 7 18% 59 23% 6 15% 49 24%

2 DX 1 3% 36 14% 2 5% 9 4%

3 DX 2 5% 11 4% 4 10% 6 3%

4 or more DX 1 3% 9 3% 0 0% 3 1%

Table 3.14 2009 AND 2008 DoDSER MOOD DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

DX W/ MOOD DISORDER Yes 4 10% 71 28% 9 23% 37 18%

No 27 69% 151 59% 20 51% 122 60%

Don't Know 8 21% 36 14% 10 26% 45 22%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 55

Table 3.14 2009 AND 2008 DoDSER MOOD DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

 Bipolar disorder Yes 0 0% 2 1% 0 0% 2 1%

No 28 72% 211 82% 28 72% 147 72%

Don't Know 11 28% 45 17% 11 28% 55 27%

 Major depression Yes 1 3% 33 13% 4 10% 9 4%

No 28 72% 183 71% 24 62% 143 70%

Don't Know 10 26% 42 16% 11 28% 52 25%

 Dysthymic disorder Yes 0 0% 5 2% 0 0% 2 1%

No 28 72% 206 80% 29 74% 147 72%

Don't Know 11 28% 47 18% 10 26% 55 27%

 Other mood disorder Yes 0 0% 15 6% 5 13% 16 8%

No 28 72% 198 77% 24 62% 132 65%

Don't Know 11 28% 45 17% 10 26% 56 27%

 Unspecified mood disorder Yes 2 5% 7 3% 0 0% 6 3%

No 29 74% 215 83% 29 74% 153 75%

Don't Know 8 21% 36 14% 10 26% 45 22%

 Multiple mood DX Yes 1 3% 9 3% 0 0% 2 1%

No 30 77% 213 83% 29 74% 157 77%

Don't Know 8 21% 36 14% 10 26% 45 22%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 56

Table 3.15 2009 AND 2008 DoDSER ANXIETY DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

DX W/ ANXIETY DISORDER Yes 5 13% 48 19% 5 13% 20 10%

No 24 62% 172 67% 24 62% 141 69%

Don't Know 10 26% 38 15% 10 26% 43 21%

 PTSD Yes 1 3% 18 7% 2 5% 4 2%

No 27 69% 198 77% 25 64% 151 74%

Don't Know 11 28% 42 16% 12 31% 49 24%

 Panic disorder Yes 0 0% 0 0% 1 3% 0 0%

No 28 72% 215 83% 26 67% 153 75%

Don't Know 11 28% 43 17% 12 31% 51 25%

 Generalized anxiety disorder Yes 1 3% 2 1% 0 0% 1 <1%

No 28 72% 213 83% 26 67% 154 75%

Don't Know 10 26% 43 17% 13 33% 49 24%

 Acute stress disorder Yes 0 0% 0 0% 0 0% 1 <1%

No 28 72% 215 83% 26 67% 155 76%

Don't Know 11 28% 43 17% 13 33% 48 24%

 Other anxiety disorder Yes 1 3% 14 5% 1 3% 5 2%

No 27 69% 202 78% 26 67% 148 73%

Don't Know 11 28% 42 16% 12 31% 51 25%

 Unspecified anxiety DX Yes 0 0% 5 2% 0 0% 4 2%

No 29 74% 215 83% 29 74% 157 77%

Don't Know 10 26% 38 15% 10 26% 43 21%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 57

Table 3.15 2009 AND 2008 DoDSER ANXIETY DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

 Multiple anxiety DX Yes 2 5% 9 3% 1 3% 5 2%

No 27 69% 211 82% 28 72% 156 76%

Don't Know 10 26% 38 15% 10 26% 43 21%

Table 3.16 2009 AND 2008 DoDSER OTHER BEHAVIORAL HEALTH DISORDERS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 1 3% 14 5% 1 3% 11 5%

No 28 72% 202 78% 25 64% 150 74%

Don't Know 10 26% 42 16% 13 33% 43 21%

DX W/PSYCHOTIC DISORDER Yes 1 3% 2 1% 0 0% 2 1%

No 29 74% 216 84% 28 72% 159 78%

Don't Know 9 23% 40 16% 11 28% 43 21%

HX SUBSTANCE ABUSE Yes 6 15% 58 22% 7 18% 42 21%

No 24 62% 146 57% 20 51% 114 56%

Don't Know 9 23% 54 21% 12 31% 48 24%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 58

Treatment

Table 3.17 displays the history of decedents’ visits to treatment programs and clinics prior to suicide. The table displays the number of Service 

Members who had been seen in a program or clinic prior to death, including the 30 and 90 days prior to death. DoDSER respondents were 

instructed to select all categories that apply, thus they are not mutually exclusive.

A total of 16 (41%) Service members who completed suicide while in OEF/OIF were seen at military treatment facilities (MTFs) within the year 

preceding suicide. Of these, 26% (n=10) of decedents had been seen in MTFs within 90 days of the suicide and 18% (n=7) had been seen within 

30 days. Fifteen percent (n=6) had been seen in outpatient behavioral health facilities within 30 days of the suicide, and 21% (n=8) within 90 

days. Table 3.17 also summarizes information about visits to the other programs and broadly-defined behavioral health resources (i.e., Chaplain,

Family Advocacy Program, Alcohol and Substance Abuse Program, and Inpatient Behavioral Health facilities) within 30 and 90 days. Table 3.18

summarizes decedents’ prescription drug use.

Table 3.17 2009 AND 2008 DoDSER TREATMENT HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 16 41% 159 62% 19 49% 107 52%

 Within 30 days 7 18% 100 39% 12 31% 59 29%

 Within 90 days (inclusive)* 10 26% 133 52% 16 41% 80 39%

No 16 41% 64 25% 9 23% 56 27%

Don't Know 7 18% 35 14% 11 28% 41 20%

SUBSTANCE ABUSE SERVICES Yes 3 8% 46 18% 2 5% 25 12%

 Within 30 days 0 0% 24 9% 0 0% 10 5%

 Within 90 days (inclusive)* 0 0% 26 10% 0 0% 15 7%

No 27 69% 173 67% 25 64% 138 68%

Don't Know 9 23% 39 15% 12 31% 41 20%

FAMILY ADVOCACY PROGRAMS Yes 1 3% 19 7% 0 0% 15 7%

 Within 30 days 0 0% 4 2% 0 0% 8 4%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 59

Table 3.17 2009 AND 2008 DoDSER TREATMENT HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

 Within 90 days (inclusive)* 0 0% 9 3% 0 0% 9 4%

No 26 67% 185 72% 27 69% 142 70%

Don't Know 12 31% 54 21% 12 31% 47 23%

CHAPLAIN SERVICES Yes 8 21% 30 12% 9 23% 25 12%

 Within 30 days 7 18% 17 7% 7 18% 11 5%

 Within 90 days (inclusive)* 8 21% 24 9% 8 21% 17 8%

No 18 46% 107 41% 13 33% 90 44%

Don't Know 13 33% 121 47% 17 44% 89 44%

OUTPATIENT BEHAVIORAL HEALTH Yes 14 36% 107 41% 16 41% 64 31%

 Within 30 days 6 15% 57 22% 9 23% 32 16%

 Within 90 days (inclusive)* 8 21% 65 25% 11 28% 43 21%

No 18 46% 120 47% 18 46% 106 52%

Don't Know 7 18% 31 12% 5 13% 34 17%

INPATIENT BEHAVIORAL HEALTH Yes 2 5% 43 17% 3 8% 22 11%

 Within 30 days 0 0% 7 3% 0 0% 10 5%

 Within 90 days (inclusive)* 0 0% 19 7% 0 0% 13 6%

No 27 69% 180 70% 29 74% 136 67%

Don't Know 10 26% 35 14% 7 18% 46 23%

HX PHYSICAL HEALTH PROBLEM Yes 2 5% 62 24% 5 13% 44 22%

 Within 30 days 1 3% 36 14% 3 8% 24 12%

 Within 90 days (inclusive)* 1 3% 43 17% 5 13% 35 17%

No 26 67% 140 54% 25 64% 111 54%

Don't Know 11 28% 56 22% 9 23% 49 24%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 60

Table 3.18 2009 AND 2008 DoDSER PSYCHOTROPIC MEDICATION USE FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 5 13% 66 26% 11 28% 40 20%

No 24 62% 138 53% 19 49% 108 53%

Don't Know 10 26% 54 21% 9 23% 56 27%

 Antidepressants Yes 3 8% 59 23% 9 23% 34 17%

No 26 67% 144 56% 20 51% 111 54%

Don't Know 10 26% 55 21% 10 26% 59 29%

 Antianxiety Yes 2 5% 25 10% 4 10% 12 6%

No 27 69% 175 68% 24 62% 133 65%

Don't Know 10 26% 58 22% 11 28% 59 29%

 Antimanics Yes 0 0% 2 1% 0 0% 2 1%

No 29 74% 198 77% 27 69% 141 69%

Don't Know 10 26% 58 22% 12 31% 61 30%

 Anticonvulsants Yes 0 0% 7 3% 0 0% 5 2%

No 29 74% 194 75% 27 69% 138 68%

Don't Know 10 26% 57 22% 12 31% 61 30%

 Antipsychotics Yes 1 3% 14 5% 0 0% 6 3%

No 28 72% 187 72% 27 69% 138 68%

Don't Know 10 26% 57 22% 12 31% 60 29%

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These data include information about family 

histories and interpersonal relationships, legal, financial and administrative difficulties, and reports of prior abuse.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 61

Family and Relationship History

Table 3.19 reports relationship history factors. Failed marital or intimate relationships were reported for 46% (n=18) of OEF/OIF decedents. In 

addition, other failed relationships (non-intimate) were reported for 18% (n=7) of suicide decedents. Fifty-four percent (n=21) of decedents 

reportedly had a history of failure for either intimate or non-intimate relationship prior to death.

Most of these failed relationships occurred close in time to the suicidal behaviors for both OEF/OIF events and non-OEF/OIF events. Twenty-six 

percent (n=10) of OEF/OEF events had failed intimate relationships within 30 days of the suicide. Other failed relationships occurred within 30

days of the suicides for 15% (n=6) of OEF/OIF suicides.

Table 3.19 2009 AND 2008 DoDSER RELATIONSHIP HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 18 46% 132 51% 18 46% 109 53%

 Within 30 days 10 26% 71 28% 13 33% 67 33%

 Within 90 days (inclusive)* 13 33% 89 34% 15 38% 90 44%

No 10 26% 66 26% 9 23% 49 24%

Don't Know 11 28% 60 23% 12 31% 46 23%

HX FAILED OTHER RELATIONSHIP Yes 7 18% 32 12% 4 10% 31 15%

 Within 30 days 6 15% 18 7% 3 8% 16 8%

 Within 90 days (inclusive)* 7 18% 20 8% 3 8% 23 11%

No 16 41% 126 49% 13 33% 93 46%

Don't Know 16 41% 100 39% 22 56% 80 39%

HX ANY FAILED RELATIONSHIP Yes 21 54% 137 53% 19 49% 118 58%

 Within 30 days 14 36% 74 29% 15 38% 73 36%

 Within 90 days (inclusive)* 17 44% 92 36% 16 41% 96 47%

No 8 21% 64 25% 8 21% 42 21%

Don't Know 10 26% 57 22% 12 31% 44 22%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 62

There were also reported histories of recent spousal or family death (other than by suicide) for 5% (n=2) of OEF/OIF suicides, as shown in Table 

3.20. Chronic spousal or family severe illness was reported for 8% (n=3) of OEF/OIF suicides and family histories of behavioral health illness or 

suicide was reported for 18% (n=7) of decedents. These rates are similar to those of non-OEF/OIF suicides and are likely underestimates for both 

OEF/OIF and non-OEF/OIF events because “don’t know” responses were common for all risk factors.

Table 3.20 2009 AND 2008 DoDSER FAMILY HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX SPOUSE SUICIDE Yes 0 0% 1 <1% 0 0% 1 <1%

No 31 79% 218 84% 31 79% 146 72%

Don't Know 8 21% 39 15% 8 21% 57 28%

HX FAMILY MEMBER SUICIDE Yes 1 3% 11 4% 1 3% 10 5%

No 24 62% 166 64% 24 62% 95 47%

Don't Know 14 36% 81 31% 14 36% 99 49%

HX FRIEND SUICIDE Yes 1 3% 4 2% 0 0% 3 1%

No 24 62% 149 58% 24 62% 98 48%

Don't Know 14 36% 105 41% 15 38% 103 50%

HX DEATH OF FAMILY MEMBER Yes 2 5% 16 6% 2 5% 15 7%

No 24 62% 151 59% 23 59% 94 46%

Don't Know 13 33% 91 35% 14 36% 95 47%

HX DEATH OF FRIEND Yes 0 0% 9 3% 2 5% 10 5%

No 25 64% 135 52% 20 51% 81 40%

Don't Know 14 36% 114 44% 17 44% 113 55%

HX FAMILY ILLNESS Yes 3 8% 16 6% 2 5% 10 5%

No 22 56% 158 61% 19 49% 91 45%

Don't Know 14 36% 84 33% 18 46% 103 50%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 63

Table 3.20 2009 AND 2008 DoDSER FAMILY HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 7 18% 37 14% 5 13% 16 8%

No 11 28% 79 31% 7 18% 39 19%

Don't Know 21 54% 142 55% 27 69% 149 73%

Administrative and Legal History

Article 15 proceedings were reported for 10% (n=4) of OEF/OIF events compared to 16% (n=42) for non-OEF/OIF suicides. Civil legal problems 

were reported among 5% (n=2) of OEF/OIF events compared to 13% (n=34) of non-OEF/OIF suicides. Other administrative and legal risk factors 

were less commonly reported, as shown in Table 3.21.

Table 3.21 2009 AND 2008 DoDSER ADMIN/LEGAL HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX COURTS MARTIAL Yes 0 0% 19 7% 1 3% 2 1%

No 34 87% 201 78% 30 77% 169 83%

Don't Know 5 13% 38 15% 8 21% 33 16%

HX ARTICLE 15 Yes 4 10% 42 16% 7 18% 19 9%

No 29 74% 148 57% 19 49% 73 36%

Don't Know 6 15% 68 26% 13 33% 112 55%

HX ADMIN SEPARATION Yes 1 3% 24 9% 2 5% 12 6%

No 33 85% 197 76% 30 77% 150 74%

Don't Know 5 13% 37 14% 7 18% 42 21%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 64

Table 3.21 2009 AND 2008 DoDSER ADMIN/LEGAL HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX AWOL Yes 0 0% 30 12% 1 3% 13 6%

No 34 87% 195 76% 32 82% 150 74%

Don't Know 5 13% 33 13% 6 15% 41 20%

HX MEDICAL BOARD Yes 0 0% 24 9% 1 3% 8 4%

No 34 87% 201 78% 31 79% 154 75%

Don't Know 5 13% 33 13% 7 18% 42 21%

HX CIVIL LEGAL PROBLEMS Yes 2 5% 34 13% 4 10% 28 14%

No 30 77% 164 64% 25 64% 126 62%

Don't Know 7 18% 60 23% 10 26% 50 25%

HX NON-SELECTION Yes 2 5% 21 8% 1 3% 9 4%

No 31 79% 188 73% 25 64% 130 64%

Don't Know 6 15% 49 19% 13 33% 65 32%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 65

Abuse History

As shown in Table 3.22, 8% (n=3) of OEF/OIF events had a reported history of physical abuse, 5% (n=2) had a history of sexual abuse, and 10% 

(n=4) had a history of emotional abuse. Sexual harassment was reported for one OEF/OIF event. Abuse in which the decedent was the 

perpetrator was not frequently indicated, although DoDSERs for 8% (n=3) of OEF/OIF events reported that they had been alleged or confirmed 

perpetrators of physical abuse and that 5% (n=2) had been alleged or confirmed perpetrators of sexual abuse.

Table 3.22 2009 AND 2008 DoDSER ABUSE HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 3 8% 17 7% 2 5% 8 4%

No 28 72% 148 57% 16 41% 99 49%

Don't Know 8 21% 93 36% 21 54% 97 48%

HX VICTIM SEXUAL ABUSE Yes 2 5% 11 4% 2 5% 4 2%

No 29 74% 154 60% 17 44% 105 51%

Don't Know 8 21% 93 36% 20 51% 95 47%

HX VICTIM EMOTIONAL ABUSE Yes 4 10% 17 7% 2 5% 9 4%

No 26 67% 145 56% 16 41% 97 48%

Don't Know 9 23% 96 37% 21 54% 98 48%

HX VICTIM SEXUAL HARASSMENT Yes 1 3% 0 0% 0 0% 0 0%

No 29 74% 159 62% 19 49% 107 52%

Don't Know 9 23% 99 38% 20 51% 97 48%

HX PERPETRATOR PHYSICAL ABUSE Yes 3 8% 23 9% 0 0% 13 6%

No 25 64% 148 57% 22 56% 94 46%

Don't Know 11 28% 87 34% 17 44% 97 48%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 66

Table 3.22 2009 AND 2008 DoDSER ABUSE HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

HX PERPETRATOR SEXUAL ABUSE Yes 2 5% 8 3% 1 3% 8 4%

No 26 67% 157 61% 22 56% 102 50%

Don't Know 11 28% 93 36% 16 41% 94 46%

HX PERPETRATOR EMOTIONAL 

ABUSE

Yes 2 5% 7 3% 1 3% 7 3%

No 26 67% 153 59% 22 56% 100 49%

Don't Know 11 28% 98 38% 16 41% 97 48%

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 2 5% 3 1% 1 3% 2 1%

No 25 64% 160 62% 22 56% 107 52%

Don't Know 12 31% 95 37% 16 41% 95 47%

(cont.)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 67

Financial and Workplace Difficulties

Excessive debt or bankruptcy was reported for 13% (n=5) of OEF/OIF decedents compared to 10% (n=27) for non-OEF/OIF decedents. A history 

of job problems was reported for 36% (n=14) of OEF/OIF decedents compared to 26% (n=67) for non-OEF/OIF decedents. There was a greater 

percentage of reported history of supervisor or co-worker issues for OEF/OIF events (36%, n=14) compared to non-OEF/OIF suicides (11%, n=28).

Additional information related to job or employment difficulties is presented in Table 3.23.

Table 3.23 2009 AND 2008 DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 5 13% 27 10% 2 5% 23 11%

No 22 56% 139 54% 21 54% 104 51%

Don't Know 12 31% 92 36% 16 41% 77 38%

HX JOB LOSS/INSTABILITY Yes 14 36% 67 26% 9 23% 35 17%

No 17 44% 134 52% 21 54% 128 63%

Don't Know 8 21% 57 22% 9 23% 41 20%

HX SUPERVISOR/COWORKER ISSUES Yes 14 36% 28 11% 10 26% 16 8%

No 15 38% 164 64% 19 49% 117 57%

Don't Know 10 26% 66 26% 10 26% 71 35%

HX POOR WORK EVALUATION Yes 11 28% 39 15% 7 18% 20 10%

No 21 54% 164 64% 20 51% 125 61%

Don't Know 7 18% 55 21% 12 31% 59 29%

HX UNIT/WORKPLACE HAZING Yes 2 5% 3 1% 1 3% 1 <1%

No 23 59% 185 72% 24 62% 134 66%

Don't Know 14 36% 70 27% 14 36% 69 34%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 68

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Members’ most recent three deployments. Data include deployment 

location information as well as a history of direct combat operations.

Deployment History and Days Deployed

Figure 3.2 displays the length of time that Service Members were deployed prior to suicide in OEF/OIF.

Figure 3.2 2009 OEF/OIF MONTHS DEPLOYED

15%

23%

10%

15%

10%

3% 5%

8%

<1% <1% <1% 3%

8%

0

10

20

30

40

50

60

70

80

90

100

Percentage

Month (30 Days)
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 69

Table 3.24 summarizes deployment history for Service Members who completed suicide in OEF/OIF and in non-OEF/OIF locations. The 

deployment during which the Service Member died is included in the counts. The “Other” group includes decedents who never deployed, thus 

the percentages will not sum to 100%. Forty-one percent (n=16) of OEF/OIF decedents had deployed more than once. Forty-nine percent (n=19) 

died by suicide within the first three months of their OEF/OIF deployment, and an additional 28% (n=11) within the next three months.

Table 3.24 2009 AND 2008 DoDSER NUMBER OF DEPLOYMENTS FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

NUMBER OF DEPLOYMENTS 1 23 59% 77 30% 25 64% 66 32%

2 10 26% 42 16% 9 23% 20 10%

3 or more 6 15% 33 13% 4 10% 8 4%
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 70

Combat History

Ten percent (n=4) of OEF/OIF decedents had a reported history of direct combat operations compared to 18% (n=47) of non-OEF/OIF decedents

(Table 3.25). One OEF/OIF decedent had witnessed casualties compared to 60% of those with combat experience (n=28) for non-OEF/OIF 

decedents.

Table 3.25 2009 AND 2008 DoDSER COMBAT HISTORY FOR OEF/OIF AND NON-OEF/OIF EVENTS

2009 2008

OEF/OIF Other OEF/OIF Other

Count Percent Count Percent Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 4 10% 47 18% 7 18% 32 16%

 Combat Resulted in Injuries/Casualties 1 25% 33 28% 4 57% 18 56%

 Injured in Combat 0 0% 10 21% 1 14% 7 22%

 Witnessed in Combat 1 25% 28 60% 3 43% 17 53%

 Saw Dead Bodies in Combat 1 25% 27 57% 3 43% 14 44%

 Killed Others in Combat 0 0% 12 36% 1 14% 7 22%

NO DIRECT COMBAT HX 35 90% 211 82% 32 82% 172 84%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat. Percentages for these items reflect proportion of those with 

combat experience.
DoDSER 2009 Annual Report

Chapter 3 DoD-Wide Results for Completed Suicides in OEF/OIF and Non-OEF/OIF Locations

Page | 71

Summary

For calendar year 2009, characteristics of decedents of suicide that occurred during OEF/OIF deployments were presented in this report. Of the 

309 suicides that occurred in 2009, 43 occurred during OEF/OIF; DoDSERs were submitted for 39 of the OEF/OIF suicides.

The majority of OEF/OIF suicides occurred at decedents’ military residences (62%, n=24). Thirteen percent (n=5) of OEF/OIF suicides occurred at 

job sites and 26% (n=10) occurred at other settings. Consistent with 2008, military firearms were the most reported method for OEF/OIF suicides 

(97%, n=38).

The majority of suicide decedents did not have a reported history of prior self-injury. Five percent (n=2) had history of one prior event and 8%

(n=3) had a history of more than one event. Twenty-eight percent (n=11) of OEF/OIF decedents had a history of at least one behavioral health 

disorder. Ten percent (n=4) of decedents had been diagnosed with mood disorders. Thirteen percent (n=5) had been diagnosed with anxiety 

disorders, including one decedent diagnosed with PTSD. One decedent had a history of substance abuse. Twenty-six percent (n=10) of OEF/OIF 

decedents had been seen in MTFs within 90 days of the suicide and 18% (n=7) had been seen within 30 days. Fifteen percent of OEF/OIF 

decedents (n=6) had been seen in outpatient behavioral health facilities within 30 days of the suicide, and 21% (n=8) within 90 days.

Twenty-six percent (n=10) of OEF/OIF decedents had a failed intimate relationship within 30 days of the suicide. Other failed relationships 

occurred within 30 days of the events in 15% (n=6) of suicides. The overall percent of failed relationships for OEF/OIF decedents (54%, n=21) was 

similar to that of non OEF/OIF decedents (53%, n=137). Thirty-one percent (n=12) of decedents were reported to have had minor children at the 

time of the suicide.

Article 15 proceedings were reported for 10% of decedents (n=4) and civil legal problems were reported among 5% of individuals (n=2).

Excessive debt or bankruptcy was reported for 13% (n=5) of OEF/OIF suicides. A history of job problems was reported for 36% (n=14) of OEF/OIF 

decedents and a history of supervisor or co-worker issues was reported for 36% (n=14) of decedents.

Ten percent (n=4) of decedents were reported to have experienced direct combat operations. Similar to 2008, the percentages of decedents 

who had experienced combat were generally low. The percentage of OEF/OIF decedents who experienced direct combat operations (10%, n=4) 

was lower than non OEF/OIF decedents (18%, n=47).
DoDSER 2009 Annual Report

Page | 72

Chapter 4

AIR FORCE RESULTS FOR COMPLETED SUICIDES

Air Force DoDSER Submissions and POC Compliance

2009 Reported Suicide Events

Forty-three Air Force suicides were confirmed by the Armed Forces Medical Examiner System (AFMES) 

for calendar year 2009 (Table 4.1). Forty-three Air Force Department of Defense Suicide Event Reports 

(DoDSERs) were submitted and analyzed, for a submission compliance rate of 100%. An additional three 

DoDSERs were submitted and analyzed, but not confirmed by AFMES at the time of analysis. 

Consequently, a total of 46 suicides for 2009 were included in this report.

Table 4.1 2009 AIR FORCE AFMES CONFIRMED AND PENDING SUICIDES AND DoDSERs SUBMITTED

2009

Total DoDSERs 46 d 

Total AFMES Confirmed and Pending Suicides 46 d 

AFMES Confirmed Suicides 43 d 

DoDSER Submission Compliance 100% d 

Additional DoDSERs Pending AFMES Confirmation 3 d 

Data from 1/1/2009 through 12/31/2009 as of 4/1/2010

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that 

may have been associated with or contributed to the suicidal events. These factors include decedents’ 

demographic characteristics, event setting, suicide method, substance use during the event, possible

motive and intent to die, and communication of intent with others.

Demographics

Table 4.2 contains demographic data provided from DMDC. All but two of the 46 Air Force 2009 suicides 

were completed by males. Decedents were primarily Caucasian, enlisted, and regular component, 

consistent with 2008.

Table 4.2 2009 AND 2008 AFMES AIR FORCE DEMOGRAPHICS

2009 2008

Count Percent Count Percent
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 73

Table 4.2 2009 AND 2008 AFMES AIR FORCE DEMOGRAPHICS

2009 2008

Count Percent Count Percent

Total 46 100% 45 100%

GENDER Male 44 97% 43 96%

Female 2 3% 2 4%

RACE Asian/Pacific Islander 2 4% 1 2%

African American 5 11% 4 9%

Caucasian 35 76% 30 67%

American Indian/Alaska Native 2 4% 4 9%

Other/Don’t Know/Missing 2 4% 6 13%

AGE RANGE Under 25 17 37% 20 44%

25-29 11 24% 4 9%

30-39 10 22% 11 24%

40 + 8 17% 10 22%

RANK E1-E4 21 46% 15 33%

E5-E9 20 43% 23 51%

Officer 5 11% 7 16%

Warrant Officer 0 0% 0 0%

Cadet/Midshipman 0 0% 0 0%

COMPONENT Regular 41 89% 39 87%

Reserve 3 7% 1 2%

National Guard 2 4% 5 11%

EDUCATION Did not graduate high school 0 0% 0 0%

GED 0 0% 0 0%

High school graduate 35 76% 27 60%

Some college or technical school 1 2% 0 0%

Degree/certificate of less than 4 years 4 9% 8 18%

Four-year college degree 1 2% 5 11%

Master’s degree or greater 5 11% 5 11%

Don’t Know 0 0% 0 0%

MARITAL STATUS Never Married 14 30% 12 27%

Married 26 57% 26 58%

Legally Separated 0 0% 0 0%

Divorced 6 13% 7 16%

Widowed 0 0% 0 0%

Don’t Know 0 0% 0 0%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 through 

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 74

Table 4.2 2009 AND 2008 AFMES AIR FORCE DEMOGRAPHICS

2009 2008

Count Percent Count Percent

12/31/2009 as of 4/1/2010. 

Event Setting

The most common settings for Air Force suicides in 2009 were Airmen’s personal residences or barracks 

(67%, n=31), an increase of 10% from the previous year (Table 4.3). Two additional 2009 suicides 

occurred at the residence of a family or friend, and three in automobiles, unlike 2008 when there were 

none in either setting. Ten other event locations were reported, primarily public outdoor settings. The 

AFMES reported 2 Air Force OIF suicides and 1 OEF suicide as of 1 April 2010. DoDSER data provides a 

description of the event country. Six Air Force suicides took place while Service Members were serving

outside the United States (Table 4.4).

Table 4.3 2009 AND 2008 AIR FORCE DoDSER EVENT SETTING

2009 2008

Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 31 67% 20 57%

Residence of friend or family 2 4% 0 0%

Work/jobsite 0 0% 2 6%

Automobile (away from residence) 3 7% 0 0%

Inpatient medical facility 0 0% 0 0%

Other 10 22% 13 37%

Table 4.4 2009 AND 2008 AIR FORCE DoDSER EVENT COUNTRY

2009 2008

Count Percent Count Percent

EVENT COUNTRY United States 40 87% 32 91%

Iraq 2 4% 0 0%

Afghanistan 1 2% 0 0%

Kuwait 1 2% 0 0%

Korea 1 2% 0 0%

Europe 1 2% 3 9%
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 75

Event Method

Figure 4.1 shows the methods Air Force decedents chose for suicide in 2009.

Figure 4.1 2009 AND 2008 AIR FORCE DoDSER EVENT METHODS

Most Air Force suicides involved non-military firearms (57%, n=26), hanging (20%, n=9), and military 

issue firearms (11%, n=5) (Table 4.5). Methods used for the remaining suicides included sharp or blunt 

objects, and other methods.

Table 4.5 2009 AND 2008 AIR FORCE DoDSER EVENT METHOD

2009 2008

Count Percent Count Percent

EVENT METHOD Drugs 1 2% 0 0%

Gas, vehicle exhaust 0 0% 3 9%

Gas, utility (or other) 1 2% 0 0%

Hanging 9 20% 9 26%

Firearm, military issue 5 11% 1 3%

Firearm, non-military issue 26 57% 17 49%

Sharp or blunt object 2 4% 0 0%

Jumping from high place 1 2% 1 3%

Other 1 2% 1 3%

Don't Know 0 0% 3 9%

11%

57%

17% 17%

3%

49%

26%

23%

0

10

20

30

40

50

60

70

80

90

100

Firearm, 

military issue

Firearm, nonmilitary issueHanging Other

Percentage

2009

2008
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 76

Event Motivation

For most decedents in 2009, the motivation behind the suicide was not known (Table 4.6). For the few 

instances in which a motive was identified, reasons were broadly spread to include impulsivity, 

emotional relief, hopelessness, and “other non-defined stressors.”

Table 4.6 2009 AIR FORCE DoDSER EVENT MOTIVATION

2009

Count Percent

EVENT MOTIVATION Emotional Relief 3 7%

Influence 1 2%

Individual Reasons 1 2%

Hopelessness 3 7%

Depression 1 2%

Impulsivity 4 9%

Other 3 7%

Don’t Know 30 65%

Substance Use during the Event

For 46% of Air Force suicides in 2009, data about substance use during the event were not available 

(Table 4.7). However, when data were available, they indicated that alcohol accompanied suicide more 

frequently than did drugs. Of the 25 suicides for which substance use or non-use was known, alcohol use 

was reported for 17 suicides and drug use was reported for six.

Table 4.7 2009 AND 2008 AIR FORCE DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

ALCOHOL USED Yes 17 37% 9 26%

No 8 17% 16 46%

Don’t Know 21 46% 10 29%

ANY DRUGS USED Yes 6 13% 3 9%

No 19 41% 21 60%

Don’t Know 21 46% 11 31%

 Illegal drugs Overdose 0 0% 0 0%

Used, no overdose 0 0% 0 0%

Were not used 25 54% 23 66%

Don’t Know 21 46% 12 34%
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 77

Table 4.7 2009 AND 2008 AIR FORCE DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

 Prescription drugs Overdose 1 2% 0 0%

Used, no overdose 1 2% 2 6%

Were not used 23 50% 22 63%

Don’t Know 21 46% 11 31%

 OTC drugs Overdose 0 0% 0 0%

Used, no overdose 4 9% 1 3%

Were not used 21 46% 22 63%

Don’t Know 21 46% 12 34%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicate potential for 

self-harm when known. As shown in Table 4.8, 74% of Air Force decedents in 2009 had no known history 

of communicating a potential for self-harm prior to taking their lives. Twelve decedents reportedly had 

communicated their potential to one or more types of recipients prior to the suicide (Table 4.8). Six of 

those were reported to have expressed their intent verbally (Table 4.9).

Table 4.8 2009 AND 2008 AIR FORCE DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT 

2009 2008

Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 34 74% 25 71%

1 6 13% 9 26%

2 3 7% 0 0%

3 3 7% 1 3%

Table 4.9 2009 AND 2008 AIR FORCE DoDSER MODE OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 6 13% 1 3%

Written Only 1 2% 0 0%

Other 1 2% 2 6%

Multiple Modes 4 9% 0 0%

Note: Multiple modes include a combination of verbal, written, or other mode of communicating intent to suicide.

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 78

As displayed in Table 4.10, five individuals (11%) made known their intent to their spouse, four (9%) to 

behavioral health staff, four (9%) to a supervisor or chaplain, one to a friend, and the remaining seven 

(15%) to a variety of other persons (these included an ex-spouse or ex-girlfriend, and someone in the 

role of helping services). Note that these figures are not mutually exclusive – some decedents 

communicated their intent to more than one type of recipient, as demonstrated in Table 4.10 and Table 

4.8. In fact, 14% of Air Force decedents communicated their potential for self-harm to two or three 

types of recipients.

Table 4.10 2009 AND 2008 AIR FORCE DoDSER RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

COMMUNICATION Friend 1 2% 2 6%

Behavioral Health Staff 4 9% 1 3%

Supervisor 3 7% 1 3%

Spouse 5 11% 0 0%

Chaplain 1 2% 0 0%

Other 7 15% 8 23%

Made Multiple Communication 6 13% 1 3%

Additional Event Information

Table 4.11 shows that there was evidence that 72% (n=33) of decedents intended to die. Fourteen 

suicides appeared to be planned or premeditated (10 were not), and most took place where it was 

unlikely that others could observe or intervene (54%, n=25). A suicide note was found for 24% (n=11). As 

demonstrated in Table 4.11, equivalent data for 2008 were also limited. Given the limited data on this 

variable, comparisons with 2008 should be made with caution.

Table 4.11 2009 AND 2008 AIR FORCE DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

EVIDENCE EXISTS INDICATING 

INTENTION TO DIE

Yes 33 72% 12 34%

No 2 4% 0 0%

Don’t Know 11 24% 23 66%

DEATH RISK GAMBLING Yes 0 0% 0 0%

No 33 72% 0 0%

Don’t Know 13 28% 35 100%

PLANNED/PREMEDITATED Yes 14 30% 6 17%

No 10 22% 0 0%

Don’t Know 22 48% 29 83%
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 79

Table 4.11 2009 AND 2008 AIR FORCE DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

OBSERVABLE Yes 9 20% 0 0%

No 25 54% 0 0%

Don’t Know 12 26% 35 100%

SUICIDE NOTE LEFT Yes 11 24% 0 0%

No 22 48% 0 0%

Don’t Know 13 28% 35 100%

Contextual Factors

This section describes DoDSER data that pertains to situational and contextual factors such as place of 

residence, duty environment, and general living situation.

Situational Factors

As shown in Table 4.12, in 2009, Service Members who died by suicide most frequently lived in off-base

family housing (63%, n=29) at the time the suicide took place. More than one-third of decedents (35%, 

n=16) were living with a spouse, and 24% (n=11) were living with children. A firearm was reported to be 

in the home or immediate environment in nearly half (46%, n=21) of suicide events. Information about 

situational factors such as residence was not available for the majority of suicides in 2008, precluding 

comparisons with the current data.

Table 4.12 2009 AND 2008 AIR FORCE DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDENCE AT TIME OF EVENT Shared military living environment 8 17% 0 0%

On-base family housing 3 7% 2 6%

Owned or leased apartment or house 29 63% 11 31%

Other 4 9% 1 3%

Don’t Know 2 4% 21 60%

MARRIED SERVICE MEMBER 

RESIDENCE

Resides with spouse 16 35% 15 43%

Separated due to relationship issues 2 4% 1 3%

Apart for other reasons/deployed 2 4% 0 0%

Don’t Know 4 9% 4 11%

Unmarried at time of event 22 48% 15 43%

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 80

Table 4.12 2009 AND 2008 AIR FORCE DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDED ALONE Yes 20 43% 6 17%

No 20 43% 17 49%

Don’t Know 6 13% 12 34%

HAD MINOR CHILDREN Yes 18 39% 12 34%

No 22 48% 3 9%

Don’t Know 6 13% 20 57%

CHILDREN RESIDED WITH Yes 11 24% 11 31%

No 5 11% 0 0%

Don’t Know 2 4% 1 3%

No Known Children 28 61% 23 66%

FIREARM IN IMMEDIATE/LIVING 

ENVIRONMENT

Yes 21 46% 12 34%

No 13 28% 0 0%

Don’t Know 12 26% 23 66%

Duty Environment

As shown in Table 4.13, “Garrison” was the most frequently reported duty environment for Air Force 

decedents (70%, n=32). Seven suicides occurred at various other duty locations. Four additional Service 

Members took their lives while on leave.

Table 4.13 2009 AND 2008 AIR FORCE DoDSER DUTY ENVIRONMENT

2009 2008

Count Percent Count Percent

DUTY ENVIRONMENT Garrison 32 70% 27 77%

Leave 4 9% 1 3%

Medical Hold 1 2% 0 0%

TDY 1 2% 0 0%

Other 7 15% 3 9%

Training 1 2% 0 0%

Multiple Duty Environments Provided 5 11% 0 0%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 81

Suicide Completions by Month

Consistent with data from 2008, no clear pattern exists for Air Force suicides by month (Table 4.14).

Table 4.14 2009 AND 2008 AIR FORCE DoDSER SUICIDE EVENTS BY MONTH

2009 2008

Count Percent Count Percent

MONTH January 3 7% 4 11%

February 6 13% 2 6%

March 0 0% 1 3%

April 6 13% 4 11%

May 2 4% 1 3%

June 4 9% 2 6%

July 4 9% 6 17%

August 3 7% 1 3%

September 5 11% 4 11%

October 6 13% 5 14%

November 4 9% 5 14%

December 3 7% 0 0%

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be 

associated with subsequent suicidal behavior. These factors include data on prior self-harm, previous 

diagnoses of behavioral health disorders and behavioral health issues, and relevant treatment histories, 

including prescribed medication.

Prior Self-Injury

Nine decedents (20%) had histories of prior self-injury, with two of those nine known to have injured 

themselves more than once (Table 4.15).
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 82

Table 4.15 2009 AND 2008 AIR FORCE DoDSER PRIOR SELF-INJURY

2009 2008

Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 9 20% 3 9%

 Within 30 days 2 4% 0 0%

 Within 90 days (inclusive)* 3 7% 2 6%

No 22 48% 0 0%

Don’t Know 15 33% 32 91%

 Number prior self-injuries One prior event 7 15% ---- ----

More than one prior event 2 4% ---- ----

N/A 37 80% ---- ----

 Event similar to prior self-injury No 5 11% 0 0%

Don’t Know 4 9% 3 9%

N/A 37 80% 32 91%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”

Behavioral Health Disorders

Thirty-nine percent (n= 18; Table 4.16) of Air Force decedents in 2009 had a history of at least one 

behavioral health disorder. Specifically, mood disorders were reported for 28% of individuals in 2009, 

compared with 14% in 2008 (Table 4.17). Mood disorders in 2009 included four instances of major 

depression, one each of bipolar disorder and dysthymic disorder, and seven other undifferentiated 

diagnoses. Additionally, 24% of Airmen dying by suicide in 2009 had been diagnosed with an anxiety 

disorder (n=11) (Table 4.18). PTSD was not commonly reported (4%, n=2) and no instances of panic 

disorder, generalized anxiety disorder or acute stress disorder were indicated. Furthermore, Table 4.19

shows that few decedents had been diagnosed with personality disorder (4%, n=2) or had a history of 

substance abuse (13%, n=6), and no psychotic disorders were reported among Air Force suicides in 

2009. Finally, only two individuals had been diagnosed with more than two comorbid behavioral health 

conditions prior to their suicides (Table 4.16). Less DoDSER data about behavioral health disorders were 

available in 2008 than in 2009, making comparisons between 2008 and 2009 potentially unreliable.
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 83

Table 4.16 2009 AND 2008 AIR FORCE DoDSER COMORBIDITY RATES

2009 2008

Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 28 61% 26 74%

1 DX 8 17% 9 26%

2 DX 8 17% 0 0%

3 DX 2 4% 0 0%

4 or more DX 0 0% 0 0%

Table 4.17 2009 AND 2008 AIR FORCE DoDSER MOOD DISORDERS

2009 2008

Count Percent Count Percent

DX W/MOOD DISORDER Yes 13 28% 5 14%

No 25 54% 16 46%

Don’t Know 8 17% 14 40%

 Bipolar disorder Yes 1 2% 0 0%

No 36 78% 16 46%

Don’t Know 9 20% 19 54%

 Major depression Yes 4 9% 0 0%

No 32 70% 16 46%

Don’t Know 10 22% 19 54%

 Dysthymic disorder Yes 1 2% 0 0%

No 34 74% 16 46%

Don’t Know 11 24% 19 54%

 Other mood disorder Yes 7 15% 1 3%

No 30 65% 16 46%

Don’t Know 9 20% 18 51%

 Unspecified mood disorder Yes 0 0% 4 11%

No 38 83% 17 49%

Don’t Know 8 17% 14 40%

 Multiple mood DX Yes 0 0% 0 0%

No 38 83% 21 60%

Don’t Know 8 17% 14 40%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had a mood disorder.
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 84

Table 4.18 2009 AND 2008 AIR FORCE DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

DX W/ANXIETY DISORDER Yes 11 24% 4 11%

No 26 57% 18 51%

Don’t Know 9 20% 13 37%

 PTSD Yes 2 4% 1 3%

No 33 72% 18 51%

Don’t Know 11 24% 16 46%

 Panic disorder Yes 0 0% 0 0%

No 35 76% 18 51%

Don’t Know 11 24% 17 49%

 Generalized anxiety disorder Yes 0 0% 0 0%

No 35 76% 18 51%

Don’t Know 11 24% 17 49%

 Acute stress disorder Yes 0 0% 0 0%

No 35 76% 18 51%

Don’t Know 11 24% 17 49%

 Other anxiety disorder Yes 7 15% 0 0%

No 29 63% 18 51%

Don’t Know 10 22% 17 49%

 Unspecified anxiety DX Yes 2 4% 3 9%

No 35 76% 19 54%

Don’t Know 9 20% 13 37%

 Multiple anxiety DX Yes 0 0% 0 0%

No 37 80% 22 63%

Don’t Know 9 20% 13 37%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had an anxiety disorder.

Table 4.19 2009 AND 2008 AIR FORCE DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

2009 2008

Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 2 4% 2 6%

No 33 72% 19 54%

Don’t Know 11 24% 14 40%

DX W/PSYCHOTIC DISORDER Yes 0 0% 1 3%

No 37 80% 20 57%

Don’t Know 9 20% 14 40%
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 85

Table 4.19 2009 AND 2008 AIR FORCE DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

2009 2008

Count Percent Count Percent

HX SUBSTANCE ABUSE Yes 6 13% 7 20%

No 26 57% 14 40%

Don’t Know 14 30% 14 40%

Treatment

Table 4.20 summarizes the history of Air Force decedents’ visits to treatment programs and clinics prior 

to their suicides. In 2009, 43% of decedents had been seen in a military treatment facility (MTF) within 

90 days of their suicides. Ten individuals in 2009 were treated by substance abuse services compared to 

just two in 2008, 18 had been treated in outpatient behavioral health facilities in 2009, and eight 

received inpatient behavioral health treatment in 2009. Approximately 20% of decedents had received 

outpatient behavioral health treatment within 30 days of their suicides in both 2009 and 2008. In all of 

these comparisons, it is not clear how the discrepancies were influenced by the larger number of 

unknowns in 2008.

Table 4.20 2009 AND 2008 AIR FORCE DoDSER TREATMENT HISTORY 

2009 2008

Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 28 61% 17 49%

 Within 30 days 15 33% 3 9%

 Within 90 days (inclusive)* 20 43% 7 20%

No 7 15% 6 17%

Don’t Know 11 24% 12 34%

SUBSTANCE ABUSE SERVICES Yes 10 22% 2 6%

 Within 30 days 5 11% 1 3%

 Within 90 days (inclusive)* 5 11% 1 3%

No 28 61% 19 54%

Don’t Know 8 17% 14 40%

FAMILY ADVOCACY PROGRAMS Yes 3 7% 3 9%

 Within 30 days 0 0% 1 3%

 Within 90 days (inclusive)* 1 2% 2 6%

No 33 72% 18 51%

Don’t Know 10 22% 14 40%

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 86

Table 4.20 2009 AND 2008 AIR FORCE DoDSER TREATMENT HISTORY 

2009 2008

Count Percent Count Percent

CHAPLAIN SERVICES Yes 5 11% 3 9%

 Within 30 days 2 4% 1 3%

 Within 90 days (inclusive)* 3 7% 3 9%

No 11 24% 18 51%

Don’t Know 30 65% 14 40%

OUTPATIENT BEHAVIORAL HEALTH Yes 18 39% 9 26%

 Within 30 days 10 22% 7 20%

 Within 90 days (inclusive)* 11 24% 8 23%

No 21 46% 12 34%

Don’t Know 7 15% 14 40%

INPATIENT BEHAVIORAL HEALTH Yes 8 17% 0 0%

 Within 30 days 0 0% 0 0%

 Within 90 days (inclusive)* 1 2% 0 0%

No 28 61% 12 34%

Don’t Know 10 22% 23 66%

HX PHYSICAL HEALTH PROBLEM Yes 16 35% 6 17%

 Within 30 days 6 13% 1 3%

 Within 90 days (inclusive)* 8 17% 4 11%

No 17 37% 8 23%

Don’t Know 13 28% 21 60%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time 

frames sums to more than the total number of cases in some instances. 

Table 4.21 shows psychotropic medications used by individuals prior to suicide. Definitive data were

available for 76% of decedents in 2009 but for only 29% of decedents in 2008. In 2009, 10 decedents 

were reported to have used psychotropic drugs while 25 were known to have not. All 10 had reportedly 

used antidepressants, whereas use of antianxiety medications, anticonvulsants, and antipsychotics was

rare.

Table 4.21 2009 AND 2008 AIR FORCE DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 10 22% 1 3%

No 25 54% 9 26%

Don’t Know 11 24% 25 71%

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 87

Table 4.21 2009 AND 2008 AIR FORCE DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

 Antidepressants Yes 10 22% 1 3%

No 25 54% 9 26%

Don’t Know 11 24% 25 71%

 Antianxiety Yes 3 7% 0 0%

No 31 67% 10 29%

Don’t Know 12 26% 25 71%

 Antimanics Yes 0 0% 0 0%

No 34 74% 10 29%

Don’t Know 12 26% 25 71%

 Anticonvulsants Yes 1 2% 0 0%

No 33 72% 10 29%

Don’t Know 12 26% 25 71%

 Antipsychotics Yes 2 4% 0 0%

No 33 72% 10 29%

Don’t Know 11 24% 25 71%

Note: Indented items were only asked in cases where the respondent indicated that the decedent used psychotropic medication.

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These 

data include information about family histories and interpersonal relationships, legal, financial and 

administrative difficulties, and reports of prior abuse.

Family and Relationship History

A history of a failed or failing spousal or intimate relationship was commonly reported for Air Force 

suicides in 2009 (Table 4.22). Failures of intimate relationships were known to have occurred prior to 26 

suicides. Of those 26, 11 were known to have experienced a failed spousal relationship within 30 days of

suicide, and another four within 90 days of suicide. Other possible family and relationship factors, such 

as the death or suicide of a spouse, family or friend, appear to be rare (Table 4.23).

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 88

Table 4.22 2009 AND 2008 AIR FORCE DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 26 57% 14 40%

 Within 30 days 11 24% 3 9%

 Within 90 days (inclusive)* 15 33% 14 40%

No 11 24% 6 17%

Don’t Know 9 20% 15 43%

HX FAILED OTHER RELATIONSHIP Yes 3 7% 7 20%

 Within 30 days 2 4% 0 0%

 Within 90 days (inclusive)* 2 4% 6 17%

No 22 48% 7 20%

Don’t Know 21 46% 21 60%

HX ANY FAILED RELATIONSHIP Yes 26 57% 15 43%

 Within 30 days 11 24% 3 9%

 Within 90 days (inclusive)* 15 33% 14 40%

No 11 24% 5 14%

Don’t Know 9 20% 15 43%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time 

frames sums to more than the total number of cases in some instances. 

Table 4.23 2009 AND 2008 AIR FORCE DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX SPOUSE SUICIDE Yes 0 0% 0 0%

No 35 76% 1 3%

Don’t Know 11 24% 34 97%

HX FAMILY MEMBER SUICIDE Yes 3 7% 0 0%

No 23 50% 0 0%

Don’t Know 20 43% 35 100%

HX FRIEND SUICIDE Yes 2 4% 0 0%

No 19 41% 0 0%

Don’t Know 25 54% 35 100%

HX DEATH OF SPOUSE/FAMILY

MEMBER

Yes 3 7% 1 3%

No 17 37% 0 0%

Don’t Know 26 57% 34 97%
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 89

Table 4.23 2009 AND 2008 AIR FORCE DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX DEATH OF FRIEND Yes 1 2% 0 0%

No 18 39% 0 0%

Don’t Know 27 59% 35 100%

HX SPOUSE/FAMILY ILLNESS Yes 2 4% 0 0%

No 21 46% 0 0%

Don’t Know 23 50% 35 100%

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 7 15% 1 3%

No 14 30% 0 0%

Don’t Know 25 54% 34 97%

Administrative and Legal History

A history of legal or administrative problems before an Air Force suicide was relatively uncommon (Table 

4.24). Few instances of courts martial, Article 15 proceedings, administrative separations, absences 

without leave, medical evaluation board reviews, or job selection or promotion concerns were reported. 

Civil legal problems (e.g., child custody, litigation) were the most prevalent legal issues reported to have 

occurred prior to suicides (15%, n=7).

Table 4.24 2009 AND 2008 AIR FORCE DoDSER ADMIN/LEGAL HISTORY

2009 2008

Count Percent Count Percent

HX COURTS MARTIAL Yes 2 4% 0 0%

No 33 72% 19 54%

Don’t Know 11 24% 16 46%

HX ARTICLE 15 Yes 5 11% 2 6%

No 28 61% 18 51%

Don’t Know 13 28% 15 43%

HX ADMIN SEPARATION Yes 1 2% 0 0%

No 33 72% 10 29%

Don’t Know 12 26% 25 71%

HX AWOL Yes 1 2% 0 0%

No 33 72% 9 26%

Don’t Know 12 26% 26 74%

HX MEDICAL BOARD Yes 4 9% 0 0%

No 33 72% 4 11%

Don’t Know 9 20% 31 89%

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 90

Table 4.24 2009 AND 2008 AIR FORCE DoDSER ADMIN/LEGAL HISTORY

2009 2008

Count Percent Count Percent

HX CIVIL LEGAL PROBLEMS Yes 7 15% 1 3%

No 24 52% 16 46%

Don’t Know 15 33% 18 51%

HX NON-SELECTION Yes 5 11% 0 0%

No 26 57% 0 0%

Don’t Know 15 33% 35 100%

Abuse History

A history of physical, sexual or emotional abuse, either as a victim or perpetrator, was not commonly 

reported for Air Force Service Members taking their lives (Table 4.25). Most notably, there were five 

known instances of decedents who were perpetrators of physical abuse.

Table 4.25 2009 AND 2008 AIR FORCE DoDSER ABUSE HISTORY

2009 2008

Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 2 4% 0 0%

No 30 65% 0 0%

Don’t Know 14 30% 35 100%

HX VICTIM SEXUAL ABUSE Yes 1 2% 0 0%

No 31 67% 0 0%

Don’t Know 14 30% 35 100%

HX VICTIM EMOTIONAL ABUSE Yes 3 7% 0 0%

No 29 63% 0 0%

Don’t Know 14 30% 35 100%

HX VICTIM SEXUAL HARASSMENT Yes 0 0% 0 0%

No 30 65% 0 0%

Don’t Know 16 35% 35 100%

HX PERPETRATOR PHYSICAL ABUSE Yes 5 11% 0 0%

No 23 50% 0 0%

Don’t Know 18 39% 35 100%

HX PERPETRATOR SEXUAL ABUSE Yes 2 4% 0 0%

No 25 54% 0 0%

Don’t Know 19 41% 35 100%

HX PERPETRATOR EMOTIONAL ABUSE Yes 0 0% 0 0%

No 25 54% 0 0%

Don’t Know 21 46% 35 100%

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 91

Table 4.25 2009 AND 2008 AIR FORCE DoDSER ABUSE HISTORY

2009 2008

Count Percent Count Percent

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 1 2% 0 0%

No 25 54% 0 0%

Don’t Know 20 43% 35 100%

Financial and Workplace Difficulties

A small proportion of Air Force decedents in 2009 (4 of 29 with available financial data) were reported

to have had excessive debt or bankruptcy compared with the previous year (7 of 15 known for 2008). 

Table 4.26 shows that job loss or job instability preceding suicide was the most prevalent financial or 

workplace difficulty reported (30%, n=14). Supervisory or co-worker issues and poor work performance 

reviews were less frequently reported.

Table 4.26 2009 AND 2008 AIR FORCE DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES

2009 2008

Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 4 9% 7 20%

No 25 54% 8 23%

Don’t Know 17 37% 20 57%

HX JOB PROBLEMS Yes 14 30% 8 23%

No 19 41% 11 31%

Don’t Know 13 28% 16 46%

HX SUPERVISOR/COWORKER ISSUES Yes 4 9% 0 0%

No 26 57% 0 0%

Don’t Know 16 35% 35 100%

HX POOR WORK EVALUATION Yes 7 15% 2 6%

No 25 54% 3 9%

Don’t Know 14 30% 30 86%

HX UNIT/WORKPLACE HAZING Yes 0 0% 0 0%

No 29 63% 0 0%

Don’t Know 17 37% 35 100%

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Member’s most recent three 

deployments. Data include deployment location information as well as a history of direct combat 

operations. Comparisons of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) suicide 

events to non-OEF/OIF suicide events are reported in Chapter 3.

(cont.)
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 92

Deployment and Combat History

Ten (22%) of the Air Force Service Members who died by suicide in 2009 had served in Afghanistan or 

Iraq (Table 4.27), and few reported combat experiences (Table 4.28).

Table 4.27 2009 AND 2008 AIR FORCE DoDSER EVER DEPLOYED TO OEF/OIF

2009 2008

Count Percent Count Percent

HX DEPLOYMENT OEF/OIF AFGHANISTAN 4 9% 0 0%

IRAQ 6 13% 0 0%

KUWAIT 2 4% 0 0%

MULTIPLE OEF/OIF LOCATIONS 1 2% 0 0%

NO HX OEF/OIF DEPLOYMENT 33 72% 35 100%

Table 4.28 2009 AND 2008 AIR FORCE DoDSER COMBAT HISTORY

2009 2008

Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 3 7% 0 0%

 Combat Resulted in Injuries/Casualties 2 67% 0 0%

 Injured in Combat 1 33% 0 0%

 Witnessed Killing in Combat 2 67% 0 0%

 Saw Dead Bodies in Combat 1 33% 0 0%

NO DIRECT COMBAT HX 43 93% 35 100%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat.

Percentages for these items reflect proportion of those with combat experience.
DoDSER 2009 Annual Report

Chapter 4 Air Force Results for Completed Suicides

Page | 93

Summary

This annual report of the Air Force DoDSER provides data on Air Force suicides that occurred in 2009. An 

Air Force DoDSER was submitted for all suicides for 2009 (n=46). This report also includes equivalent 

data from the 2008 Air Force DoDSER Annual Report. Reliable comparisons between the two years are 

difficult because of the low number of suicides in each year and because of the substantial numbers of 

DoDSER items for which details were not known or were unavailable, especially in 2008. Consequently, 

interpretations of the data presented here must be made with particular caution.

Suicides in 2009 were most common among young, Caucasian, married, enlisted, active component 

Service Members. Firearms (both non-military and military-issue) and hanging were the most frequent 

methods of suicide. In most instances, the motivations behind the suicides were not known, and few 

decedents were reported to have communicated their intent to others.

Off-base housing was the most common place of residence at the time of suicide in 2009. Suicides most 

frequently occurred in Service Members’ personal residences or barracks. Sixty-one percent of 

decedents had been seen in an MTF prior to taking their lives, including 43% within three months of 

their suicides. Behavioral health histories were reported for approximately one-fourth of suicides, with 

mood and anxiety disorders most commonly reported. The most frequently reported stressors included 

failed or failing spousal or other intimate relationships, and job related problems. Ten of the 46 

decedents had a history of deployment to OEF/OIF, and few reported combat experiences.
DoDSER 2009 Annual Report

Page | 94

Chapter 5

ARMY RESULTS

Army Results for Completed Suicides

This chapter presents a summary of calendar year 2009 Army Department of Defense Suicide Event 

Report (DoDSER) data. Data collection processes following a suicide are described in Chapter 1, Method. 

The Army DoDSER chapter for 2009 contains more information than do the other Services’ DoDSER

chapters. This is because the Army’s previous system, the Army Suicide Event Report (ASER), captured 

data on non-fatal suicide events (attempts, self-harm, suicidal ideation) in addition to data on suicide 

completions. This system was seamlessly transferred to the new DoDSER in 2008, providing additional

data to analyze (data regarding non-fatal 2009 Army events are provided in the “Army Results for NonFatal Events” section of this chapter, page 117). All of the Services began collecting data on suicide 

attempts by 1 January 2010, which will be available in the 2010 DoDSER Annual Report.

Army DoDSER Submissions for Completed Suicides, and POC Compliance

Table 5.1 shows the number of Armed Forces Medical Examiner System (AFMES) confirmed Army 

suicides for 2009, and the compliance rate for Army DoDSER submissions at the time of this report. As 

shown below, 161 suicide cases were confirmed by the AFMES as of 31 January 2010, and 153 Army 

DoDSERs were submitted, for a compliance rate of 95%.

Table 5.1 2009 ARMY AFMES CONFIRMED AND PENDING SUICIDES AND DoDSERs SUBMITTED

2009

Total DoDSERs 153

Total AFMES Confirmed and Pending Suicides 164

AFMES Confirmed Suicides (as of 31 JAN 2010) 161

DoDSER Submission Compliance 95%

Additional DoDSERs Pending AFMES Confirmation 0

Data from 1/1/2009 through 12/31/2009 as of 4/1/2010

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that 

may have been associated with or contributed to the suicidal events. These factors include decedents’ 

demographic characteristics, event setting, suicide method, substance use during the event, potential

motives and intent to die, and communication of potential for self-harm.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 95

Demographics

Table 5.2 summarizes demographic data for Army suicides for 2009. The majority of decedents were 

Caucasian (79%, n=130), under 25 years of age (43%, n=71), married (51%, n=83), and lower enlisted 

(57%, n=94). The highest level of education for the majority of decedents was high school graduate or 

GED (General Equivalency Diploma) (79%, n=130). As shown, the demographic characteristics of 

decedents in 2009 were very similar to suicide decedents in 2008.

Table 5.2 2009 AND 2008 AFMES ARMY DEMOGRAPHICS

2009 2008

Count Percent Count Percent

GENDER Male 159 97% 132 94%

Female 5 3% 8 6%

RACE Asian/Pacific Islander 10 6% 7 5%

African American 19 12% 20 14%

Caucasian 130 79% 109 78%

American Indian/Alaska Native 5 3% 1 1%

Other/Don’t Know/Missing 0 0% 6 13%

AGE RANGE Under 25 71 43% 70 50%

25-29 49 30% 22 16%

30-39 33 21% 30 21%

40 + 11 6% 18 13%

RANK E1-E4 94 57% 78 56%

E5-E9 51 31% 46 33%

Officer 15 9% 13 9%

Warrant Officer 2 1% 2 1%

Cadet/Midshipman 0 0% 1 1%

COMPONENT Regular 147 90% 116 83%

Reserve 3 2% 8 6%

National Guard 14 9% 16 11%

EDUCATION Did not graduate high school 2 1% 4 3%

GED 34 21% 22 16%

High school graduate 96 59% 81 58%

Some college or technical school 11 7% 0 0%

Degree/certificate of less than four years 3 2% 15 11%

Four-year college degree 12 7% 10 7%

Master’s degree or greater 4 2% 8 6%

Don’t Know 2 1% 0 0%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 96

Table 5.2 2009 AND 2008 AFMES ARMY DEMOGRAPHICS

2009 2008

Count Percent Count Percent

MARITAL STATUS Never Married 58 35% 54 39%

Married 83 51% 77 55%

Legally Separated 0 0% 0 0%

Divorced 22 13% 8 6%

Widowed 1 1% 0 0%

Don’t Know 0 0% 1 1%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 through 

12/31/2009 as of 4/1/2010. As such, the total indicated above (n=164) is higher than the total used throughout the remainder of this chapter 

(n=153).

Event Setting

Table 5.3 displays the DoDSER data regarding the countries where the suicides occurred. The AFMES 

reported 23 OIF suicides and 6 OEF pending and confirmed Army suicides as of 1 April 2010. DoDSER 

data provide a description of the event country for all events, although DoDSERs were not received for 

all suicides, as noted in Chapter 2. DoDSER data shows that seventy-three percent (n=112) occurred in 

the United States, and very few occurred during deployment. Of those occurring overseas, the majority 

occurred in Iraq or Europe.

Table 5.3 2009 AND 2008 ARMY DoDSER EVENT COUNTRY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

EVENT COUNTRY United States 112 73% 90 71%

Iraq 22 14% 25 20%

Afghanistan 3 2% 7 6%

Kuwait 0 0% 1 1%

Korea 5 3% 0 0%

Europe 7 5% 2 2%

Canada 1 1% 0 0%

Other 2 1% 0 0%

Don't Know 1 1% 1 1%

Note: Data differs from AFMES OEF/OIF counts due to missing DoDSERs.

As shown in Table 5.4, suicides most commonly occurred in the personal residences of Soldiers (58%, 

n=89), followed by friend or family member residences (9%, n=14). Twenty-two percent of suicides were 

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 97

completed in “other” settings including an interstate, latrine, movie theater, parking garage, pasture, 

and an unoccupied building, with the most commonly reported “other” setting being a hotel room.

Table 5.4 2009 AND 2008 ARMY DoDSER EVENT SETTING FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 89 58% 74 59%

Residence of friend or family 14 9% 10 8%

Work/jobsite 8 5% 11 9%

Automobile (away from residence) 9 6% 7 6%

Inpatient medical facility 0 0% 1 1%

Other 33 22% 23 18%

Event Method

Figure 5.1 and Table 5.5 show the methods decedents used to end their lives. Firearms were the most 

commonly reported suicide method (19%, n=29 for military firearm; 40%, n=61 for non-military firearm; 

59%, n=90 for total combined), followed by hanging 22% (n=33).

Figure 5.1 2009 AND 2008 ARMY DoDSER EVENT METHODS

19%

39%

21% 20%

28%

40%

16%

17%

0

10

20

30

40

50

60

70

80

90

100

Firearm, 

military issue

Firearm, nonmilitary issueHanging Other

Percentage

2009

2008
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 98

Table 5.5 2009 AND 2008 ARMY DoDSER EVENT METHOD FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

EVENT METHOD Drugs 8 5% 10 8%

Alcohol 1 1% 1 1%

Gas, vehicle exhaust 7 5% 1 1%

Gas, utility (or other) 2 1% 1 1%

Hanging 33 22% 19 15%

Firearm, military issue 29 19% 35 28%

Firearm, non-military issue 61 40% 51 40%

Fire, steam, etc. 0 0% 1 1%

Sharp or blunt object 1 1% 0 0%

Jumping from high place 2 1% 2 2%

Lying in front of moving object 2 1% 0 0%

Other 6 4% 1 1%

Don't Know 1 1% 4 3%

Event Motivation

After reviewing all relevant records and conducting interviews, the Army DoDSER respondents reviewed 

available evidence and made a subjective assessment of the decedent’s primary motivation for the 

suicide. It is important to note that such reporting attempts to simplify extremely complex behavior. 

Due to the subjectivity of the content, results should be interpreted with caution.

As shown in Table 5.6, 18% (n=28) of decedents reportedly ended their lives because they sought 

emotional relief (e.g., to stop bad feelings or self-hatred, to relieve anxiety). This was the most 

commonly cited motivation, followed by feelings of hopelessness (10%, n=15). These proportions are 

similar to those reported for 2008 suicides. “Other” reported event motivations included pending 

investigation and disciplinary action, failing relationships, accidental shooting, and the sense that there 

was “no other choice.” Suicide motivation was not reported for nearly half of the decedents.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 99

Table 5.6 2009 AND 2008 ARMY DoDSER EVENT MOTIVATION FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

EVENT MOTIVATION Emotional Relief 28 18% 26 21%

Influence 0 0% 4 3%

Avoidance 4 3% 15 12%

Individual Reasons 7 5% 3 2%

Hopelessness 15 10% 12 10%

Depression 7 5% 5 4%

Other Psychiatric 4 3% 3 2%

Impulsivity 13 8% 11 9%

Other 8 5% 10 8%

Don't Know 67 44% 37 29%

Substance Use during the Event

The DoDSER process captures information about whether alcohol or other drugs were used during the 

suicide (not necessarily as a method for suicide). As shown in Table 5.7, 22% (n=33) of Soldiers were 

reported to have used alcohol during suicide. A much smaller proportion was reported to have used 

drugs, including OTC and prescription medications. These percentages may be underestimates, as no 

information was reported in a significant proportion of the cases, presumably because autopsy results 

were not available at the time of the Army DoDSER submissions.

Table 5.7 2009 AND 2008 ARMY DoDSER SUBSTANCE(S) USED DURING EVENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

ALCOHOL USED Yes 33 22% 26 21%

No 60 39% 47 37%

Don’t Know 60 39% 53 42%

ANY DRUGS USED Yes 9 6% 11 9%

No 71 46% 55 44%

Don’t Know 73 48% 60 48%

 Illegal drugs Overdose 0 0% 1 1%

Used, no overdose 1 1% 0 0%

Were not used 79 52% 62 49%

Don’t Know 73 48% 63 50%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 100

Table 5.7 2009 AND 2008 ARMY DoDSER SUBSTANCE(S) USED DURING EVENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

 Prescription drugs Overdose 6 4% 11 9%

Used, no overdose 0 0% 0 0%

Were not used 74 48% 55 44%

Don’t Know 73 48% 60 48%

 OTC drugs Overdose 2 1% 4 3%

Used, no overdose 0 0% 1 1%

Were not used 78 51% 58 46%

Don’t Know 73 48% 63 50%

BOTH ALCOHOL AND DRUGS USED Yes 2 1% 2 2%

No 75 49% 63 50%

Don’t Know 76 50% 61 48%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicated potential 

for self-harm when known. As shown in Table 5.8, 29% of Soldiers (n=45) who died by suicide were 

reported to have communicated their potential for self-harm prior to taking their lives. Fifteen Soldiers 

(10%) who died by suicide reportedly communicated their potential for self-harm to multiple people. 

These percentages may be an underestimate, as it is possible that some Soldiers did communicate their 

potential for self-harm, but this information might not have been available to the DoDSER respondent.

The majority of Army decedents were not reported to have disclosed their suicidal intent (71%, n=108). 

Of decedents who did communicate intent for self-harm, the majority (20%, n=30) expressed this intent 

to one recipient. A much smaller proportion (7%, n=10) communicated intent for self-harm to two 

recipients (Table 5.8).

Table 5.8 2009 AND 2008 ARMY DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT FOR COMPLETED 

SUICIDES

2009 2008

Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 108 71% 91 72%

1 30 20% 22 17%

2 10 7% 9 7%

3 2 1% 4 3%

4 2 1% 0 0%

5 1 1% 0 0%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

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As indicated in Table 5.9, decedents most commonly shared their intent with their spouses (13%, n=20) 

and friends (11%, n=17). “Other” individuals or groups with whom decedents were reported to have 

communicated suicidal intent include a blog community, mothers and other relatives, members of their 

command, their unit, and patrons at a community center.

Table 5.9 2009 AND 2008 ARMY DoDSER RECIPIENTS OF COMMUNICATED INTENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

COMMUNICATION Friend 17 11% 11 9%

Behavioral Health Staff 9 6% 7 6%

Supervisor 7 5% 5 4%

Spouse 20 13% 17 13%

Chaplain 3 2% 3 2%

Other 13 8% 9 7%

Made Multiple Communication 15 10% 13 10%

Table 5.10 displays the modes of communication of suicidal intent. As shown, the majority of 

communications were verbal. “Other” methods of communication included instant messaging, blogging, 

MySpace posting, through previous self-harm behaviors, and text messaging. In a significant proportion 

of cases there was no known communication of intent.

Table 5.10 2009 AND 2008 ARMY DoDSER MODE OF COMMUNICATED INTENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 26 17% 26 21%

Written Only 6 4% 1 1%

Other 11 7% 1 1%

Multiple Modes 3 2% 8 6%

Note: Multiple Modes includes a combination of verbal, written, or other mode of communicating intent to suicide.

Additional Event Information

Additional details about Army suicides were consistent from 2008 to 2009. As shown in Table 5.11, most

decedents were reported to have intended to die (76%, n=117), but only 42% (n=65) of the suicides 

were deemed to have been premeditated. The majority of decedents (69%, n=106) reportedly took their 

lives in places where it was unlikely that others could observe or intervene, and in most cases (54%, 

n=82) no suicide note was found.
DoDSER 2009 Annual Report

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Table 5.11 2009 AND 2008 ARMY DoDSER OTHER EVENT INFORMATION FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

INTENDED TO DIE Yes 117 76% 106 84%

No 10 7% 7 6%

Don't Know 26 17% 13 10%

DEATH RISK GAMBLING Yes 3 2% 2 2%

No 133 87% 101 80%

Don't Know 17 11% 23 18%

PLANNED/PREMEDITATED Yes 65 42% 54 43%

No 47 31% 40 32%

Don't Know 41 27% 32 25%

OBSERVABLE Yes 35 23% 29 23%

No 106 69% 84 67%

Don't Know 12 8% 13 10%

SUICIDE NOTE LEFT Yes 38 25% 34 27%

No 82 54% 62 49%

Don't Know 33 22% 30 24%

Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty 

environments.

Home Environment

Items pertaining to the individual’s situation at the time of suicide, such as residence, living situation, 

presence of minor children in the home, and firearms in the immediate living environment are shown in 

Table 5.12. For the majority of suicides (42%, n=64), decedents resided in barracks or similar shared 

military housing. Owned or leased apartments or homes were the second most prevalent response 

(39%, n=59). Twenty percent (n=31) of suicide decedents were reported to have lived with a spouse, 

whereas the majority, 53% (n=81) were reported as having been unmarried at the time of the event. 

Thirty-three percent (n=50) of decedents were reported to have lived alone at the time of the suicide. 

Forty percent (n=61) of decedents reportedly had minor children; the majority did not live with their 

children at the time of the event. Access to a firearm was reported for 52% (n=79) of completed 

suicides.
DoDSER 2009 Annual Report

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Table 5.12 2009 AND 2008 ARMY DoDSER HOME ENVIRONMENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

RESIDENCE AT TIME OF EVENT Shared military living environment 64 42% 59 47%

Bachelor quarters 1 1% 0 0%

On-base family housing 7 5% 5 4%

Owned or leased apartment or house 59 39% 46 37%

Other 16 10% 9 7%

Don't Know 6 4% 7 6%

MARRIED SERVICE MEMBER 

RESIDENCE

Resides with spouse 31 20% 24 19%

Separated due to relationship issues 18 12% 17 13%

Apart for other reasons/deployed 18 12% 16 13%

Don't Know 5 3% 2 2%

Unmarried at time of event 81 53% 67 53%

RESIDED ALONE Yes 50 33% 35 28%

No 84 55% 72 57%

Don't Know 19 12% 19 15%

HAD MINOR CHILDREN Yes 61 40% 42 33%

No 71 46% 59 47%

Don't Know 21 14% 25 20%

CHILDREN RESIDED WITH Yes 22 14% 14 11%

No 37 24% 27 21%

Don't Know 2 1% 1 1%

No Children 92 60% 84 67%

FIREARM IN IMMEDIATE/LIVING 

ENVIRONMENT

Yes 79 52% 80 63%

No 37 24% 13 10%

Don't Know 37 24% 33 26%

Duty Environment

Data pertaining to the duty environments associated with Army suicides are presented in Table 5.13. 

Garrison was by far the most commonly reported duty environment for decedents in 2009, (59%, n=91). 

Twelve percent (n=18) of suicides were reportedly completed while Soldiers were on leave.
DoDSER 2009 Annual Report

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Table 5.13 2009 AND 2008 ARMY DoDSER DUTY ENVIRONMENT FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

DUTY ENVIRONMENT Garrison 91 59% 63 50%

Psych Hosp 1 1% 1 1%

Leave 18 12% 13 10%

Medical Hold 3 2% 3 2%

TDY 1 1% 0 0%

Evacuation Chain 0 0% 1 1%

AWOL 7 5% 3 2%

Under Command Observation 1 1% 1 1%

Other 12 8% 9 7%

Training 6 4% 3 2%

Multiple Duty Environments Provided 13 8% 6 5%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.

Suicide Completions by Month

Consistent with data from 2008, no clear pattern exists for Army suicides by month, as shown in Table 

5.14.

Table 5.14 2009 AND 2008 ARMY DoDSER SUICIDE EVENTS BY MONTH FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

MONTH January 19 12% 5 4%

February 20 13% 11 9%

March 12 8% 10 8%

April 9 6% 12 10%

May 18 12% 8 6%

June 8 5% 12 10%

July 12 8% 10 8%

August 10 7% 13 10%

September 7 5% 12 10%

October 19 12% 11 9%

November 10 7% 12 10%

December 9 6% 10 8%
DoDSER 2009 Annual Report

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Page | 105

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be 

associated with subsequent suicidal behavior. These factors include data on prior self-harm, previous 

diagnoses of behavioral health disorders and behavioral health issues, and relevant treatment histories, 

including prescribed medication.

Prior Self-Injury

As shown in Table 5.15, 20% (n=30) of Army decedents had a reported history of prior self-injury. Nine

percent (n=14) were reported to have had more than one previous incident of self-injury. Seven percent 

of decedents had a known prior self-injury event within 90 days of death.

Table 5.15 2009 AND 2008 ARMY DoDSER PRIOR SELF-INJURY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 30 20% 20 16%

 Within 30 days 6 4% 2 2%

 Within 90 days (inclusive)* 11 7% 4 3%

No 87 57% 65 52%

Don’t Know 36 24% 41 33%

 Number prior self-injuries One prior event 16 10% ---- ----

More than one prior event 14 9% ---- ----

N/A 123 80% ---- ----

 Event similar to prior self-injury Yes 5 3% 2 2%

No 19 12% 16 13%

Don’t Know 6 4% 2 2%

N/A 123 80% 106 84%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” 

Behavioral Health Disorders

Table 5.16, Table 5.17 and Table 5.18 contain information on the types of behavioral health disorders 

reported for decedents. As displayed in Table 5.16, 28% (n=43) of decedents had been diagnosed with a 

mood disorder, including major depression (n=21), dysthymic disorder (n=2), and bipolar disorder (n=1). 

Nineteen percent (n=29) had been diagnosed with an anxiety disorder, including PTSD (9%, n=14; Table 

5.17). Two decedents had been diagnosed with a psychotic disorder and seven had personality disorder 

diagnoses. Nearly a quarter of decedents (23%, n=35) had a history of substance abuse (Table 5.18).
DoDSER 2009 Annual Report

Chapter 5 Army Results

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Table 5.16 2009 AND 2008 ARMY DoDSER MOOD DISORDERS FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

DX W/MOOD DISORDER Yes 43 28% 32 25%

No 94 61% 69 55%

Don’t Know 16 10% 25 20%

 Bipolar disorder Yes 1 1% 2 2%

No 132 86% 96 76%

Don’t Know 20 13% 28 22%

 Major depression Yes 21 14% 10 8%

No 114 75% 90 71%

Don’t Know 18 12% 26 21%

 Dysthymic disorder Yes 2 1% 1 1%

No 131 86% 98 78%

Don’t Know 20 13% 27 21%

 Other mood disorder Yes 5 3% 17 13%

No 127 83% 81 64%

Don’t Know 21 14% 28 22%

 Unspecified mood disorder Yes 6 4% 0 0%

No 131 86% 101 80%

Don’t Know 16 10% 25 20%

 Multiple mood DX Yes 8 5% 2 2%

No 129 84% 99 79%

Don’t Know 16 10% 25 20%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had a mood disorder.

Table 5.17 2009 AND 2008 ARMY DoDSER ANXIETY DISORDERS FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

DX W/ ANXIETY DISORDER Yes 29 19% 15 12%

No 105 69% 85 67%

Don't Know 19 12% 26 21%

 PTSD Yes 14 9% 5 4%

No 119 78% 93 74%

Don't Know 20 13% 28 22%

 Panic disorder Yes 0 0% 1 1%

No 132 86% 96 76%

Don't Know 21 14% 29 23%
DoDSER 2009 Annual Report

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Page | 107

Table 5.17 2009 AND 2008 ARMY DoDSER ANXIETY DISORDERS FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

 Generalized anxiety disorder Yes 2 1% 0 0%

No 131 86% 96 76%

Don't Know 20 13% 30 24%

 Acute stress disorder Yes 0 0% 0 0%

No 132 86% 96 76%

Don't Know 21 14% 30 24%

 Other anxiety disorder Yes 6 4% 5 4%

No 125 82% 91 72%

Don't Know 22 14% 30 24%

 Unspecified anxiety DX Yes 2 1% 1 1%

No 132 86% 99 79%

Don't Know 19 12% 26 21%

 Multiple anxiety DX Yes 5 3% 3 2%

No 129 84% 97 77%

Don't Know 19 12% 26 21%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had an anxiety disorder.

Table 5.18 2009 AND 2008 ARMY DoDSER OTHER BEHAVIORAL HEALTH DISORDERS FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 7 5% 8 6%

No 126 82% 89 71%

Don’t Know 20 13% 29 23%

DX W/PSYCHOTIC DISORDER Yes 2 1% 1 1%

No 132 86% 99 79%

Don’t Know 19 12% 26 21%

HX SUBSTANCE ABUSE Yes 35 23% 30 24%

No 91 59% 68 54%

Don’t Know 27 18% 28 22%

As shown in Table 5.19, slightly more than half of the decedents (54%, n=83) had no reported behavioral 

health diagnoses. Twenty-three percent (n=35) had at least one documented behavioral health

diagnosis, 13% (n=20) had two, 5% (n=8) had three, and an additional 5% (n=7) had four or more 

documented behavioral health diagnoses.

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 108

Table 5.19 2009 AND 2008 ARMY DoDSER COMORBIDITY RATES FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 83 54% 76 60%

1 DX 35 23% 31 25%

2 DX 20 13% 9 7%

3 DX 8 5% 8 6%

4 or more DX 7 5% 2 2%

Treatment

Table 5.20 shows the history of Army decedents’ visits to treatment programs and clinics prior to taking 

their lives. DoDSER respondents were instructed to select all categories that apply, thus categories are 

not mutually exclusive.

Fifty-three percent (n=81) of decedents had been seen in military treatment facilities (MTFs) within 90 

days of suicide, and 40% (n=61) within 30 days. Thirty-two percent (n=48) of decedents had been seen in 

outpatient behavioral health facilities within 90 days of suicide. Nineteen percent (n=29) of decedents 

were reported to have been admitted to inpatient behavioral health facilities prior to suicide. Table 5.20

also provides information about the history of decedents’ visits to other broadly-defined behavioral

health resources (i.e., Chaplain, Family Advocacy Program, Army Substance Abuse Program) within 30 

and 90 days of suicide.

Table 5.20 2009 AND 2008 ARMY DoDSER TREATMENT HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 95 62% 75 60%

 Within 30 days 61 40% 49 39%

 Within 90 days (inclusive)* 81 53% 63 50%

No 43 28% 27 21%

Don't Know 15 10% 24 19%

SUBSTANCE ABUSE SERVICES Yes 22 14% 19 15%

 Within 30 days 11 7% 8 6%

 Within 90 days (inclusive)* 12 8% 12 10%

No 110 72% 82 65%

Don't Know 21 14% 25 20%
DoDSER 2009 Annual Report

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Page | 109

Table 5.20 2009 AND 2008 ARMY DoDSER TREATMENT HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

FAMILY ADVOCACY PROGRAMS Yes 11 7% 8 6%

 Within 30 days 3 2% 4 3%

 Within 90 days (inclusive)* 5 3% 4 3%

No 115 75% 93 74%

Don't Know 27 18% 25 20%

CHAPLAIN SERVICES Yes 16 10% 20 16%

 Within 30 days 14 9% 13 10%

 Within 90 days (inclusive)* 16 10% 15 12%

No 63 41% 44 35%

Don't Know 74 48% 62 49%

OUTPATIENT BEHAVIORAL HEALTH Yes 76 50% 54 43%

 Within 30 days 42 28% 27 21%

 Within 90 days (inclusive)* 48 32% 37 29%

No 65 42% 58 46%

Don't Know 12 8% 14 11%

INPATIENT BEHAVIORAL HEALTH Yes 29 19% 20 16%

 Within 30 days 5 3% 8 6%

 Within 90 days (inclusive)* 15 10% 10 8%

No 108 71% 90 71%

Don't Know 16 10% 16 13%

HX PHYSICAL HEALTH PROBLEM Yes 35 23% 31 25%

 Within 30 days 25 16% 19 15%

 Within 90 days (inclusive)* 28 18% 27 21%

No 80 52% 74 59%

Don't Know 38 25% 21 17%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances.

As shown in Table 5.21, 35% (n=54) of decedents were reported to have taken psychotropic medications 

prior to their suicides. The majority of these were antidepressant (30%, n=46) and antianxiety 

medications (14%, n=21). Very few decedents were reported to have taken antimanics, anticonvulsants, 

or antipsychotics.

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 110

Table 5.21 2009 AND 2008 ARMY DoDSER PSYCHOTROPIC MEDICATION USE FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 54 35% 42 33%

No 76 50% 61 48%

Don't Know 23 15% 23 18%

 Antidepressants Yes 46 30% 35 28%

No 84 55% 65 52%

Don't Know 23 15% 26 21%

 Antianxiety Yes 21 14% 13 10%

No 107 70% 85 67%

Don't Know 25 16% 28 22%

 Antimanics Yes 1 1% 1 1%

No 127 83% 95 75%

Don't Know 25 16% 30 24%

 Anticonvulsants Yes 4 3% 4 3%

No 125 82% 92 73%

Don't Know 24 16% 30 24%

 Antipsychotics Yes 12 8% 5 4%

No 116 76% 92 73%

Don't Know 25 16% 29 23%

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These 

data include information about family histories and interpersonal relationships, legal, financial and 

administrative difficulties, and reports of prior abuse.

Family and Relationship History

Table 5.22 shows relationship history factors. As in 2008, many decedents were reported to have 

experienced failed intimate relationships prior to suicide (50%, n=76). Fourteen percent (n=22) of 

decedents were reported to have experienced relationship difficulties with someone other than a 

romantic partner, and 54% (n=83) of decedents reportedly experienced some form of failed relationship 

prior to suicide, including ruptured relationships with friends as well as ruptured intimate relationships.

Twenty-seven percent (n=41) had experienced intimate relationship failure within 30 days of taking their 

lives, and 35% (n=53) within 90 days.
DoDSER 2009 Annual Report

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Page | 111

Table 5.22 2009 AND 2008 ARMY DoDSER RELATIONSHIP HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 76 50% 69 55%

 Within 30 days 41 27% 50 40%

 Within 90 days (inclusive)* 53 35% 57 45%

No 34 22% 30 24%

Don’t Know 43 28% 27 21%

HX FAILED OTHER RELATIONSHIP Yes 22 14% 18 14%

 Within 30 days 16 10% 10 8%

 Within 90 days (inclusive)* 18 12% 11 9%

No 71 46% 57 45%

Don’t Know 60 39% 51 40%

HX ANY FAILED RELATIONSHIP Yes 83 54% 74 59%

 Within 30 days 48 31% 53 42%

 Within 90 days (inclusive)* 60 39% 60 48%

No 30 20% 26 21%

Don’t Know 40 26% 26 21%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances. 

As summarized in Table 5.23, 20% (n=31) of decedents were reported to have had a family history of

behavioral health problems, 5% (n=7) had experienced the death of a family member. Eight percent 

(n=12) of decedents were reported to have had histories of family illness, and 5% of decedents were 

reported to have had histories of family member suicide. There were very few reports of suicide among 

spouses and friends of decedents.

Table 5.23 2009 AND 2008 ARMY DoDSER FAMILY HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX SPOUSE SUICIDE Yes 1 1% 1 1%

No 124 81% 102 81%

Don't Know 28 18% 23 18%

HX FAMILY MEMBER SUICIDE Yes 7 5% 6 5%

No 97 63% 69 55%

Don't Know 49 32% 51 40%

HX FRIEND SUICIDE Yes 1 1% 2 2%

No 92 60% 72 57%

Don't Know 60 39% 52 41%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 112

Table 5.23 2009 AND 2008 ARMY DoDSER FAMILY HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX DEATH OF FAMILY MEMBER Yes 7 5% 12 10%

No 94 61% 65 52%

Don't Know 52 34% 49 39%

HX DEATH OF FRIEND Yes 5 3% 8 6%

No 86 56% 58 46%

Don't Know 62 41% 60 48%

HX FAMILY ILLNESS Yes 12 8% 7 6%

No 92 60% 61 48%

Don't Know 49 32% 58 46%

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 31 20% 14 11%

No 47 31% 31 25%

Don't Know 75 49% 81 64%

Administrative and Legal History

As shown in Table 5.24, decedents had experienced a variety of administrative and legal difficulties prior 

to suicide. Twelve percent (n=19) had a history of Article 15 proceedings, 9% (n=14) had a history of 

being absent without leave, and 9% (n=14) had undergone administrative separation proceedings. Civil 

legal problems and other legal and administrative problems were reported in 11% (n=17) of suicides.

Ten percent (n=16) of decedents had reported histories of medical board proceedings.

Table 5.24 2009 AND 2008 ARMY DoDSER ADMIN/LEGAL HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX COURTS MARTIAL Yes 11 7% 2 2%

No 114 75% 99 79%

Don’t Know 28 18% 25 20%

HX ARTICLE 15 Yes 19 12% 24 19%

No 101 66% 74 59%

Don’t Know 33 22% 28 22%

HX ADMIN SEPARATION Yes 14 9% 9 7%

No 111 73% 94 75%

Don’t Know 28 18% 23 18%

HX AWOL Yes 14 9% 9 7%

No 115 75% 96 76%

Don’t Know 24 16% 21 17%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 113

Table 5.24 2009 AND 2008 ARMY DoDSER ADMIN/LEGAL HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX MEDICAL BOARD Yes 16 10% 5 4%

No 113 74% 104 83%

Don’t Know 24 16% 17 13%

HX CIVIL LEGAL PROBLEMS Yes 17 11% 25 20%

No 97 63% 69 55%

Don’t Know 39 25% 32 25%

HX NON-SELECTION Yes 9 6% 3 2%

No 109 71% 85 67%

Don’t Know 35 23% 38 30%

Abuse History

Overall, very little abuse history was reported (Table 5.25). Four percent (n=6) had a known history of 

sexual abuse, 7% (n=10) had a history of emotional abuse, and 7% (n=10) also had a history of physical 

abuse. Nine percent (n=14) of Army decedents had a known history of perpetrating physical abuse, and 

half of these incidents (n=2, 4%) occurred within one year of the suicide. A history of sexual harassment 

was reported in only one case. However, caution should be taken in interpreting these data, given that 

abuse history was not known for a significant proportion of decedents.

Table 5.25 2009 AND 2008 ARMY DoDSER ABUSE HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 10 7% 7 6%

No 82 54% 64 51%

Don’t Know 61 40% 55 44%

HX VICTIM SEXUAL ABUSE Yes 6 4% 6 5%

No 87 57% 66 52%

Don’t Know 60 39% 54 43%

HX VICTIM EMOTIONAL ABUSE Yes 10 7% 8 6%

No 80 52% 62 49%

Don’t Know 63 41% 56 44%

HX VICTIM SEXUAL HARASSMENT Yes 1 1% 0 0%

No 89 58% 69 55%

Don’t Know 63 41% 57 45%

HX PERPETRATOR PHYSICAL ABUSE Yes 14 9% 8 6%

No 80 52% 61 48%

Don’t Know 59 39% 57 45%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 114

Table 5.25 2009 AND 2008 ARMY DoDSER ABUSE HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX PERPETRATOR SEXUAL ABUSE Yes 6 4% 7 6%

No 84 55% 65 52%

Don’t Know 63 41% 54 43%

HX PERPETRATOR EMOTIONAL ABUSE Yes 6 4% 8 6%

No 83 54% 62 49%

Don’t Know 64 42% 56 44%

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 4 3% 1 1%

No 84 55% 68 54%

Don’t Know 65 42% 57 45%

Financial and Workplace Difficulties

Of the financial and workplace issues assessed by DoDSER, the most commonly reported difficulties for 

decedents were job problems (25%, n=39) and poor work performance (16%, n=24), as shown in Table 

5.26. Thirteen percent (n=20) of decedents had a history of difficulties with either supervisors or 

coworkers, and 8% (n=12) had a history of excessive debt or bankruptcy.

Table 5.26 2009 AND 2008 ARMY DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 12 8% 11 9%

No 84 55% 65 52%

Don’t Know 57 37% 50 40%

HX JOB PROBLEMS Yes 39 25% 25 20%

No 71 46% 73 58%

Don’t Know 43 28% 28 22%

HX SUPERVISOR/COWORKER ISSUES Yes 20 13% 18 14%

No 83 54% 72 57%

Don’t Know 50 33% 36 29%

HX POOR WORK EVALUATION Yes 24 16% 17 13%

No 89 58% 73 58%

Don’t Know 40 26% 36 29%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 115

Table 5.26 2009 AND 2008 ARMY DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX UNIT/WORKPLACE HAZING Yes 4 3% 2 2%

No 94 61% 84 67%

Don’t Know 55 36% 40 32%

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Soldier’s most recent three 

deployments. Data include deployment location information as well as a history of direct combat 

operations. Comparisons of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) suicide 

events to non-OEF/OIF suicide events are reported in Chapter 3.

Deployment History

As shown in Table 5.27, the majority (65%, n=99) of Army decedents had been deployed as part of 

OEF/OIF at least once. Fifty-one percent (n=78) had been deployed to only Iraq, and 8% (n=13) had been 

deployed to multiple OEF/OIF locations.

Table 5.27 2009 AND 2008 ARMY DoDSER EVER DEPLOYED TO OEF/OIF FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

HX DEPLOYMENT OEF/OIF AFGHANISTAN 3 2% 9 7%

IRAQ 78 51% 57 45%

KUWAIT 5 3% 2 2%

MULTIPLE OEF/OIF LOCATIONS 13 8% 3 2%

NO HX OEF/OIF DEPLOYMENT 54 35% 56 44%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 116

Combat History

As shown in Table 5.28, the majority of Army decedents had no known direct combat history (75%, 

n=115). Of the 38 decedents (25%) with combat history, 24 (63%) were reported to have witnessed 

killing and 24 (63%) were reported to have seen dead bodies during combat.

Table 5.28 2009 AND 2008 ARMY DoDSER COMBAT HISTORY FOR COMPLETED SUICIDES

2009 2008

Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 38 25% 24 19%

 Combat Resulted in Injuries/Casualties 31 82% 12 50%

 Injured in Combat 9 24% 4 17%

 Witnessed Killing in Combat 24 63% 8 33%

 Saw Dead Bodies in Combat 24 63% 9 38%

 Killed Others in Combat 12 32% 1 4%

NO DIRECT COMBAT HX 115 75% 102 81%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat.

Percentages for these items reflect proportion of those with combat experience.
DoDSER 2009 Annual Report

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Page | 117

Army Results for Non-Fatal Events

In addition to DoDSERs collected for suicides, Army DoDSERs were submitted for any suicide-related 

behavior that resulted in hospitalization or evacuation from theater. Army DoDSER data are presented 

separately for suicide attempts, self-harm without intent to die, and suicidal ideation only. While there 

is debate regarding what types of events should be classified as a suicide attempt, the Army DoDSER 

process has adopted the following definition: “A self-inflicted potentially injurious behavior with a nonfatal outcome for which there is evidence (either explicit or implicit) of intent to die.”

A suicide attempt may or may not result in injury.

[3]

Therefore, this category includes behaviors for 

which there is evidence that the individual intended to die, but the event resulted in no injuries. For 

example, if someone wrestled a firearm away from a Soldier intending to use it on himself, this would be 

classified as a suicide attempt even though there were no injuries.

Self-harm without intent to die is defined as a potentially injurious self-directed behavior for which 

there is evidence (either implicit or explicit) that the person did not intend to kill himself or herself.

Persons engage in these self-harm behaviors when they wish to use the appearance of a suicide attempt

to attain some other end (e.g., to seek help, punish others, receive attention, or regulate negative 

mood). Suicidal ideation only (without an attempt or self-harm) is defined as any self-reported thoughts 

of engaging in suicide-related behaviors.

[3]

Data collection processes for Army DoDSERs following non-fatal suicide events differ somewhat from 

the data collection process for suicides. The data sources used to complete an Army DoDSER for a nonfatal event include medical and behavioral health records, and an interview with the patient is 

frequently used to collect the required information.

The reporting process for non-fatal suicide events requires the Army DoDSER reporter for each MTF to 

track these events and ensure DoDSER submission. DoDSER respondents are required to submit monthly 

reports on suicide-related hospitalizations for each MTF by the fifth working day of the following month 

to identify the number of hospitalizations or evacuations for that MTF. DoDSERs are then expected for 

events based on these reports. This generally involves coordination with inpatient behavioral health

personnel and outpatient behavioral health clinic personnel.
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Army DoDSERs Submitted for Non-Fatal Events

A total of 2,047 Army DoDSERs for non-fatal events were submitted for 2009. Of these, 502 (25%) were submitted for suicide attempts, 347 

(17%) for instances of self-harm without intent to die, and 1198 (59%) for suicidal ideation only, as shown in Table 5.29.

Table 5.29 2009 AND 2008 NON-FATAL ARMY DoDSERs SUBMITTED

2009 2008

Count Percent Count Percent

EVENT TYPE Suicide Attempt 502 25% 591 29%

Self-Harm (w/o Intent to Die) 347 17% 418 21%

Ideation Only 1198 59% 1017 50%

Total 2047 59% 2026 50%

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of Service Members that may have been associated with or 

contributed to the suicidal events. These factors include demographic characteristics, event setting, suicide attempt method, substance use 

during the event, possible motive and intent to die, and communication of intent with others.

Demographics

Table 5.30 shows demographic data for non-fatal events for 2009. Across all non-fatal event types, the majority of Soldiers were male, 

Caucasian, under 25, and lower enlisted. In addition, the educational level of the majority of Soldiers across event types was high school or the 

equivalent.
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Table 5.30 2009 AND 2008 NON-FATAL ARMY DoDSER DEMOGRAPHICS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

GENDER Male 373 74% 454 77% 249 72% 307 73% 924 77% 820 81%

Female 129 26% 137 23% 98 28% 111 27% 274 23% 197 19%

RACE Asian/Pacific Islander 14 3% 12 2% 11 3% 8 2% 32 3% 27 3%

African American 78 16% 77 13% 41 12% 45 11% 186 16% 122 12%

Caucasian 319 64% 405 69% 244 71% 289 70% 784 66% 703 70%

Hispanic 21 4% 11 2% 6 2% 9 2% 16 1% 12 1%

Other/Don’t Know/Missing 65 13% 80 14% 44 13% 59 14% 168 14% 142 14%

AGE RANGE Under 25 298 59% 381 64% 224 65% 290 69% 752 63% 650 64%

25-29 119 24% 103 17% 75 22% 81 19% 230 19% 175 17%

30-39 69 14% 85 14% 36 10% 40 10% 161 13% 146 14%

40 + 16 3% 22 4% 12 3% 7 2% 54 5% 46 5%

RANK E1-E4 373 74% 463 78% 277 80% 357 85% 961 80% 827 81%

E5-E9 109 22% 104 18% 51 15% 56 13% 185 15% 161 16%

Officer 12 2% 21 4% 12 3% 4 1% 24 2% 18 2%

Warrant Officer 1 <1% 0 0% 1 <1% 1 <1% 5 <1% 2 <1%

Cadet/Midshipman 2 <1% 1 <1% 5 1% 0 0% 9 1% 5 <1%

Does Not Apply 5 1% 2 <1% 1 <1% 0 0% 10 1% 4 <1%

COMPONENT Regular 458 91% 533 90% 314 90% 385 92% 1065 89% 911 90%

Reserve 16 3% 25 4% 5 1% 13 3% 36 3% 34 3%

National Guard 25 5% 31 5% 24 7% 20 5% 80 7% 65 6%

Other 3 1% 2 <1% 4 1% 0 0% 13 1% 7 1%
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Table 5.30 2009 AND 2008 NON-FATAL ARMY DoDSER DEMOGRAPHICS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

EDUCATION Some high school 7 1% 7 1% 5 1% 7 2% 7 1% 14 1%

GED 89 18% 107 18% 49 14% 54 13% 164 14% 147 14%

High school graduate 171 34% 239 40% 169 49% 212 51% 569 48% 442 43%

Some college or technical school 142 28% 104 18% 71 20% 82 20% 245 21% 206 20%

2 year degree/certificate 19 4% 28 5% 5 1% 10 2% 37 3% 36 4%

Four-year college degree 18 4% 27 5% 15 4% 6 1% 45 4% 23 2%

Master’s degree or greater 3 1% 8 1% 6 2% 3 1% 13 1% 11 1%

Don’t Know 53 11% 71 12% 27 8% 44 11% 115 10% 138 14%

MARITAL 

STATUS

Never Married 215 43% 264 45% 163 47% 198 47% 586 49% 477 47%

Married 220 44% 253 43% 148 43% 172 41% 456 38% 425 42%

Legally Separated 15 3% 20 3% 11 3% 9 2% 47 4% 28 3%

Divorced 41 8% 38 6% 20 6% 28 7% 71 6% 57 6%

Widowed 2 <1% 4 1% 0 0% 3 1% 0 0% 2 <1%

Don’t Know 9 2% 12 2% 5 1% 8 2% 36 3% 28 3%

(cont.)
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Event Setting

As shown in Table 5.31, for all types of non-fatal events, the United States was the most commonly reported location. Iraq was the second most 

common location. However, as shown in the table, this proportion was small, as were the proportions for the remaining locations.

Table 5.31 2009 AND 2008 NON-FATAL ARMY DoDSER EVENT COUNTRY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

EVENT COUNTRY United States 396 79% 447 76% 295 85% 350 84% 1066 89% 927 91%

Iraq 43 9% 80 14% 19 5% 36 9% 50 4% 59 6%

Afghanistan 8 2% 10 2% 6 2% 3 1% 9 1% 6 1%

Kuwait 3 1% 2 <1% 2 1% 2 <1% 3 <1% 2 <1%

Korea 17 3% 18 3% 7 2% 10 2% 6 1% 10 1%

Kosovo 0 0% 0 0% 1 <1% 0 0% 1 <1% 0 0%

Europe 26 5% 30 5% 13 4% 14 3% 51 4% 13 1%

Canada 3 1% 1 <1% 0 0% 0 0% 3 <1% 0 0%

Central or South America 0 0% 1 <1% 0 0% 0 0% 1 <1% 0 0%

Other 4 1% 0 0% 2 1% 0 0% 0 0% 0 0%

Don’t Know 2 <1% 2 <1% 2 1% 3 1% 2 <1% 0 0%
DoDSER 2009 Annual Report

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As shown in Table 5.32, non-fatal events occurred most often in Soldiers’ personal residences. Very few self-harm behaviors were reported to 

have occurred in other locations.

Table 5.32 2009 AND 2008 NON-FATAL ARMY DoDSER EVENT SETTING

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 397 79% 468 79% 289 83% 357 85% 898 75% 735 72%

Residence of friend or family 26 5% 29 5% 10 3% 11 3% 29 2% 26 3%

Work/jobsite 8 2% 24 4% 14 4% 16 4% 105 9% 128 13%

Automobile 28 6% 18 3% 9 3% 8 2% 35 3% 18 2%

Inpatient medical facility 3 1% 4 1% 7 2% 0 0% 6 1% 7 1%

Other 40 8% 48 8% 18 5% 26 6% 119 10% 103 10%
DoDSER 2009 Annual Report

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Event Method

Figure 5.2 and Table 5.33 show the self-harm methods used for each type of non-fatal event. Drugs were most frequently reported. Use of sharp 

or blunt objects, followed by hanging, were the next most common methods with which Soldiers were reported to have harmed themselves.

Figure 5.2 2009 AND 2008 NON-FATAL ARMY DoDSER EVENT METHODS

54%

8%

15%

9%

14%

57%

9% 12% 7%

15%

0

10

20

30

40

50

60

70

80

90

100

Drugs Hanging Sharp or Blunt 

Object

Firearm Other

Percentage

2009

2008
DoDSER 2009 Annual Report

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Table 5.33 2009 AND 2008 NON-FATAL ARMY DoDSER EVENT METHOD

Suicide Attempt Self-Harm (w/o Intent to Die)

2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent

EVENT METHOD Drugs 271 54% 334 57% 159 46% 192 46%

Alcohol 11 2% 19 3% 16 5% 22 5%

Gas, vehicle exhaust 4 1% 4 1% 2 1% 0 0%

Gas, utility (or other) 2 <1% 0 0% 0 0% 0 0%

Chemicals 6 1% 5 1% 1 <1% 2 <1%

Hanging 40 8% 54 9% 15 4% 16 4%

Drowning 1 <1% 1 <1% 2 1% 0 0%

Firearm, military issue 25 5% 32 5% 9 3% 7 2%

Firearm, non-military issue 18 4% 13 2% 7 2% 5 1%

Fire, steam, etc. 0 0% 0 0% 1 <1% 3 1%

Sharp or blunt object 76 15% 71 12% 95 27% 118 28%

Jumping from high place 4 1% 6 1% 5 1% 1 <1%

Crashing a motor vehicle 10 2% 8 1% 2 1% 3 1%

Other 30 6% 35 6% 25 7% 38 9%

Don’t Know 4 1% 9 2% 8 2% 11 3%

Event Motivation

After reviewing all relevant records and conducting interviews, Army DoDSER respondents reviewed available evidence and subjectively 

assessed the Soldier’s primary motivation for the non-fatal event. It is important to note that this attempts to simplify extremely complex 

behavior. Due to the subjectivity of the content, results should be interpreted with caution. These data are summarized in Table 5.34.
DoDSER 2009 Annual Report

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For all non-fatal events, the principal motivation reported was emotional relief. Thirty-four percent of the Soldiers who attempted suicide 

(n=171) reported that they had been motivated by a desire for emotional relief; 42% (n=146) of Soldiers who engaged in self-harming behavior 

reported the same motivation. Very little data were reported for event motivation of suicidal ideation.

Table 5.34 2009 AND 2008 NON-FATAL ARMY DoDSER EVENT MOTIVATION

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

EVENT 

MOTIVATION

Emotional Relief 171 34% 184 31% 146 42% 161 39% 17 1% 1 <1%

Influence 28 6% 35 6% 37 11% 42 10% 0 0% 0 0%

Feeling Generation 2 <1% 2 <1% 2 1% 3 1% 1 <1% 0 0%

Avoidance 33 7% 47 8% 19 5% 38 9% 3 <1% 0 0%

Individual Reasons 22 4% 19 3% 13 4% 12 3% 1 <1% 0 0%

Hopelessness 44 9% 67 11% 12 3% 7 2% 1 <1% 0 0%

Depression 67 13% 88 15% 26 7% 26 6% 3 <1% 1 <1%

Other Behavioral Health 13 3% 18 3% 5 1% 14 3% 0 0% 0 0%

Impulsivity 55 11% 45 8% 44 13% 58 14% 0 0% 0 0%

Other 28 6% 41 7% 28 8% 34 8% 1 <1% 0 0%

Don’t Know 39 8% 45 8% 15 4% 23 6% 1171 98% 1015 100%

Post-Event Actions

The Army DoDSER asked respondents to identify actions taken as a consequence of the non-fatal event.

Table 5.35 shows the numbers and percentages of Soldiers who were hospitalized, evacuated, or referred to outpatient services following 

suicide attempts, self-harm without intent to die events, and reports of suicidal ideation only. The majority of Soldiers engaging in self-harm 

behaviors were hospitalized. DoDSERs submitted for non-fatal events may be completed shortly after the event. Therefore, it is very likely that 

more patients were referred for outpatient services after a hospitalization.
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Table 5.35 2009 AND 2008 NON-FATAL ARMY DoDSER POST-EVENT ACTIONS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

POST EVENT 

ACTIONS

HOSPITALIZED 456 91% 556 94% 330 95% 394 94% 1125 94% 973 96%

OUTPATIENT 35 7% 35 6% 27 8% 18 4% 75 6% 25 2%

EVACUATED 45 9% 39 7% 29 8% 31 7% 53 4% 36 4%

OTHER 10 2% 13 2% 2 1% 3 1% 6 1% 7 1%

UNKNOWN 11 2% 1 <1% 6 2% 2 <1% 44 4% 12 1%

Substance Use during the Event

The DoDSER process captures information about whether alcohol or other drugs were used during the non-fatal event (not necessarily as a 

method for inflicting self-harm). As shown in Table 5.36, drugs were the most common type of substance reported to have been used during 

suicide attempts and self-harm without intent to die. Sixty percent (n=300) of Soldiers who attempted suicide were reported to have used drugs 

during the event. A similar proportion (50%, n=173) of Soldiers who inflicted non-fatal self-harm were reported to have used drugs. Seventeen 

percent (n=87) of suicide attempts, and 14% (n=47) of self-harm cases were reported to have used both alcohol and drugs during the event. Few 

DoDSERs included data regarding substance use during suicidal ideation.

Table 5.36 2009 AND 2008 NON-FATAL ARMY DoDSER SUBSTANCE(S) USED DURING EVENT

Suicide Attempt Self-Harm (w/o Intent to Die)

2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent

ALCOHOL USED Yes 138 27% 147 25% 94 27% 108 26%

No 323 64% 381 64% 235 68% 256 61%

Don’t Know 41 8% 63 11% 18 5% 54 13%
DoDSER 2009 Annual Report

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Table 5.36 2009 AND 2008 NON-FATAL ARMY DoDSER SUBSTANCE(S) USED DURING EVENT

Suicide Attempt Self-Harm (w/o Intent to Die)

2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent

ANY DRUGS 

USED

Yes 300 60% 353 60% 173 50% 204 49%

No 175 35% 196 33% 159 46% 175 42%

Don’t Know 27 5% 42 7% 15 4% 39 9%

Illegal drugs Overdose 17 3% 18 3% 9 3% 5 1%

Used, no overdose 12 2% 13 2% 9 3% 13 3%

Were not used 397 79% 411 70% 293 84% 323 77%

Don’t Know 76 15% 149 25% 36 10% 77 18%

Prescription 

drugs

Overdose 197 39% 220 37% 80 23% 99 24%

Used, no overdose 29 6% 40 7% 48 14% 50 12%

Were not used 237 47% 263 45% 196 56% 219 52%

Don’t Know 39 8% 68 12% 23 7% 50 12%

OTC drugs Overdose 78 16% 92 16% 32 9% 36 9%

Used, no overdose 13 3% 20 3% 17 5% 18 4%

Were not used 339 68% 345 58% 262 76% 291 70%

Don’t Know 72 14% 134 23% 36 10% 73 17%

BOTH ALCOHOL 

AND DRUGS 

USED

Yes 87 17% 94 16% 47 14% 59 14%

No 366 73% 426 72% 275 79% 301 72%

Don’t Know 49 10% 71 12% 25 7% 58 14%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicated their potential for self-harm behaviors, when 

known. As shown in Table 5.37, across all types of non-fatal events, the majority of Soldiers were not reported to have communicated their 

(cont.)
DoDSER 2009 Annual Report

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Page | 128

potential for suicidal behaviors prior to the non-fatal events. Among Soldiers reported to have communicated this potential, friends, behavioral 

health staff, supervisors, and spouses were the most commonly reported recipients of the communications.

Table 5.37 2009 AND 2008 NON-FATAL ARMY DoDSER RECIPIENTS OF COMMUNICATED INTENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

COMMUNICATION Friend 24 5% 48 8% 14 4% 14 3% 3 <1% 0 0%

Behavioral Health Staff 34 7% 38 6% 20 6% 26 6% 1 <1% 0 0%

Supervisor 21 4% 30 5% 17 5% 17 4% 1 <1% 0 0%

Spouse 38 8% 27 5% 10 3% 11 3% 1 <1% 0 0%

Chaplain 6 1% 10 2% 0 0% 5 1% 1 <1% 0 0%

Other 30 6% 38 6% 6 2% 13 3% 12 1% 0 0%

Made Multiple Communication 27 5% 45 8% 11 3% 15 4% 1 <1% 0 0%

Table 5.38 displays the number and types of recipients of the communicated potential for self-harm. The vast majority of Soldiers were not 

known to communicate their potential for self-harm. Less than 2% of suicidal ideation cases were reported to communicate their potential for 

self-harm to another person.
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Table 5.38 2009 AND 2008 NON-FATAL ARMY DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

NUMBER OF 

TYPES OF 

RECIPIENTS OF 

COMMUNICATED 

INTENT

0 389 77% 463 78% 293 84% 358 86% 1180 98% 1017 100%

1 86 17% 83 14% 43 12% 45 11% 17 1% 0 0%

2 18 4% 32 5% 9 3% 7 2% 1 <1% 0 0%

3 6 1% 10 2% 2 1% 5 1% 0 0% 0 0%

4 2 <1% 1 <1% 0 0% 3 1% 0 0% 0 0%

5 1 <1% 2 <1% 0 0% 0 0% 0 0% 0 0%

As shown in Table 5.39, the majority of reported communications of intent for self-harm without intent to die were verbal. However, “no known 

communication” was the most frequent response reported across all types of non-fatal events.

Table 5.39 2009 AND 2008 NON-FATAL ARMY DoDSER MODE OF COMMUNICATED INTENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

MODE OF 

COMMUNICATED 

INTENT

Verbal Only 81 16% 98 17% 43 12% 52 12% 17 1% 0 0%

Written Only 15 3% 10 2% 5 1% 3 1% 0 0% 0 0%

Other 6 1% 0 0% 4 1% 1 <1% 1 <1% 0 0%

Multiple Modes 10 2% 16 3% 2 1% 1 <1% 0 0% 0 0%

Note: Multiple Modes includes a combination of verbal, written, or other mode of communicating intent to suicide.

Additional Event Information

Additional details about non-fatal events were consistent from 2008 to 2009. As shown in Table 5.40, most Soldiers who attempted suicide were 

deemed to have intended to die (70%, n=351), however, very few suicide notes were found (12%, n=62). Nearly half of the Soldiers attempted 
DoDSER 2009 Annual Report

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Page | 130

suicide in locations where it was likely that others could observe or intervene (46%, n=229). A much smaller proportion of self-harm and 

ideation-only cases were deemed to have intended to die. Fifty-six percent of self-harm without intent to die events (n=195) were reported to 

have taken place in locations where they were likely to be observed by others.

Table 5.40 2009 AND 2008 NON-FATAL ARMY DoDSER OTHER EVENT INFORMATION

Suicide Attempt Self-Harm (w/o Intent to Die)

2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent

EVIDENCE EXISTS 

INDICATING 

INTENTION TO 

DIE

Yes 351 70% 385 65% 22 6% 17 4%

No 63 13% 78 13% 260 75% 330 79%

Don’t Know 88 18% 128 22% 65 19% 71 17%

DEATH RISK 

GAMBLING

Yes 8 2% 8 1% 1 <1% 13 3%

No 465 93% 539 91% 339 98% 383 92%

Don’t Know 29 6% 44 7% 7 2% 22 5%

PLANNED/ 

PREMEDITATED

Yes 136 27% 158 27% 37 11% 42 10%

No 295 59% 324 55% 257 74% 327 78%

Don’t Know 71 14% 109 18% 53 15% 49 12%

OBSERVABLE Yes 229 46% 236 40% 195 56% 220 53%

No 193 38% 261 44% 103 30% 140 33%

Don’t Know 80 16% 94 16% 49 14% 58 14%

SUICIDE NOTE 

LEFT

Yes 62 12% 88 15% 7 2% 10 2%

No 385 77% 426 72% 309 89% 372 89%

Don’t Know 55 11% 77 13% 31 9% 36 9%
DoDSER 2009 Annual Report

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Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty environments.

Home Environment

Most of the Soldiers who attempted suicide lived on military installations at the time of the attempt, with 58% (n=292) having lived in barracks 

or similar shared military housing and 24% (n=121) having lived in off-base family housing. Thirty-five percent of suicide attempters (n=177) had 

minor children, though most did not reside with their children at the time of the attempt. Only 15% (n=75) were reported to have had access to 

firearms in the immediate environment. Similar patterns were observed for Soldiers reported to have harmed themselves without intending to 

die, and for Soldiers reported to have had suicidal ideations (Table 5.41).

Table 5.41 2009 AND 2008 NON-FATAL ARMY DoDSER HOME ENVIRONMENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

RESIDENCE AT 

TIME OF EVENT Shared military living environ. 292 58% 396 67% 201 58% 271 65% 774 65% 641 63%

Bachelor quarters 4 1% 6 1% 0 0% 3 1% 9 1% 5 <1%

On-base family housing 31 6% 25 4% 18 5% 31 7% 76 6% 58 6%

Apartment or house 121 24% 120 20% 93 27% 93 22% 246 21% 215 21%

Ship 0 0% 0 0% 0 0% 0 0% 1 <1% 0 0%

Other 26 5% 21 4% 16 5% 10 2% 40 3% 40 4%

Don’t Know 28 6% 23 4% 19 5% 10 2% 50 4% 58 6%

MARRIED SERVICE 

MEMBER 

RESIDENCE

Resides with spouse 100 20% 101 17% 76 22% 89 21% 201 17% 199 20%

Separated due to relationship 

issues

44 9% 50 8% 29 8% 31 7% 100 8% 86 8%

Apart for other 

reasons/deployed 68 14% 98 17% 35 10% 50 12% 137 11% 112 11%

Don’t Know 10 2% 5 1% 9 3% 2 <1% 17 1% 31 3%

Unmarried at time of event 280 56% 337 57% 198 57% 246 59% 743 62% 589 58%
DoDSER 2009 Annual Report

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Table 5.41 2009 AND 2008 NON-FATAL ARMY DoDSER HOME ENVIRONMENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

RESIDED ALONE Yes 136 27% 160 27% 62 18% 97 23% 226 19% 198 19%

No 301 60% 363 61% 232 67% 290 69% 830 69% 729 72%

Don’t Know 65 13% 68 12% 53 15% 31 7% 141 12% 90 9%

HAD MINOR 

CHILDREN

Yes 177 35% 187 32% 90 26% 91 22% 316 26% 278 27%

No 292 58% 360 61% 216 62% 292 70% 795 66% 631 62%

Don’t Know 33 7% 44 7% 41 12% 35 8% 86 7% 108 11%

CHILDREN RESIDED 

WITH

Yes 56 11% 62 10% 34 10% 26 6% 102 9% 103 10%

No 115 23% 124 21% 55 16% 65 16% 194 16% 171 17%

Don’t Know 6 1% 3 1% 2 1% 1 <1% 23 2% 7 1%

No Known Children 325 65% 402 68% 256 74% 326 78% 879 73% 736 72%

FIREARM IN 

IMMEDIATE/

LIVING 

ENVIRONMENT

Yes 75 15% 110 19% 37 11% 58 14% 141 12% 140 14%

No 332 66% 341 58% 252 73% 277 66% 870 73% 642 63%

Don’t Know 95 19% 140 24% 58 17% 83 20% 187 16% 235 23%

(cont.)
DoDSER 2009 Annual Report

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Duty Environment

Data pertaining to the duty environment are provided in Table 5.42. Garrison was the most commonly reported duty environment for Soldiers 

who made suicide attempts (66%, n=332). Fourteen percent of Soldiers who attempted suicide were in training (n=68). Similar patterns were 

observed for Soldiers reported to have harmed themselves without intending to die, and for Soldiers reported to have had suicidal ideations.

Table 5.42 2009 AND 2008 NON-FATAL ARMY DoDSER DUTY ENVIRONMENT

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

DUTY 

ENVIRONMENT

Garrison 332 66% 383 65% 261 75% 287 69% 844 70% 676 66%

Psych Hosp 3 1% 4 1% 4 1% 1 <1% 9 1% 4 <1%

Leave 16 3% 20 3% 6 2% 7 2% 11 1% 13 1%

Medical Hold 16 3% 24 4% 20 6% 12 3% 32 3% 24 2%

TDY 1 <1% 0 0% 1 <1% 3 1% 5 <1% 2 <1%

Evacuation Chain 0 0% 2 <1% 3 1% 1 <1% 1 <1% 2 <1%

AWOL 7 1% 7 1% 5 1% 4 1% 13 1% 16 2%

Under Command Observation 4 1% 6 1% 2 1% 8 2% 4 <1% 8 1%

Other 18 4% 31 5% 5 1% 19 5% 25 2% 51 5%

Training 68 14% 95 16% 37 11% 69 17% 192 16% 196 19%

Multiple Duty Environments

Provided 31 6% 61 10% 34 10% 29 7% 74 6% 55 5%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.
DoDSER 2009 Annual Report

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Page | 134

Non-fatal Events by Month

Consistent with data from 2008, no clear pattern exists for Army non-fatal events by month (Table 5.43).

Table 5.43 2009 AND 2008 NON-FATAL ARMY DoDSER SUICIDE EVENTS BY MONTH

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

MONTH January 70 14% 60 10% 38 11% 33 8% 101 8% 66 6%

February 35 7% 53 9% 31 9% 21 5% 102 9% 61 6%

March 56 11% 47 8% 45 13% 31 7% 106 9% 45 4%

April 45 9% 38 6% 28 8% 29 7% 120 10% 70 7%

May 42 8% 40 7% 26 7% 38 9% 126 11% 63 6%

June 43 9% 54 9% 27 8% 44 11% 126 11% 91 9%

July 44 9% 56 9% 34 10% 39 9% 103 9% 96 9%

August 48 10% 57 10% 30 9% 40 10% 101 8% 101 10%

September 44 9% 54 9% 16 5% 40 10% 90 8% 121 12%

October 41 8% 50 8% 30 9% 43 10% 100 8% 118 12%

November 18 4% 42 7% 23 7% 24 6% 63 5% 99 10%

December 16 3% 40 7% 19 5% 36 9% 60 5% 86 8%

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be associated with subsequent suicidal 

behavior. These factors include data on prior self-harm, previous diagnoses of behavioral health disorders and behavioral health issues, and 

relevant treatment histories, including prescribed medication.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 135

Prior Self-Injury

As shown in Table 5.44, 40% (n=199) of Soldiers who attempted suicide, 35% (n=122) of self-harm cases, and 26% (n=311) of suicidal ideation 

cases had known histories of prior self-injury. The proportions for more than one prior self-harm event were: 30% (n=149), 26% (n= 91), and 18% 

(n=217) for attempts, self-harm, and suicidal ideation, respectively. Particular non-fatal events were reported to have been similar to prior 

instances of self-injury in 20% (n=99) of attempts, 22% (n=77) of self-harm cases, and 9% (n=104) suicidal ideation cases.

Table 5.44 2009 AND 2008 NON-FATAL ARMY DoDSER PRIOR SELF-INJURY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX PRIOR SELFINJURYYes 199 40% 221 37% 122 35% 149 36% 311 26% 264 26%

 Within 30 days 35 7% 16 3% 27 8% 16 4% 49 4% 26 3%

 Within 90 days (inclusive)* 56 11% 30 5% 40 12% 27 6% 77 6% 49 5%

No 265 53% 292 49% 189 54% 224 54% 739 62% 598 59%

Don't Know 38 8% 78 13% 36 10% 45 11% 148 12% 155 15%

Number prior 

self-injuries

One prior event 48 10% ---- ---- 28 8% ---- ---- 90 8% ---- ----

More than one prior event 149 30% ---- ---- 91 26% ---- ---- 217 18% ---- ----

N/A 303 61% ---- ---- 225 65% ---- ---- 887 74% ---- ----

Event similar to 

prior self-injury

Yes 99 20% 115 19% 77 22% 94 22% 104 9% 100 10%

No 80 16% 84 14% 32 9% 38 9% 132 11% 113 11%

Don't Know 19 4% 22 4% 13 4% 17 4% 75 6% 51 5%

N/A 303 60% 370 63% 225 65% 269 64% 887 74% 753 74%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 136

Behavioral Health Disorders

As shown in Table 5.45, 43% (n=216) of Soldiers with attempted suicides had no reported behavioral health diagnoses. Similarly, 39% (n=136) of 

Soldiers with self-harm without intent to die, and 46% (n=554) with suicidal ideation had no reported behavioral health diagnoses. Close to onethird of Soldiers with any type of non-fatal event had one reported behavioral health diagnosis. As displayed in the table, much smaller 

proportions of Soldiers had reported comorbid diagnoses across all types of non-fatal events.

Thirty-nine percent (n=197) of Service Members with a suicide attempt had been diagnosed with a mood disorder, including major depression 

(19%, n=96), bipolar disorder (3%, n=16), and dysthymic disorder (1%, n=4; Table 5.46). Twenty-four percent (n=120) of Service Members with a 

suicide attempt had been diagnosed with an anxiety disorder, including PTSD (10%, n=49; Table 5.47). As summarized in Table 5.48, 1% (n=6) 

had been diagnosed with a psychotic disorder, 7% (n=33) had been diagnosed with a personality disorder, and 28% (n=139) had a history of 

substance abuse.

Table 5.45 2009 AND 2008 NON-FATAL ARMY DoDSER COMORBIDITY RATES

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

NUMBER OF 

BEHAVIORAL 

HEALTH 

DIAGNOSES

No DX 216 43% 259 44% 136 39% 204 49% 554 46% 511 50%

1 DX 149 30% 163 28% 96 28% 112 27% 348 29% 277 27%

2 DX 74 15% 104 18% 67 19% 74 18% 188 16% 143 14%

3 DX 42 8% 47 8% 38 11% 24 6% 71 6% 55 5%

4 or more DX 21 4% 18 3% 10 3% 4 1% 37 3% 31 3%
DoDSER 2009 Annual Report

Chapter 5 Army Results

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Table 5.46 2009 AND 2008 NON-FATAL ARMY DoDSER MOOD DISORDERS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

DX W/MOOD 

DISORDER

Yes 197 39% 246 42% 138 40% 156 37% 433 36% 348 34%

No 258 51% 269 46% 178 51% 221 53% 635 53% 527 52%

Don’t Know 47 9% 76 13% 31 9% 41 10% 130 11% 142 14%

Bipolar disorder Yes 16 3% 18 3% 10 3% 22 5% 45 4% 32 3%

No 426 85% 470 80% 300 86% 343 82% 1001 84% 821 81%

Don’t Know 60 12% 103 17% 37 11% 53 13% 152 13% 164 16%

Major 

depression

Yes 96 19% 139 24% 64 18% 65 16% 183 15% 165 16%

No 351 70% 361 61% 248 71% 302 72% 868 72% 688 68%

Don’t Know 55 11% 91 15% 35 10% 51 12% 147 12% 164 16%

Dysthymic 

disorder

Yes 4 1% 2 <1% 7 2% 4 1% 19 2% 12 1%

No 436 87% 483 82% 300 86% 358 86% 1029 86% 836 82%

Don’t Know 62 12% 106 18% 40 12% 56 13% 150 13% 169 17%

Other mood 

disorder

Yes 44 9% 48 8% 37 11% 41 10% 118 10% 69 7%

No 398 79% 434 73% 271 78% 327 78% 927 77% 784 77%

Don’t Know 60 12% 109 18% 39 11% 50 12% 153 13% 164 16%

Unspecified 

mood disorder

Yes 6 1% 11 2% 4 1% 7 2% 15 1% 24 2%

No 449 89% 504 85% 312 90% 370 89% 1053 88% 851 84%

Don’t Know 47 9% 76 13% 31 9% 41 10% 130 11% 142 14%

Multiple mood 

DX

Yes 31 6% 28 5% 16 5% 17 4% 53 4% 46 5%

No 424 84% 487 82% 300 86% 360 86% 1015 85% 829 82%

Don’t Know 47 9% 76 13% 31 9% 41 10% 130 11% 142 14%

Note: Mixed-case items were only asked in cases where the respondent indicated that the Service Member had a mood disorder.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 138

Table 5.47 summarizes diagnoses of anxiety disorders.

Table 5.47 2009 AND 2008 NON-FATAL ARMY DoDSER ANXIETY DISORDERS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

DX W/ANXIETY 

DISORDER

Yes 120 24% 138 23% 97 28% 68 16% 212 18% 200 20%

No 338 67% 365 62% 219 63% 302 72% 864 72% 667 66%

Don’t Know 44 9% 88 15% 31 9% 48 11% 122 10% 150 15%

PTSD Yes 49 10% 68 12% 37 11% 31 7% 89 7% 82 8%

No 402 80% 428 72% 276 80% 333 80% 980 82% 775 76%

Don’t Know 51 10% 95 16% 34 10% 54 13% 129 11% 160 16%

Panic disorder Yes 4 1% 4 1% 2 1% 3 1% 3 <1% 9 1%

No 447 89% 484 82% 308 89% 359 86% 1056 88% 847 83%

Don’t Know 51 10% 103 17% 37 11% 56 13% 139 12% 161 16%

Generalized 

anxiety disorder

Yes 10 2% 16 3% 11 3% 7 2% 28 2% 27 3%

No 439 87% 472 80% 301 87% 357 85% 1033 86% 828 81%

Don’t Know 53 11% 103 17% 35 10% 54 13% 137 11% 162 16%

Acute stress 

disorder

Yes 2 <1% 0 0% 0 0% 1 <1% 0 0% 2 <1%

No 449 89% 483 82% 310 89% 362 87% 1061 89% 850 84%

Don’t Know 51 10% 108 18% 37 11% 55 13% 137 11% 165 16%

Other anxiety 

disorder

Yes 26 5% 21 4% 20 6% 17 4% 40 3% 36 4%

No 428 85% 467 79% 290 84% 348 83% 1021 85% 823 81%

Don’t Know 48 10% 103 17% 37 11% 53 13% 137 11% 158 16%

Unspecified 

anxiety DX

Yes 5 1% 6 1% 2 1% 2 <1% 11 1% 9 1%

No 453 90% 497 84% 314 90% 368 88% 1065 89% 858 84%

Don’t Know 44 9% 88 15% 31 9% 48 11% 122 10% 150 15%
DoDSER 2009 Annual Report

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Page | 139

Table 5.47 2009 AND 2008 NON-FATAL ARMY DoDSER ANXIETY DISORDERS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

Multiple anxiety 

DX

Yes 24 5% 23 4% 25 7% 7 2% 41 3% 35 3%

No 434 86% 480 81% 291 84% 363 87% 1035 86% 832 82%

Don’t Know 44 9% 88 15% 31 9% 48 11% 122 10% 150 15%

Note: Mixed-case items were only asked in cases where the respondent indicated that the Service Member had an anxiety disorder.

As shown in Table 5.48, small proportions of Soldiers were reported to have been diagnosed with personality and psychotic disorders across all 

types of non-fatal events. The proportion of reported histories of substance abuse was greater: 28% (n=139), 30% (n=104), and 26% (n=316) for 

attempts, self-harm without intent to die, and suicidal ideation, respectively.

Table 5.48 2009 AND 2008 NON-FATAL ARMY DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

DX 

W/PERSONALITY 

DISORDER

Yes 33 7% 45 8% 37 11% 41 10% 72 6% 62 6%

No 419 83% 442 75% 270 78% 324 78% 995 83% 801 79%

Don’t Know 50 10% 104 18% 40 12% 53 13% 131 11% 154 15%

DX 

W/PSYCHOTIC 

DISORDER

Yes 6 1% 12 2% 1 <1% 8 2% 19 2% 20 2%

No 450 90% 500 85% 312 90% 365 87% 1062 89% 856 84%

Don’t Know 46 9% 79 13% 34 10% 45 11% 117 10% 141 14%

HX SUBSTANCE 

ABUSE

Yes 139 28% 159 27% 104 30% 108 26% 316 26% 249 24%

No 313 62% 349 59% 215 62% 260 62% 760 63% 630 62%

Don’t Know 50 10% 83 14% 28 8% 50 12% 122 10% 138 14%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 140

Treatment

Table 5.49 shows the history of Soldiers’ visits to treatment programs and clinics prior to the non-fatal events. DoDSER respondents were 

instructed to select all categories that apply, thus categories are not mutually exclusive.

Thirty-five percent (n=177) of Soldiers who attempted suicide had been seen in military treatment facilities within 90 days of the attempt, and 

28% (n=140) within 30 days. Forty-seven percent (n=238) had been seen in outpatient behavioral health facilities within 90 days of the attempt.

Similar patterns were observed for Soldiers reported to have harmed themselves without intending to die, and for Soldiers reported to have had 

suicidal ideation. Table 5.49 also provides information about the history of Soldiers’ visits to other broadly-defined behavioral health resources 

(i.e., Chaplain, Family Advocacy Program, Army Substance Abuse Program and Inpatient behavioral health programs) within 30 and 90 days 

across all categories of non-fatal events.

Table 5.49 2009 AND 2008 NON-FATAL ARMY DoDSER TREATMENT HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

SEEN AT 

MILITARY 

TREATMENT 

FACILITY

Yes 220 44% 262 44% 138 40% 179 43% 566 47% 483 47%

 Within 30 days 140 28% 193 33% 87 25% 136 33% 404 34% 324 32%

 Within 90 days (inclusive)* 177 35% 240 41% 109 31% 171 41% 502 42% 418 41%

No 228 45% 271 46% 174 50% 201 48% 508 42% 424 42%

Don’t Know 54 11% 58 10% 35 10% 38 9% 124 10% 110 11%

SUBSTANCE 

ABUSE SERVICES

Yes 73 15% 96 16% 60 17% 68 16% 197 16% 129 13%

 Within 30 days 39 8% 47 8% 34 10% 31 7% 115 10% 53 5%

 Within 90 days (inclusive)* 49 10% 62 10% 45 13% 48 11% 150 13% 82 8%

No 381 76% 430 73% 257 74% 310 74% 877 73% 772 76%

Don’t Know 48 10% 65 11% 30 9% 40 10% 124 10% 116 11%

FAMILY 

ADVOCACY 

PROGRAMS

Yes 31 6% 25 4% 22 6% 23 6% 63 5% 45 4%

 Within 30 days 11 2% 7 1% 7 2% 9 2% 22 2% 23 2%

 Within 90 days (inclusive)* 22 4% 14 2% 14 4% 17 4% 38 3% 31 3%
DoDSER 2009 Annual Report

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Table 5.49 2009 AND 2008 NON-FATAL ARMY DoDSER TREATMENT HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

No 420 84% 490 83% 289 83% 350 84% 1003 84% 826 81%

Don’t Know 51 10% 76 13% 36 10% 45 11% 132 11% 146 14%

CHAPLAIN 

SERVICES

Yes 92 18% 99 17% 42 12% 59 14% 207 17% 149 15%

 Within 30 days 58 12% 62 10% 25 7% 42 10% 152 13% 113 11%

 Within 90 days (inclusive)* 81 16% 83 14% 33 10% 53 13% 189 16% 134 13%

No 303 60% 331 56% 218 63% 249 60% 611 51% 463 46%

Don’t Know 107 21% 161 27% 87 25% 110 26% 380 32% 405 40%

OUTPATIENT 

BEHAVIORAL 

HEALTH

Yes 287 57% 354 60% 217 63% 236 56% 753 63% 610 60%

 Within 30 days 204 41% 235 40% 150 43% 155 37% 543 45% 435 43%

 Within 90 days (inclusive)* 238 47% 287 49% 176 51% 190 45% 625 52% 509 50%

No 184 37% 200 34% 108 31% 165 39% 368 31% 325 32%

Don’t Know 31 6% 37 6% 22 6% 17 4% 77 6% 82 8%

INPATIENT 

BEHAVIORAL 

HEALTH

Yes 143 28% 152 26% 101 29% 92 22% 318 27% 247 24%

 Within 30 days 58 12% 59 10% 38 11% 31 7% 129 11% 117 12%

 Within 90 days (inclusive)* 88 18% 94 16% 67 19% 56 13% 193 16% 167 16%

No 325 65% 394 67% 220 63% 302 72% 787 66% 677 67%

Don’t Know 34 7% 45 8% 26 7% 24 6% 93 8% 93 9%

HX PHYSICAL 

HEALTH 

PROBLEM

Yes 103 21% 107 18% 58 17% 61 15% 227 19% 183 18%

 Within 30 days 66 13% 56 9% 33 10% 42 10% 106 9% 86 8%

 Within 90 days (inclusive)* 79 16% 73 12% 46 13% 51 12% 149 12% 122 12%

No 350 70% 419 71% 272 78% 321 77% 875 73% 712 70%

Don’t Know 49 10% 65 11% 17 5% 36 9% 96 8% 122 12%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames sums to more than the total number of cases in some 

instances. 

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 142

Table 5.50 shows that nearly half of all Soldiers with reported non-fatal events were reported to have taken psychotropic medication. The 

majority of these were antidepressants and antianxiety medications.

Table 5.50 2009 AND 2008 NON-FATAL ARMY DoDSER PSYCHOTROPIC MEDICATION USE

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

TAKEN 

PSYCHOTROPIC 

MEDS

Yes 204 41% 242 41% 155 45% 155 37% 489 41% 341 34%

No 259 52% 287 49% 157 45% 226 54% 577 48% 538 53%

Don’t Know 39 8% 62 10% 35 10% 37 9% 132 11% 138 14%

Antidepressants Yes 178 35% 213 36% 140 40% 134 32% 426 36% 297 29%

No 282 56% 309 52% 171 49% 244 58% 620 52% 569 56%

Don’t Know 42 8% 69 12% 36 10% 40 10% 152 13% 151 15%

Antianxiety Yes 77 15% 97 16% 66 19% 46 11% 171 14% 129 13%

No 370 74% 403 68% 237 68% 318 76% 856 71% 717 71%

Don’t Know 55 11% 91 15% 44 13% 54 13% 171 14% 171 17%

Antimanics Yes 7 1% 14 2% 6 2% 15 4% 28 2% 25 2%

No 433 86% 472 80% 296 85% 352 84% 991 83% 824 81%

Don’t Know 62 12% 105 18% 45 13% 51 12% 179 15% 168 17%

Anticonvulsants Yes 9 2% 12 2% 9 3% 7 2% 25 2% 14 1%

No 434 86% 480 81% 294 85% 357 85% 995 83% 833 82%

Don’t Know 59 12% 99 17% 44 13% 54 13% 178 15% 170 17%

Antipsychotics Yes 47 9% 53 9% 41 12% 32 8% 86 7% 75 7%

No 395 79% 444 75% 265 76% 332 79% 939 78% 770 76%

Don’t Know 60 12% 94 16% 41 12% 54 13% 173 14% 172 17%

Note: Mixed-case items were only asked in cases where the respondent indicated that the Service Member had taken psychotropic medication.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 143

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a non-fatal suicide event. These data include information about 

family histories and interpersonal relationships, legal, financial and administrative difficulties, and reports of prior abuse.

Family and Relationship History

Table 5.51 shows relationship history factors. Many Soldiers who attempted suicide had experienced a failed intimate relationship before the 

attempt (50%, n=252). Thirty-one percent (n=154) had experienced the loss within 30 days of the attempt, as was true for 26% of Soldiers who 

engaged in non-fatal self-harm behavior. Seventeen percent (n=85) of those who attempted suicide had experienced a relationship difficulty 

with someone other than a romantic partner.

Table 5.51 2009 AND 2008 NON-FATAL ARMY DoDSER RELATIONSHIP HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX FAILED 

INTIMATE 

RELATIONSHIP

Yes 252 50% 276 47% 185 53% 180 43% 470 39% 359 35%

 Within 30 days 154 31% 161 27% 90 26% 89 21% 212 18% 179 18%

 Within 90 days (inclusive)* 193 38% 214 36% 143 41% 131 31% 319 27% 270 27%

No 210 42% 259 44% 139 40% 200 48% 636 53% 531 52%

Don’t Know 40 8% 56 9% 23 7% 38 9% 92 8% 127 12%

HX FAILED 

OTHER 

RELATIONSHIP

Yes 85 17% 69 12% 39 11% 36 9% 150 13% 98 10%

 Within 30 days 44 9% 33 6% 19 5% 20 5% 63 5% 44 4%

 Within 90 days (inclusive)* 58 12% 47 8% 26 7% 28 7% 91 8% 63 6%

No 350 70% 426 72% 277 80% 327 78% 918 77% 749 74%

Don’t Know 67 13% 96 16% 31 9% 55 13% 130 11% 170 17%
DoDSER 2009 Annual Report

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Page | 144

Table 5.51 2009 AND 2008 NON-FATAL ARMY DoDSER RELATIONSHIP HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX ANY FAILED 

RELATIONSHIP

Yes 280 56% 295 50% 197 57% 191 46% 527 44% 404 40%

 Within 30 days 175 35% 171 29% 101 29% 96 23% 249 21% 199 20%

 Within 90 days (inclusive)* 213 42% 223 38% 153 44% 136 33% 354 30% 290 29%

No 182 36% 240 41% 127 37% 192 46% 582 49% 490 48%

Don’t Know 40 8% 56 9% 23 7% 35 8% 89 7% 123 12%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames sums to more than the total number of cases in some 

instances. 

As summarized in Table 5.52, 13% (n=66) of Soldiers who attempted suicide had experienced the death of a family member (other than by 

suicide) prior to the attempt, and there was one report of spousal suicide for each type of non-fatal event. Ten percent (n=49) of Soldiers had 

experienced the death of a friend, 6% (n=31) had experienced the suicide of a family member, and 8% (n=41) were reported to have experienced 

the illness of a family member. These rates may be underestimates, as “don’t know” responses were fairly common for some of these factors.

Similar patterns were observed for Soldiers reported to have harmed themselves without intending to die by suicide, and for Soldiers reported

to have had suicidal ideation.

Table 5.52 2009 AND 2008 NON-FATAL ARMY DoDSER FAMILY HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX SPOUSE 

SUICIDE

Yes 1 <1% 2 <1% 1 <1% 2 <1% 1 <1% 3 <1%

No 462 92% 530 90% 328 95% 385 92% 1120 93% 891 88%

Don’t Know 39 8% 59 10% 18 5% 31 7% 77 6% 123 12%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 145

Table 5.52 2009 AND 2008 NON-FATAL ARMY DoDSER FAMILY HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX FAMILY 

MEMBER 

SUICIDE

Yes 31 6% 39 7% 13 4% 18 4% 53 4% 45 4%

No 416 83% 475 80% 310 89% 358 86% 1038 87% 823 81%

Don’t Know 55 11% 77 13% 24 7% 42 10% 107 9% 149 15%

HX FRIEND 

SUICIDE

Yes 37 7% 37 6% 14 4% 23 6% 80 7% 45 4%

No 406 81% 468 79% 308 89% 349 83% 1003 84% 813 80%

Don’t Know 59 12% 86 15% 25 7% 46 11% 115 10% 159 16%

HX DEATH OF 

SPOUSE/FAMILY

MEMBER

Yes 66 13% 92 16% 31 9% 43 10% 127 11% 132 13%

No 382 76% 420 71% 293 84% 329 79% 964 80% 733 72%

Don’t Know 54 11% 79 13% 23 7% 46 11% 107 9% 152 15%

HX DEATH OF 

FRIEND

Yes 49 10% 70 12% 19 5% 29 7% 110 9% 98 10%

No 390 78% 435 74% 306 88% 340 81% 974 81% 753 74%

Don’t Know 63 13% 86 15% 22 6% 49 12% 114 10% 166 16%

HX 

SPOUSE/FAMILY 

ILLNESS

Yes 41 8% 66 11% 34 10% 36 9% 83 7% 110 11%

No 402 80% 444 75% 289 83% 326 78% 996 83% 737 72%

Don’t Know 59 12% 81 14% 24 7% 56 13% 119 10% 170 17%

HX FAMILY 

BEHAVIORAL 

HEALTH 

PROBLEMS

Yes 161 32% 212 36% 112 32% 138 33% 354 30% 304 30%

No 257 51% 251 42% 189 54% 199 48% 635 53% 489 48%

Don’t Know 84 17% 128 22% 46 13% 81 19% 209 17% 224 22%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 146

Administrative and Legal History

As shown in Table 5.53, Soldiers who attempted suicide reportedly had experienced a variety of administrative and legal difficulties. Nineteen 

percent (n=96) had a history of Article 15 proceedings, 11% (n=54) had a history of administrative separation, and 6% (n=30) had been absent 

without leave. Civil legal problems were reported for a minority of Soldiers.

Similar patterns were observed for Soldiers reported to have harmed themselves without intending to die by suicide, and for Soldiers reported

to have had suicidal ideation.

Table 5.53 2009 AND 2008 NON-FATAL ARMY DoDSER ADMIN/LEGAL HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX COURTS 

MARTIAL

Yes 20 4% 12 2% 13 4% 10 2% 37 3% 30 3%

No 427 85% 500 85% 309 89% 367 88% 1040 87% 846 83%

Don’t Know 55 11% 79 13% 25 7% 41 10% 121 10% 141 14%

HX ARTICLE 15 Yes 96 19% 112 19% 71 20% 81 19% 204 17% 166 16%

No 345 69% 405 69% 244 70% 293 70% 855 71% 692 68%

Don’t Know 61 12% 74 13% 32 9% 44 11% 139 12% 159 16%

HX ADMIN 

SEPARATION

Yes 54 11% 63 11% 33 10% 45 11% 125 10% 97 10%

No 394 78% 445 75% 285 82% 329 79% 953 80% 756 74%

Don’t Know 54 11% 83 14% 29 8% 44 11% 120 10% 164 16%

HX AWOL Yes 30 6% 36 6% 32 9% 27 6% 111 9% 92 9%

No 422 84% 492 83% 298 86% 355 85% 983 82% 800 79%

Don’t Know 50 10% 63 11% 17 5% 36 9% 104 9% 125 12%

HX MEDICAL 

BOARD

Yes 39 8% 51 9% 27 8% 34 8% 76 6% 58 6%

No 409 81% 474 80% 300 86% 350 84% 1011 84% 821 81%

Don’t Know 54 11% 66 11% 20 6% 34 8% 111 9% 138 14%
DoDSER 2009 Annual Report

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Page | 147

Table 5.53 2009 AND 2008 NON-FATAL ARMY DoDSER ADMIN/LEGAL HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX CIVIL LEGAL 

PROBLEMS

Yes 47 9% 46 8% 23 7% 33 8% 76 6% 69 7%

No 397 79% 464 79% 296 85% 326 78% 1000 83% 768 76%

Don’t Know 58 12% 81 14% 28 8% 59 14% 122 10% 180 18%

HX NONSELECTIONYes 15 3% 7 1% 12 3% 10 2% 20 2% 18 2%

No 421 84% 502 85% 304 88% 345 83% 1034 86% 811 80%

Don’t Know 66 13% 82 14% 31 9% 63 15% 144 12% 188 18%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 148

Abuse History

As shown in Table 5.54, 23% (n=113) of Soldiers who attempted suicide had a history of physical abuse, 17% had a history of sexual abuse, and 

25% had a history of emotional abuse. The portions of reported physical, sexual, and emotional abuse were very similar for those with self-harm 

behaviors and those with suicidal ideation. Reports of Soldiers having perpetrated abuse or having been victims of sexual harassment were not 

common for any category of non-fatal event.

Table 5.54 2009 AND 2008 NON-FATAL ARMY DoDSER ABUSE HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX VICTIM 

PHYSICAL ABUSE

Yes 113 23% 111 19% 71 20% 76 18% 244 20% 186 18%

No 325 65% 380 64% 222 64% 276 66% 784 65% 642 63%

Don’t Know 64 13% 100 17% 54 16% 66 16% 170 14% 189 19%

HX VICTIM 

SEXUAL ABUSE

Yes 84 17% 71 12% 50 14% 48 11% 154 13% 125 12%

No 351 70% 415 70% 241 69% 301 72% 856 71% 708 70%

Don’t Know 67 13% 105 18% 56 16% 69 17% 188 16% 184 18%

HX VICTIM 

EMOTIONAL 

ABUSE

Yes 125 25% 122 21% 64 18% 70 17% 251 21% 188 18%

No 306 61% 361 61% 222 64% 275 66% 764 64% 646 64%

Don’t Know 71 14% 108 18% 61 18% 73 17% 183 15% 183 18%

HX VICTIM 

SEXUAL 

HARASSMENT

Yes 19 4% 27 5% 7 2% 6 1% 39 3% 29 3%

No 406 81% 450 76% 283 82% 335 80% 967 81% 776 76%

Don’t Know 77 15% 114 19% 57 16% 77 18% 192 16% 212 21%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 149

Table 5.54 2009 AND 2008 NON-FATAL ARMY DoDSER ABUSE HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX 

PERPETRATOR 

PHYSICAL ABUSE

Yes 28 6% 25 4% 18 5% 19 5% 54 5% 43 4%

No 405 81% 467 79% 274 79% 330 79% 984 82% 778 76%

Don’t Know 69 14% 99 17% 55 16% 69 17% 160 13% 196 19%

HX 

PERPETRATOR 

SEXUAL ABUSE

Yes 9 2% 5 1% 3 1% 4 1% 12 1% 12 1%

No 423 84% 482 82% 288 83% 344 82% 1021 85% 811 80%

Don’t Know 70 14% 104 18% 56 16% 70 17% 165 14% 194 19%

HX 

PERPETRATOR 

EMOTIONAL 

ABUSE

Yes 16 3% 14 2% 3 1% 10 2% 28 2% 13 1%

No 412 82% 468 79% 285 82% 338 81% 1005 84% 799 79%

Don’t Know 74 15% 109 18% 59 17% 70 17% 165 14% 205 20%

HX 

PERPETRATOR 

SEXUAL 

HARASSMENT

Yes 2 <1% 2 <1% 1 <1% 3 1% 12 1% 4 <1%

No 427 85% 485 82% 288 83% 343 82% 1024 85% 813 80%

Don’t Know 73 15% 104 18% 58 17% 72 17% 162 14% 200 20%

(cont.)
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 150

Financial and Workplace Difficulties

Of the financial and workplace issues assessed by DoDSER, the most common for Soldiers who attempted suicide were job loss or instability 

(27%, n=137) and problems with supervisors or co-workers (24%, n=121), as shown in Table 5.55. Workplace hazing was reported in a small 

number of those with non-fatal events, ranging from 3% to 5% of cases.

Similar patterns were observed for Soldiers reported to have harmed themselves without intending to die, and for Soldiers reported to have had 

suicidal ideations.

Table 5.55 2009 AND 2008 NON-FATAL ARMY DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

EXCESSIVE DEBT/ 

BANKRUPTCY

Yes 51 10% 66 11% 36 10% 52 12% 127 11% 114 11%

No 378 75% 411 70% 273 79% 291 70% 946 79% 703 69%

Don’t Know 73 15% 114 19% 38 11% 75 18% 125 10% 200 20%

HX JOB 

PROBLEMS

Yes 137 27% 159 27% 106 31% 134 32% 358 30% 310 30%

No 306 61% 342 58% 221 64% 231 55% 740 62% 561 55%

Don’t Know 59 12% 90 15% 20 6% 53 13% 100 8% 146 14%

HX SUPERVISOR/ 

COWORKER 

ISSUES

Yes 121 24% 143 24% 99 29% 129 31% 320 27% 282 28%

No 309 62% 341 58% 221 64% 229 55% 757 63% 572 56%

Don’t Know 72 14% 107 18% 27 8% 60 14% 121 10% 163 16%

HX POOR WORK 

EVALUATION

Yes 63 13% 90 15% 80 23% 98 23% 198 17% 199 20%

No 364 73% 383 65% 234 67% 249 60% 858 72% 629 62%

Don’t Know 75 15% 118 20% 33 10% 71 17% 142 12% 189 19%

HX UNIT/ 

WORKPLACE 

HAZING

Yes 27 5% 23 4% 13 4% 14 3% 37 3% 27 3%

No 397 79% 448 76% 306 88% 325 78% 1023 85% 781 77%

Don’t Know 78 16% 120 20% 28 8% 79 19% 138 12% 209 21%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 151

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Member’s most recent three deployments. Data include deployment 

location information as well as a history of direct combat operations. Comparisons of OEF/OIF suicide events to non-OEF/OIF suicide events are 

reported in Chapter 3.

Deployment History

As shown in Table 5.56, 49% (n=245) of Soldiers who attempted suicide had been deployed as part of OEF/OIF at least once. Forty-two percent 

(n=209) had been deployed to only Iraq, and 3% (n=13) had been deployed to multiple OEF/OIF locations. These data are consistent with 2008 

Army DoDSERs.

Similar patterns were observed for Soldiers reported to have harmed themselves without intending to die, and for Soldiers reported to have had 

suicidal ideations.

Table 5.56 2009 AND 2008 NON-FATAL ARMY DoDSER EVER DEPLOYED TO OEF/OIF

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

HX 

DEPLOYMENT 

OEF/OIF

AFGHANISTAN 11 2% 35 6% 13 4% 21 5% 35 3% 73 7%

IRAQ 209 42% 59 10% 108 31% 155 37% 382 32% 345 34%

KUWAIT 12 2% 2 <1% 7 2% 8 2% 21 2% 13 1%

MULTIPLE OEF/OIF LOCATIONS 13 3% 12 2% 12 3% 6 2% 37 3% 22 2%

NO HX OEF/OIF DEPLOYMENT 257 51% 495 84% 207 60% 234 56% 723 60% 586 58%
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 152

Combat History

As shown in Table 5.57, the majority of Soldiers who attempted suicide had no known direct combat experience (76%, n=384). Of the 118 with 

combat history (24%), 85 (72%) were reported to have witnessed killing and 91 (77%) were reported to have seen dead bodies during combat. A 

similar pattern was observed for self-harm and suicidal ideation cases.

Table 5.57 2009 AND 2008 NON-FATAL ARMY DoDSER COMBAT HISTORY

Suicide Attempt Self-Harm (w/o Intent to Die) Ideation Only

2009 2008 2009 2008 2009 2008

Count Percent Count Percent Count Percent Count Percent Count Percent Count Percent

COMBAT 

HISTORY

HX DIRECT COMBAT 118 24% 134 23% 63 18% 72 17% 190 16% 184 18%

 Combat Resulted in

 Injuries/Casualties 89 75% 86 64% 36 57% 47 65% 129 68% 129 70%

 Injured in Combat 24 20% 33 25% 14 22% 14 19% 57 30% 48 26%

 Witnessed Killing in Combat 85 72% 81 60% 34 54% 45 63% 126 66% 128 70%

 Saw Dead Bodies in Combat 91 77% 81 60% 36 57% 52 72% 124 65% 131 71%

 Killed Others in Combat 41 35% 47 35% 16 25% 24 33% 61 32% 65 35%

NO DIRECT COMBAT HX 384 76% 457 77% 284 82% 346 83% 1008 84% 833 82%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat. Percentages for these items reflect proportion of those with 

combat experience.
DoDSER 2009 Annual Report

Chapter 5 Army Results

Page | 153

Summary

This chapter described the factors associated with Army suicides, attempted suicides, non-fatal selfharm events and instances of suicidal ideation tracked by DoDSERs in calendar year 2009.

The AFMES indicates a total of 164 Soldier suicides in 2009, including cases pending final determination 

but strongly suspected to be suicides. DoDSERs were received for 95% of confirmed 2009 Army suicides 

as of 1 April 2010. An additional 2047 Army DoDSERs were received for non-fatal Army suicide events. 

Suicide behaviors were most common for young, married, Caucasian, junior enlisted, active component

Soldiers.

Firearms and hanging were the most common method for suicides, and overdoses and cutting were the 

most common non-fatal suicide-related behaviors. The majority of events occurred in a garrison duty 

environment. It was not uncommon for individuals to have had prior self-injurious events, past 

behavioral health diagnoses, or prior outpatient or other behavioral health care, although most suicides

did not have a diagnosed behavioral health disorder reported. The most frequently reported stressors 

included failed intimate relationships, work-related problems, Article 15 proceedings and civil legal 

problems. Histories of physical, sexual, or emotional abuse were reported in 13% to 25% of all suicide 

attempts, self-harm events, and instances of suicidal ideation.

About half of Soldiers with completed suicides had deployed to Iraq at least once, and 42% of Soldiers 

who attempted suicide had been deployed to Iraq at least once. Slightly less than one-third of those 

with self-harm and suicidal ideation (31% and 32%, respectively) had been deployed in support of OIF at 

least once. The majority of suicide and non-fatal suicide event cases had no reported history of combat 

exposure.

Results from Army DoDSERs submitted for suicides in 2009 were generally consistent with patterns 

observed in 2008. Conclusions and interpretations regarding noted patterns must be made with caution 

until data are available for a comparable group of Soldiers that is demographically similar.
DoDSER 2009 Annual Report

Page | 154

Chapter 6

MARINE CORPS RESULTS FOR COMPLETED SUICIDES

DoDSER Submissions and POC Compliance

Department of Defense Suicide Event Reports (DoDSERs) were submitted for 52 Marine Corps suicides in 

2009. As indicated in Table 6.1, the 52 reports are consistent with the 51 confirmed suicides plus one as

yet unconfirmed suicide reported by the Armed Forces Medical Examiner System (AFMES).

Table 6.1 2009 MARINE CORPS AFMES CONFIRMED AND PENDING SUICIDES AND DoDSERs SUBMITTED

2009 

Total DoDSERs 52

Total AFMES Confirmed and Pending Suicides 52

AFMES Confirmed Suicides 50

DoDSER Submission Compliance 100%

Additional DoDSERs Pending AFMES Confirmation 2

Data from 1/1/2009 through 12/31/2009 as of 4/1/2010

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that 

may have been associated with or contributed to the suicidal events. These factors include decedents’ 

demographic characteristics, event setting, suicide method, substance use during the event, possible

motive and intent to die, and communication of intent with others.

Demographics

The majority of Marine Corps decedents were male and in Regular Active Duty component, as reported 

in DMDC demographic data. As in 2008, Table 6.2 shows that the majority were Caucasian (92%, n=48), 

under 25 years of age (77%, n=40), and enlisted (96%, n=50). All Marine Corps decedents had at least 

graduated high school (81%, n=42) or attained a GED (13%, n=7). Forty-eight percent had never been 

married (n=25), 42% (n=22) were married at the time of the suicide and 10% were divorced (n=5).

Table 6.2 2009 AND 2008 AFMES MARINE CORPS DEMOGRAPHICS

2009 2008

Count Percent Count Percent

Total 52 100% 42 100%

GENDER Male 52 100% 40 95%
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 155

Table 6.2 2009 AND 2008 AFMES MARINE CORPS DEMOGRAPHICS

2009 2008

Count Percent Count Percent

Female 0 0% 2 5%

RACE Asian/Pacific Islander 1 2% 0 0%

African American 3 6% 2 5%

Caucasian 48 92% 37 88%

American Indian/Alaska Native 0 0% 0 0%

Other/Don’t Know/Missing 0 0% 3 7%

AGE RANGE Under 25 40 77% 31 74%

25-29 5 10% 6 14%

30-39 6 12% 3 7%

40 + 1 2% 2 5%

RANK E1-E4 39 75% 27 64%

E5-E9 11 21% 13 31%

Officer 1 2% 2 5%

Warrant Officer 1 2% 0 0%

Cadet/Midshipman 0 0% 0 0%

COMPONENT Regular 51 98% 40 95%

Reserve 1 2% 2 5%

National Guard 0 0% 0 0%

EDUCATION Did not graduate high school 0 0% 3 7%

GED 7 13% 1 2%

High school graduate 42 81% 33 79%

Some college or technical school 2 4% 0 0%

Degree/certificate of less than four years 0 0% 2 5%

Four-year college degree 1 2% 2 5%

Master’s degree or greater 0 0% 1 2%

Don’t Know 0 0% 0 0%

MARITAL STATUS Never Married 25 48% 19 45%

Married 22 42% 18 43%

Legally Separated 0 0% 0 0%

Divorced 5 10% 3 7%

Widowed 0 0% 0 0%

Don’t Know 0 0% 2 5%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 through 

12/31/2009 as of 4/1/2010.

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 156

Event Setting

Table 6.3 identifies the country where Marine Corps suicides took place and Table 6.4 identifies specific 

settings. Marine Corps suicides took place primarily in the U.S. (75%, n=39) and Iraq (15%, n=8). The 

most common settings for Marine Corps suicides in 2009 were Service Members’ personal residences or 

barracks (60%, n=31). Fifteen percent (n=8) of suicides occurred at other locations such as hotels or 

parks. Twelve percent (n=6) occurred in the residence of a friend or family member.

Table 6.3 2009 AND 2008 MARINE CORPS DoDSER EVENT COUNTRY

2009 2008

Count Percent Count Percent

EVENT COUNTRY United States 39 75% 33 80%

Iraq 8 15% 6 15%

Afghanistan 3 6% 0 0%

Other 2 4% 0 0%

Don’t Know 0 0% 2 5%

Table 6.4 2009 AND 2008 MARINE CORPS DoDSER EVENT SETTING

2009 2008

Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 31 60% 23 56%

Residence of friend or family 6 12% 5 12%

Work/jobsite 3 6% 5 12%

Automobile (away from residence) 4 8% 4 10%

Inpatient medical facility 0 0% 0 0%

Other 8 15% 4 10%

Event Method

Figure 6.1 and Table 6.5 show the most common suicide methods used by Marine Corps Service 

Members in 2009 and 2008. The majority of decedents used firearms, including both non-military issue 

(31%, n=16) and military issue (29%, n=15). Hanging was the next most common suicide method (33%, 

n=17). The remainder of individuals used other methods (8%, n=4 in 2009).
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 157

Figure 6.1 2009 AND 2008 MARINE CORPS DoDSER EVENT METHODS

Table 6.5 2009 AND 2008 MARINE CORPS DoDSER EVENT METHOD

2009 2008

Count Percent Count Percent

EVENT METHOD Gas, vehicle exhaust 1 2% 0 0%

Hanging 17 33% 12 29%

Firearm, military issue 15 29% 12 29%

Firearm, non-military issue 16 31% 16 39%

Sharp or blunt object 2 4% 0 0%

Crashing a motor vehicle 0 0% 1 2%

Other 1 2% 0 0%

Substance Use during the Event

The DoDSER process collects information about whether alcohol or other drugs were used during the 

suicide. For approximately one half of Marine Corps decedents, it remains unknown whether they used 

alcohol or drugs. As indicated in Table 6.6, thirteen percent (n=7) of decedents were reported to have 

used alcohol and 6% (n=3) were reported to have used prescription or illegal drugs.

29% 31% 33%

8%

29%

39%

29%

2%

0

10

20

30

40

50

60

70

80

90

100

Firearm, military 

issue

Firearm, nonmilitary issueHanging Other

Percentage

2009

2008
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 158

Table 6.6 2009 AND 2008 MARINE CORPS DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

ALCOHOL USED Yes 7 13% 10 24%

No 22 42% 15 37%

Don’t Know 23 44% 16 39%

ANY DRUGS USED Yes 3 6% 1 2%

No 19 37% 22 54%

Don’t Know 30 58% 18 44%

 Illegal drugs Overdose 0 0% 0 0%

Used, no overdose 1 2% 0 0%

Were not used 21 40% 22 54%

Don’t Know 30 58% 19 46%

 Prescription drugs Overdose 0 0% 0 0%

Used, no overdose 2 4% 1 2%

Were not used 20 38% 22 54%

Don’t Know 30 58% 18 44%

 OTC drugs Overdose 0 0% 0 0%

Used, no overdose 0 0% 0 0%

Were not used 22 42% 22 54%

Don’t Know 30 58% 19 46%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicated their 

potential for self-harm when known. The majority of Marine Corps decedents were not reported to have 

disclosed to others potential for self-harm (73%, n=38), as shown in Table 6.7. The majority of reported 

communications were verbal (15%, n=8), as shown in Table 6.8. These reported communications of 

intent were to spouses (13%, n=7) or friends (13%, n=7; Table 6.9). As indicated in Table 6.7, 12% (n=6) 

communicated with at least two different categories of recipients.

Table 6.7 2009 AND 2008 MARINE CORPS DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 38 73% 28 68%

1 7 13% 11 27%

2 6 12% 2 5%

4 1 2% 0 0%
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 159

Table 6.8 2009 AND 2008 MARINE CORPS DoDSER MODE OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 8 15% 6 15%

Written Only 0 0% 1 2%

Other 2 4% 3 7%

Multiple Modes 3 6% 1 2%

Note: Multiple modes include a combination of verbal, written, or other mode of communicating intent to suicide.

Table 6.9 2009 AND 2008 MARINE CORPS DoDSER RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

COMMUNICATION Friend 7 13% 1 2%

Behavioral Health Staff 2 4% 1 2%

Supervisor 1 2% 0 0%

Spouse 7 13% 6 15%

Chaplain 0 0% 0 0%

Other 6 12% 7 17%

Made Multiple Communication 7 13% 2 5%

Additional Event Information

Additional details about Marine Corps suicides were consistent from 2008 to 2009. As shown in Table 

6.10, most decedents were deemed by respondents as having evidence of intent to die (73%, n=38), but 

only 35% (n=18) of the suicides were reported to have been premeditated. The majority of decedents 

took their lives in places where it was unlikely that others could observe or intervene (75%, n=39) and 

only 17% (n=9) left suicide notes.

Table 6.10 2009 AND 2008 MARINE CORPS DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

EVIDENCE EXISTS INDICATING 

INTENTION TO DIE

Yes 38 73% 30 73%

No 3 6% 3 7%

Don’t Know 11 21% 8 20%

DEATH RISK GAMBLING Yes 0 0% 1 2%

No 44 85% 34 83%

Don’t Know 8 15% 6 15%
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 160

Table 6.10 2009 AND 2008 MARINE CORPS DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

PLANNED/PREMEDITATED Yes 18 35% 14 34%

No 16 31% 18 44%

Don’t Know 18 35% 9 22%

OBSERVABLE Yes 6 12% 9 22%

No 39 75% 32 78%

Don’t Know 7 13% 0 0%

SUICIDE NOTE LEFT Yes 9 17% 13 32%

No 31 60% 23 56%

Don’t Know 12 23% 5 12%

Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty 

environments.

Home Environment

Most Marine Corps decedents lived in a shared military environment (37%, n=19) and 19% (n=10) lived 

in bachelor’s quarters at the time the suicide took place. Another 29% (n=15) of decedents lived in their 

own houses or apartments. Most did not live alone (71%, n=37). Fifteen percent lived with their spouses 

(n=8) or lived apart due to deployment or for reasons other than relationship difficulties (19%, n=10). 

Twenty-one percent (n=11) had minor-aged children, and 8% (n=4) lived with their children at the time 

of suicide. Half of the Marine Corps decedents (50%, n=26) had access to firearms in their living or work 

environment. See Table 6.11 for additional situational details.

Table 6.11 2009 AND 2008 MARINE CORPS DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDENCE AT TIME OF EVENT Shared military living environment 19 37% 10 24%

Bachelor quarters 10 19% 8 20%

On-base family housing 2 4% 2 5%

Owned or leased apartment or house 15 29% 17 41%

Ship 0 0% 1 2%

Other 3 6% 3 7%

Don’t Know 3 6% 0 0%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 161

Table 6.11 2009 AND 2008 MARINE CORPS DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

MARRIED SERVICE MEMBER 

RESIDENCE

Resides with spouse 8 15% 7 17%

Separated due to relationship issues 3 6% 7 17%

Apart for other reasons/deployed 10 19% 4 10%

Don’t Know 3 6% 1 2%

Unmarried at time of event 28 54% 22 54%

RESIDED ALONE Yes 13 25% 9 22%

No 37 71% 30 73%

Don’t Know 2 4% 2 5%

HAD MINOR CHILDREN Yes 11 21% 10 24%

No 41 79% 31 76%

CHILDREN RESIDED WITH Yes 4 8% 5 12%

No 6 12% 5 12%

Don’t Know 1 2% 0 0%

No Known Children 41 79% 31 76%

FIREARM IN IMMEDIATE/LIVING 

ENVIRONMENT

Yes 26 50% 23 56%

No 15 29% 13 32%

Don’t Know 11 21% 5 12%

Duty Environment

Specific duty environment possibilities presented in Table 6.12 were rare for Marine Corps decedents. 

As in 2008, 10% (n=5) of individuals were absent without leave at the time of death. See Table 6.12 for 

additional details.

Table 6.12 2009 AND 2008 MARINE CORPS DoDSER DUTY ENVIRONMENT

2009 2008

Count Percent Count Percent

DUTY ENVIRONMENT Leave 4 8% 5 12%

Medical Hold 0 0% 2 5%

TDY 4 8% 4 10%

AWOL 5 10% 4 10%

Other 4 8% 2 5%

Training 3 6% 2 5%

Multiple Duty Environments Provided 1 2% 2 5%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 162

Suicide Completions by Month

Consistent with data from 2008, no clear pattern exists for Marine Corps suicides by month, as shown in 

Table 6.13.

Table 6.13 2009 AND 2008 MARINE CORPS DoDSER SUICIDE EVENTS BY MONTH

2009 2008

Count Percent Count Percent

MONTH January 3 6% 7 17%

February 1 2% 1 2%

March 3 6% 4 10%

April 6 12% 1 2%

May 4 8% 6 15%

June 9 17% 3 7%

July 9 17% 3 7%

August 2 4% 6 15%

September 1 2% 2 5%

October 4 8% 2 5%

November 4 8% 1 2%

December 6 12% 5 12%

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be 

associated with subsequent suicidal behavior. These factors include data on prior self-harm, previous 

diagnoses of behavioral health disorders and behavioral health issues, and relevant treatment histories, 

including prescribed medication.

Prior Self-Injury

As shown in Table 6.14, 13% (n=7) of Marine Corps decedents had a reported history of prior self-injury. 

Three of the seven individuals had one known prior event, and four had more than one. Two of the 

decedents had prior self-injuries similar to the method of completed suicide. Three Marine Corps 

decedents were reported to have injured themselves within one month of the completed suicide and an 

additional two within three months.
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 163

Table 6.14 2009 AND 2008 MARINE CORPS DoDSER PRIOR SELF-INJURY

2009 2008

Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 7 13% 6 15%

 Within 30 days 3 6% 2 5%

 Within 90 days (inclusive)* 5 10% 3 7%

No 34 65% 24 59%

Don’t Know 11 21% 11 27%

 Number prior self-injuries One prior event 3 6% ---- ----

More than one prior event 4 8% ---- ----

N/A 45 87% ---- ----

 Event similar to prior self-injury Yes 2 4% 1 2%

No 5 10% 4 10%

Don’t Know 0 0% 1 2%

N/A 45 87% 35 85%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”

Behavioral Health Disorders

As shown in Table 6.15, 21% (n=11) of Marine Corps decedents reportedly had been diagnosed with a 

mood disorder. Most commonly, decedents had been previously diagnosed with major depressive 

disorder (n=5, 10%). In contrast to 2008 data, 13% (n=7) had a diagnosis of at least one anxiety disorder, 

and 10% (n=5) had more than one anxiety disorder (Table 6.16), although given the small cell sizes, 

differences between years should be interpreted with caution. As shown in Table 6.17, twenty-nine 

percent (n=15) had a reported history of substance abuse and 8% (n=4) had a diagnosis of a personality 

disorder. Only one decedent (2%) had been previously diagnosed with a psychotic disorder. 

Approximately half of Marine Corps decedents had no known behavioral health disorders (54%, n=28;

Table 6.18). Of the remainder, most had only one diagnosis (29%, n=15), and 18% (n=9) had more than 

one comorbid disorder.

Table 6.15 2009 AND 2008 MARINE CORPS DoDSER MOOD DISORDERS

2009 2008

Count Percent Count Percent

DX W/MOOD DISORDER Yes 11 21% 6 15%

No 33 63% 32 78%

Don’t Know 8 15% 3 7%
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 164

Table 6.15 2009 AND 2008 MARINE CORPS DoDSER MOOD DISORDERS

2009 2008

Count Percent Count Percent

 Bipolar disorder Yes 0 0% 0 0%

No 39 75% 35 85%

Don’t Know 13 25% 6 15%

 Major depression Yes 5 10% 2 5%

No 36 69% 34 83%

Don’t Know 11 21% 5 12%

 Dysthymic disorder Yes 0 0% 1 2%

No 39 75% 34 83%

Don’t Know 13 25% 6 15%

 Other mood disorder Yes 2 4% 1 2%

No 38 73% 34 83%

Don’t Know 12 23% 6 15%

 Unspecified mood disorder Yes 2 4% 2 5%

No 42 81% 36 88%

Don’t Know 8 15% 3 7%

 Multiple mood DX Yes 2 4% 0 0%

No 42 81% 38 93%

Don’t Know 8 15% 3 7%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had a mood disorder.

Table 6.16 2009 AND 2008 MARINE CORPS DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

DX W/ANXIETY DISORDER Yes 7 13% 2 5%

No 35 67% 36 88%

Don’t Know 10 19% 3 7%

 PTSD Yes 1 2% 0 0%

No 40 77% 37 90%

Don’t Know 11 21% 4 10%

 Panic disorder Yes 0 0% 0 0%

No 41 79% 37 90%

Don’t Know 11 21% 4 10%

 Generalized anxiety disorder Yes 1 2% 1 2%

No 40 77% 36 88%

Don’t Know 11 21% 4 10%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 165

Table 6.16 2009 AND 2008 MARINE CORPS DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

 Acute stress disorder Yes 0 0% 1 2%

No 41 79% 37 90%

Don’t Know 11 21% 3 7%

 Other anxiety disorder Yes 0 0% 0 0%

No 42 81% 37 90%

Don’t Know 10 19% 4 10%

 Unspecified anxiety DX Yes 0 0% 0 0%

No 42 81% 38 93%

Don’t Know 10 19% 3 7%

 Multiple anxiety DX Yes 5 10% 0 0%

No 37 71% 38 93%

Don’t Know 10 19% 3 7%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had an anxiety disorder.

Table 6.17 2009 AND 2008 MARINE CORPS DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

2009 2008

Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 4 8% 2 5%

No 39 75% 37 90%

Don’t Know 9 17% 2 5%

DX W/PSYCHOTIC DISORDER Yes 1 2% 0 0%

No 43 83% 38 93%

Don’t Know 8 15% 3 7%

HX SUBSTANCE ABUSE Yes 15 29% 6 15%

No 29 56% 29 71%

Don’t Know 8 15% 6 15%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 166

Table 6.18 2009 AND 2008 MARINE CORPS DoDSER COMORBIDITY RATES

2009 2008

Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 28 54% 30 73%

1 DX 15 29% 10 24%

2 DX 4 8% 1 2%

3 DX 2 4% 0 0%

4 or more DX 3 6% 0 0%

Treatment

Table 6.19 displays the history of Marine Corps decedents’ visits to treatment programs and clinics prior 

to suicide. Sixty percent (n=31) had been seen at a military treatment facility prior to the event and only 

8% (n=4) had a reported physical health problem. Outpatient mental health was the most commonly 

reported behavioral healthcare provision (35%, n=18), followed by chaplain services (21%, n=11). Only 

10% (n=5) of decedents had been prescribed psychotropic medication, as shown in Table 6.20. Most of 

these were antidepressants (8%, n=4). These data are generally consistent with patterns observed in 

2008.

Table 6.19 2009 AND 2008 MARINE CORPS DoDSER TREATMENT HISTORY

2009 2008

Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 31 60% 22 54%

 Within 30 days 19 37% 10 24%

 Within 90 days (inclusive)* 24 46% 16 39%

No 15 29% 16 39%

Don’t Know 6 12% 3 7%

SUBSTANCE ABUSE SERVICES Yes 9 17% 2 5%

 Within 30 days 6 12% 0 0%

 Within 90 days (inclusive)* 6 12% 0 0%

No 34 65% 32 78%

Don’t Know 9 17% 7 17%

FAMILY ADVOCACY PROGRAMS Yes 3 6% 3 7%

 Within 30 days 1 2% 2 5%

 Within 90 days (inclusive)* 3 6% 2 5%

No 34 65% 30 73%

Don’t Know 15 29% 8 20%
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

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Table 6.19 2009 AND 2008 MARINE CORPS DoDSER TREATMENT HISTORY

2009 2008

Count Percent Count Percent

CHAPLAIN SERVICES Yes 11 21% 5 12%

 Within 30 days 6 12% 3 7%

 Within 90 days (inclusive)* 8 15% 4 10%

No 29 56% 25 61%

Don’t Know 12 23% 11 27%

OUTPATIENT BEHAVIORAL HEALTH Yes 18 35% 12 29%

 Within 30 days 8 15% 5 12%

 Within 90 days (inclusive)* 11 21% 6 15%

No 26 50% 27 66%

Don’t Know 8 15% 2 5%

INPATIENT BEHAVIORAL HEALTH Yes 4 8% 2 5%

 Within 30 days 1 2% 2 5%

 Within 90 days (inclusive)* 2 4% 3 7%

No 38 73% 32 78%

Don’t Know 10 19% 7 17%

HX PHYSICAL HEALTH PROBLEM Yes 4 8% 9 22%

 Within 30 days 3 6% 5 12%

 Within 90 days (inclusive)* 4 8% 6 15%

No 39 75% 30 73%

Don’t Know 9 17% 2 5%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances. 

Table 6.20 2009 AND 2008 MARINE CORPS DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 5 10% 4 10%

No 34 65% 31 76%

Don’t Know 13 25% 6 15%

 Antidepressants Yes 4 8% 4 10%

No 34 65% 31 76%

Don’t Know 14 27% 6 15%

 Antianxiety Yes 2 4% 0 0%

No 36 69% 35 85%

Don’t Know 14 27% 6 15%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 168

Table 6.20 2009 AND 2008 MARINE CORPS DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

 Antimanics Yes 1 2% 1 2%

No 37 71% 34 83%

Don’t Know 14 27% 6 15%

 Anticonvulsants Yes 2 4% 1 2%

No 36 69% 34 83%

Don’t Know 14 27% 6 15%

 Antipsychotics Yes 1 2% 1 2%

No 37 71% 34 83%

Don’t Know 14 27% 6 15%

Note: Indented items were only asked in cases where the respondent indicated that the decedent used psychotropic medication.

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These 

data include information about family histories and interpersonal relationships, legal, financial and 

administrative difficulties, and reports of prior abuse.

Family and Relationship History

As in 2008, many Marine Corps decedents had experienced failed intimate relationships prior to suicide 

(n=22, 42%; Table 6.21). Twenty-seven percent (n=14) were reported to have experienced the loss 

within 30 days of taking their lives. Three decedents were reported to have experienced a relationship 

difficulty with someone other than a romantic partner within 30 days of the suicide. As shown in Table 

6.22, histories of the death or suicide of a loved one was rare.

Table 6.21 2009 AND 2008 MARINE CORPS DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 22 42% 23 56%

 Within 30 days 14 27% 14 34%

 Within 90 days (inclusive)* 15 29% 18 44%

No 17 33% 12 29%

Don’t Know 13 25% 6 15%

HX FAILED OTHER RELATIONSHIP Yes 5 10% 4 10%

 Within 30 days 3 6% 4 10%

 Within 90 days (inclusive)* 3 6% 4 10%

No 23 44% 24 59%

Don’t Know 24 46% 13 32%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 169

Table 6.21 2009 AND 2008 MARINE CORPS DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX ANY FAILED RELATIONSHIP Yes 22 42% 24 59%

 Within 30 days 14 27% 17 41%

 Within 90 days (inclusive)* 15 29% 20 49%

No 17 33% 11 27%

Don’t Know 13 25% 6 15%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances. 

Table 6.22 2009 AND 2008 MARINE CORPS DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX SPOUSE SUICIDE Yes 0 0% 0 0%

No 48 92% 39 95%

Don’t Know 4 8% 2 5%

HX FAMILY MEMBER SUICIDE Yes 2 4% 3 7%

No 34 65% 29 71%

Don’t Know 16 31% 9 22%

HX FRIEND SUICIDE Yes 1 2% 1 2%

No 33 63% 29 71%

Don’t Know 18 35% 11 27%

HX DEATH OF SPOUSE/FAMILY

MEMBER

Yes 1 2% 3 7%

No 35 67% 30 73%

Don’t Know 16 31% 8 20%

HX DEATH OF FRIEND Yes 1 2% 2 5%

No 28 54% 24 59%

Don’t Know 23 44% 15 37%

HX SPOUSE/FAMILY ILLNESS Yes 2 4% 3 7%

No 33 63% 28 68%

Don’t Know 17 33% 10 24%

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 4 8% 2 5%

No 11 21% 6 15%

Don’t Know 37 71% 33 80%

(cont.)
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 170

Administrative and Legal History

As shown in Table 6.23, Marine Corps decedents were reported to have experienced a variety of 

administrative and legal difficulties before dying by suicide. Thirty-five percent (n=18) had a history of 

Article 15 proceedings, 15% (n=8) had been absent without leave, and 12% (n=6) had a history of 

administrative separation from the Service. Civil legal problems and other legal and administrative 

problems were reported for a minority of cases.

Table 6.23 2009 AND 2008 MARINE CORPS DoDSER ADMIN/LEGAL HISTORY

2009 2008

Count Percent Count Percent

HX COURTS MARTIAL Yes 4 8% 1 2%

No 45 87% 40 98%

Don’t Know 3 6% 0 0%

HX ARTICLE 15 Yes 18 35% 0 0%

No 26 50% 0 0%

Don’t Know 8 15% 41 100%

HX ADMIN SEPARATION Yes 6 12% 4 10%

No 44 85% 36 88%

Don’t Know 2 4% 1 2%

HX AWOL Yes 8 15% 5 12%

No 43 83% 36 88%

Don’t Know 1 2% 0 0%

HX MEDICAL BOARD Yes 1 2% 4 10%

No 47 90% 37 90%

Don’t Know 4 8% 0 0%

HX CIVIL LEGAL PROBLEMS Yes 3 6% 2 5%

No 41 79% 35 85%

Don’t Know 8 15% 4 10%

HX NON-SELECTION Yes 5 10% 5 12%

No 44 85% 35 85%

Don’t Know 3 6% 1 2%

Abuse History

It is unknown whether many of the Marine Corps decedents had been either the victim or the 

perpetrator of abuse. For those with known histories of previous victimization, all incidents were 

reported to have occurred more than a year prior to the suicide. As shown in Table 6.24, 10% (n=5) had 

reported histories of sexual abuse, 8% (n=4) had histories of emotional abuse, and six percent (n=3) had 

histories of other types of physical abuse. Eight percent (n=4) of Marine Corps decedents had reported 
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 171

histories of perpetrating physical abuse, and half of these incidents (n=2, 4%) occurred within one year 

of the suicide.

Table 6.24 2009 AND 2008 MARINE CORPS DoDSER ABUSE HISTORY

2009 2008

Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 3 6% 2 5%

No 31 60% 29 71%

Don’t Know 18 35% 10 24%

HX VICTIM SEXUAL ABUSE Yes 5 10% 0 0%

No 29 56% 31 76%

Don’t Know 18 35% 10 24%

HX VICTIM EMOTIONAL ABUSE Yes 4 8% 2 5%

No 30 58% 28 68%

Don’t Know 18 35% 11 27%

HX VICTIM SEXUAL HARASSMENT Yes 0 0% 0 0%

No 32 62% 32 78%

Don’t Know 20 38% 9 22%

HX PERPETRATOR PHYSICAL ABUSE Yes 4 8% 4 10%

No 34 65% 30 73%

Don’t Know 14 27% 7 17%

HX PERPETRATOR SEXUAL ABUSE Yes 0 0% 0 0%

No 38 73% 34 83%

Don’t Know 14 27% 7 17%

HX PERPETRATOR EMOTIONAL ABUSE Yes 1 2% 0 0%

No 37 71% 34 83%

Don’t Know 14 27% 7 17%

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 0 0% 1 2%

No 38 73% 33 80%

Don’t Know 14 27% 7 17%

Financial and Workplace Difficulties

Of the financial and workplace issues assessed by DoDSER, the most commonly reported for Marine 

Corps decedents were job problems (job loss or instability; 29%, n=15) and poor work performance 

(29%, n=15), as shown in Table 6.25. Twenty-three percent (n=12) of decedents had a history of 

difficulties with either supervisors or coworkers, and 15% (n=8) had a history of excessive debt or 

bankruptcy.
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 172

Table 6.25 2009 AND 2008 MARINE CORPS DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES

2009 2008

Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 8 15% 4 10%

No 25 48% 24 59%

Don't Know 19 37% 13 32%

HX JOB LOSS/INSTABILITY Yes 15 29% 7 17%

No 29 56% 33 80%

Don't Know 8 15% 1 2%

HX SUPERVISOR/COWORKER ISSUES Yes 12 23% 5 12%

No 33 63% 34 83%

Don't Know 7 13% 2 5%

HX POOR WORK EVALUATION Yes 15 29% 6 15%

No 32 62% 35 85%

Don't Know 5 10% 0 0%

HX UNIT/WORKPLACE HAZING Yes 1 2% 0 0%

No 43 83% 40 98%

Don't Know 8 15% 1 2%

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Member’s most recent three 

deployments. Data include deployment location information as well as a history of direct combat 

operations. Comparisons of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) suicide 

events to non-OEF/OIF suicide events are reported in Chapter 3.

Deployment History

As shown in Table 6.26, the majority (68%, n=35) of Marine Corps decedents had been deployed as part 

of OEF/OIF at least once. Forty-eight percent (n=25) had been deployed to only Iraq, and 12% (n=6) had 

been deployed to multiple OEF/OIF countries. These data are consistent with 2008 Marine Corps 

DoDSERs.
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 173

Table 6.26 2009 AND 2008 MARINE CORPS DoDSER EVER DEPLOYED TO OEF/OIF

2009 2008

Count Percent Count Percent

HX DEPLOYMENT OEF/OIF AFGHANISTAN 3 6% 0 0%

IRAQ 25 48% 23 56%

KUWAIT 1 2% 5 12%

MULTIPLE OEF/OIF LOCATIONS 6 12% 0 0%

NO HX OEF/OIF DEPLOYMENT 17 33% 13 32%

Note: Data regarding multiple OEF/OIF deployments unknown for 2008.

Combat History

As shown in Table 6.27, the large majority of Marine Corps decedents had no known direct combat 

history (83%, n=43). Of the nine decedents (17%) with combat history, two (22%) were reported to have

witnessed killing and two (22%) were reported to have seen dead bodies during combat. These figures 

are lower than for 2008 Marine Corps DoDSER data.

Table 6.27 2009 AND 2008 MARINE CORPS DoDSER COMBAT HISTORY

2009 2008

Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 9 17% 15 37%

 Combat Resulted in Injuries/Casualties 1 11% 10 67%

 Injured in Combat 0 0% 4 37%

 Witnessed Killing in Combat 2 22% 12 80%

 Saw Dead Bodies in Combat 2 22% 8 53%

 Killed Others in Combat 0 0% 7 47%

NO DIRECT COMBAT HX 43 83% 26 63%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat.

Percentages for these items reflect proportion of those with combat experience.
DoDSER 2009 Annual Report

Chapter 6 Marine Corps Results for Completed Suicides

Page | 174

Summary

This chapter describes the events and historical factors associated with Marine Corps suicides in 

calendar year 2009. There were fifty-two AFMES suicide confirmations for 2009 and 52 DoDSERs 

submitted for a compliance rate of 100%.

All Marine Corps decedents were male and almost all were in a Regular Active Duty component. The 

majority were Caucasian, under 25 years of age, and enlisted. The primary location of suicide was 

Service Members’ residence or shared military living space. Most used firearms (primarily non-military), 

and hanging was the next most common method. Insufficient information exists regarding Marine Corps 

decedents’ substance use during suicide events. Although for most Marine Corps decedents there were 

no reports of having disclosed to others their potential for self-harm, when they did, they most 

commonly spoke with their spouses or friends. Most Marine Corps decedents lived on military 

installations, but specific locations of duty were often not reported.

Few Marine Corps decedents had reported histories of prior self-injury. Most decedents had no 

reported history of a behavioral health diagnosis. Of those with a behavioral health history, the most 

common diagnoses were substance abuse and mood disorder. Outpatient mental health was the most 

common behavioral healthcare provision, and few decedents had prescriptions for psychotropic 

medications.

Prior to suicide, many Marine Corps decedents were reported to have experienced failed intimate 

relationships. Further, decedents were also reported to have experienced a variety of administrative and 

legal difficulties, the most common being Article 15 proceedings. The most commonly reported financial 

and workplace difficulties for decedents were job loss or instability and poor work performance.

The majority of Marine Corps decedents had been deployed as part of OEF/OIF at least once. 

Approximately half of all decedents had been deployed to Iraq. The majority had no known direct 

combat history.

In addition to presenting 2009 DoDSER data, this chapter includes 2008 comparison data. Overall, 

patterns were generally consistent across the two years.
DoDSER 2009 Annual Report

Page | 175

Chapter 7

NAVY RESULTS FOR COMPLETED SUICIDES

Navy DoDSER Submissions and POC Compliance

Forty-five Navy suicides were confirmed by the Armed Forces Medical Examiner System (AFMES) for 

calendar year 2009 as of the Department of Defense Suicide Event Report (DoDSER) submission 

compliance cut date (31 January 2010), as described in Chapter 1, Method. Forty-five Navy DoDSERs 

were submitted and analyzed, for a submission compliance rate of 100%. Two additional suicides for 

2009 have been confirmed or are pending, and a Defense Suicide Event Report (DoDSER) was received 

for one of them. Consequently, a total of 46 suicide completions for 2009 were included in this report 

(Table 7.1).

Table 7.1 2009 NAVY AFMES CONFIRMED AND PENDING SUICIDES AND DoDSERs SUBMITTED

2009

Total DoDSERs 46..

Total AFMES Confirmed and Pending Suicides 47..

AFMES Confirmed Suicides 45..

DoDSER Submission Compliance 100%

Additional DoDSERs Pending AFMES Confirmation 1..

Data from 1/1/2009 through 12/31/2009 as of 4/1/2010

Dispositional/Personal Factors

This section reports data that describe internal characteristics or individual behaviors of decedents that 

may have been associated with or contributed to the suicidal events. These factors include decedents’ 

demographic characteristics, event setting, suicide method, substance use during the event, possible

motive and intent to die, and communication of intent with others.

Demographics

Table 7.2 contains DMDC demographic data provided by AFMES. All but two Navy suicides were 

completed by males. Suicide decedents were primarily Caucasian, enlisted, and regular component, as 

was the case in 2008. Cases were older relative to 2008, but given the small number of decedents each 

year, differences should be interpreted with caution.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 176

Table 7.2 2009 AND 2008 AFMES NAVY DEMOGRAPHICS

2009 2008

Count Percent Count Percent

Total 47 100% 41 100%

GENDER Male 45 96% 40 98%

Female 2 4% 1 2%

RACE Asian/Pacific Islander 2 4% 3 7%

African American 6 13% 7 17%

Caucasian 34 72% 28 68%

American Indian/Alaska Native 3 7% 1 2%

Other/Don’t Know/Missing 2 4% 1 2%

AGE RANGE Under 25 13 28% 21 51%

25-29 8 17% 6 15%

30-39 20 43% 9 22%

40 + 6 13% 5 12%

RANK E1-E4 13 28% 18 44%

E5-E9 30 64% 20 49%

Officer 2 4% 3 7%

Warrant Officer 1 2% 0 0%

Cadet/Midshipman 0 0% 0 0%

COMPONENT Regular 45 96% 40 98%

Reserve 2 4% 1 2%

National Guard 0 0% 0 0%

EDUCATION Did not graduate high school 0 0% 2 5%

GED 3 7% 1 2%

High school graduate 35 76% 29 71%

Some college or technical school 2 4% 4 10%

Degree/certificate of less than four years 2 4% 0 0%

Four-year college degree 3 6% 3 7%

Master’s degree or greater 1 2% 2 5%

Don’t Know 1 2% 0 0%

MARITAL STATUS Never Married 8 17% 15 37%

Married 28 60% 23 56%

Legally Separated 0 0% 0 0%

Divorced 4 9% 3 7%

Widowed 0 0% 0 0%

Don’t Know 7 15% 0 0%

Note: Demographic data were obtained from the DMDC with assistance from the AFMES and reflect suicide events from 1/1/2008 through 

12/31/2009 as of 4/1/2010. 
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 177

Event Setting

The most common settings for Navy suicides in 2009 were Service Members’ personal residences (59%,

n=27) (Table 7.3). Six additional suicides occurred at work or a jobsite, and two occurred at the 

residence of a family or friend. Eleven other locations were reported, including a variety of public, 

private, and service-related settings. Four Navy suicides took place while Service Members were outside 

the United States (Table 7.4). There were no OEF/OIF suicides in 2008 or 2009.

Table 7.3 2009 AND 2008 NAVY DoDSER EVENT SETTING

2009 2008

Count Percent Count Percent

EVENT SETTING Residence (own) or barracks 27 59% 21 51%

Residence of friend or family 2 4% 3 7%

Work/jobsite 6 13% 4 10%

Automobile (away from residence) 0 0% 5 12%

Inpatient medical facility 0 0% 0 0%

Other 11 24% 8 20%

Table 7.4 2009 AND 2008 NAVY DoDSER EVENT COUNTRY

2009 2008

Count Percent Count Percent

EVENT COUNTRY United States 42 91% 37 90%

Korea 1 2% 0 0%

Other 3 7% 0 0%

Don’t Know 0 0% 4 10%

Event Method

Most Navy suicides involved non-military firearms (39%, n=18), or hanging (24%, n=11), as shown in

Figure 7.1 and Table 7.5. The method for the remaining suicides for which there was information

available included military-issue firearms, vehicle exhaust, and other methods.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 178

Figure 7.1 2009 AND 2008 NAVY DoDSER EVENT METHODS

Table 7.5 2009 AND 2008 NAVY DoDSER EVENT METHOD

2009 2008

Count Percent Count Percent

EVENT METHOD Drugs 1 2% 1 2%

Gas, vehicle exhaust 3 7% 2 5%

Gas, utility (or other) 2 4% 0 0%

Hanging 11 24% 11 27%

Drowning 0 0% 1 2%

Firearm, military issue 3 7% 3 7%

Firearm, non-military issue 18 39% 18 44%

Sharp or blunt object 2 4% 2 5%

Jumping from high place 2 4% 0 0%

Lying in front of moving object 0 0% 1 2%

Other 4 9% 2 5%

Substance Use during the Event

For 26% of Navy suicides in 2009, information was not available about substance use during the event, 

(Table 7.6). However, when data were available, alcohol use during the event was observed for nine of 

34 events for which substance use or non-use was reported. With the exception of one overdose of 

7%

39%

24%

30%

7%

44%

27%

22%

0

10

20

30

40

50

60

70

80

90

100

Firearm, 

military issue

Firearm, nonmilitary issueHanging Other

Percentage

2009

2008
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 179

prescription drugs and one decedent taking over-the-counter medication, drug use was not known to 

have occurred during suicide.

Table 7.6 2009 AND 2008 NAVY DoDSER SUBSTANCE(S) USED DURING EVENT

2009 2008

Count Percent Count Percent

ALCOHOL USED Yes 9 20% 10 24%

No 25 54% 17 41%

Don’t Know 12 26% 14 34%

ANY DRUGS USED Yes 1 2% 2 5%

No 31 67% 24 59%

Don’t Know 14 30% 15 37%

 Illegal drugs Overdose 0 0% 0 0%

Used, no overdose 0 0% 0 0%

Were not used 32 70% 24 59%

Don’t Know 14 30% 17 41%

 Prescription drugs Overdose 1 2% 0 0%

Used, no overdose 0 0% 1 2%

Were not used 31 67% 24 59%

Don’t Know 14 30% 16 39%

 OTC drugs Overdose 0 0% 1 2%

Used, no overdose 1 2% 0 0%

Were not used 31 67% 24 59%

Don’t Know 14 30% 16 39%

BOTH ALCOHOL AND DRUGS USED Yes 0 0% 1 2%

No 32 70% 25 61%

Don’t Know 14 30% 15 37%

Communication of Intent

DoDSER respondents indicate the types of individuals with whom decedents communicated potential 

for self-harm when known. As shown in Table 7.7, 74% of Navy decedents in 2009 had no known history

of communicating a potential suicide. Twelve decedents were reported to have communicated their 

intent to one or more types of recipients prior to taking their lives. Seven of those had expressed their 

intent verbally (Table 7.8). Six individuals (13%) reportedly communicated their intent to their spouse,

three (7%) to a friend, one to a behavioral health provider, and the remaining four (9%) to a variety of 

“other” persons including an ex-girlfriend and family members (Table 7.9).
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 180

Table 7.7 2009 AND 2008 NAVY DoDSER NUMBER OF TYPES OF RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

NUMBER OF TYPES OF RECIPIENTS OF 

COMMUNICATED INTENT

0 34 74% 24 59%

1 10 22% 13 32%

2 2 4% 4 10%

Table 7.8 2009 AND 2008 NAVY DoDSER MODE OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

MODE OF COMMUNICATED INTENT Verbal Only 7 15% 11 27%

Written Only 0 0% 1 2%

Other 4 9% 3 7%

Multiple Modes 2 4% 2 5%

Note: Multiple modes include a combination of verbal, written, or other mode of communicating intent to suicide.

Table 7.9 2009 AND 2008 NAVY DoDSER RECIPIENTS OF COMMUNICATED INTENT

2009 2008

Count Percent Count Percent

COMMUNICATION Friend 3 7% 6 15%

Behavioral Health Staff 1 2% 2 5%

Supervisor 0 0% 1 2%

Spouse 6 13% 6 15%

Chaplain 0 0% 1 2%

Other 4 9% 5 12%

Made Multiple Communication 2 4% 4 10%

Additional Event Information

Table 7.10 shows that there was evidence of intent to die for 83% (n=38) of Navy decedents. For 20

suicides, there was evidence of planned or premeditated self-harm. Most suicides took place where it 

was unlikely that others could observe or intervene (74%, n=34), and in most cases (54%, n=25) no 

suicide note was found.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 181

Table 7.10 2009 AND 2008 NAVY DoDSER OTHER EVENT INFORMATION

2009 2008

Count Percent Count Percent

EVIDENCE EXISTS INDICATING 

INTENTION TO DIE

Yes 38 83% 23 56%

No 1 2% 5 12%

Don’t Know 7 15% 13 32%

DEATH RISK GAMBLING Yes 1 2% 2 5%

No 42 91% 35 85%

Don’t Know 3 7% 4 10%

PLANNED/PREMEDITATED Yes 20 43% 18 44%

No 13 28% 7 17%

Don’t Know 13 28% 16 39%

OBSERVABLE Yes 11 24% 9 22%

No 34 74% 27 66%

Don’t Know 1 2% 5 12%

SUICIDE NOTE LEFT Yes 16 35% 8 20%

No 25 54% 27 66%

Don’t Know 5 11% 6 15%

Contextual Factors

This section describes DoDSER data that pertains to contextual factors such as the home and duty 

environments.

Home Environment

As shown in Table 7.11, in 2009, Navy Service Members who died by suicide most frequently lived in offbase family housing at the time the suicide took place (74%, n=34). One-third of decedents (n=15) were 

living with a spouse, and 30% (n=14) were living with children. Firearms were reported to be in the 

homes or immediate environments of 43% (n=20) of Navy decedents.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 182

Table 7.11 2009 AND 2008 NAVY DoDSER HOME ENVIRONMENT

2009 2008

Count Percent Count Percent

RESIDENCE AT TIME OF EVENT Shared military living environment 1 2% 1 2%

Bachelor quarters 4 9% 5 12%

On-base family housing 2 4% 2 5%

Owned or leased apartment or house 34 74% 21 51%

Ship 3 7% 4 10%

Other 1 2% 5 12%

Don’t Know 1 2% 3 7%

MARRIED SERVICE MEMBER 

RESIDENCE

Resides with spouse 15 33% 7 17%

Separated due to relationship issues 6 13% 6 15%

Apart for other reasons/deployed 5 11% 3 7%

Don’t Know 1 2% 5 12%

Unmarried at time of event 19 41% 20 49%

RESIDED ALONE Yes 19 41% 9 22%

No 27 59% 28 68%

Don’t Know 0 0% 4 10%

HAD MINOR CHILDREN Yes 21 46% 15 37%

No 24 52% 23 56%

Don’t Know 1 2% 3 7%

CHILDREN RESIDED WITH Yes 14 30% 3 7%

No 7 15% 11 27%

Don’t Know 0 0% 1 2%

No Known Children 25 54% 26 63%

FIREARM IN IMMEDIATE/LIVING 

ENVIRONMENT

Yes 20 43% 18 44%

No 14 30% 10 24%

Don’t Know 12 26% 13 32%
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 183

Duty Environment

The duty location options shown in Table 7.12 were relatively rare. Five decedents (11%) died by suicide 

while on leave.

Table 7.12 2009 AND 2008 NAVY DoDSER DUTY ENVIRONMENT

2009 2008

Count Percent Count Percent

DUTY ENVIRONMENT Leave 5 11% 7 17%

Medical Hold 1 2% 0 0%

TDY 1 2% 0 0%

AWOL 3 7% 0 0%

Other 3 7% 0 0%

Training 2 4% 3 7%

Note: Duty environment was not required for all DoDSERs. As such, percentages do not add to 100%.

Suicide Completions by Month

Consistent with data from 2008, no clear pattern exists for Navy suicides by month (Table 7.13).

Table 7.13 2009 AND 2008 NAVY DoDSER SUICIDE EVENTS BY MONTH

2009 2008

Count Percent Count Percent

MONTH January 2 4% 6 15%

February 6 13% 1 2%

March 4 9% 3 7%

April 3 7% 4 10%

May 5 11% 5 12%

June 3 7% 2 5%

July 4 9% 4 10%

August 6 13% 0 0%

September 3 7% 2 5%

October 3 7% 2 5%

November 3 7% 8 20%

December 4 9% 4 10%
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 184

Clinical/Symptom Factors

The DoDSER also captures detailed information on clinical, behavioral, and symptom factors that may be 

associated with subsequent suicidal behavior. These factors include data on prior self-harm, previous 

diagnoses of behavioral health disorders and behavioral health issues, and relevant treatment histories, 

including prescribed medication.

Prior Self-Injury

Five decedents in 2009 had reported histories of prior self-injury (Table 7.14), only one of whom had 

more than one report of prior self-injury.

Table 7.14 2009 AND 2008 NAVY DoDSER PRIOR SELF-INJURY

2009 2008

Count Percent Count Percent

HX PRIOR SELF-INJURY Yes 5 11% 4 10%

 Within 30 days 1 2% 2 5%

 Within 90 days (inclusive)* 4 9% 3 7%

No 30 65% 22 54%

Don’t Know 11 24% 15 37%

 Number prior self-injuries One prior event 4 9% ---- ----

More than one prior event 1 2% ---- ----

N/A 41 89% ---- ----

 Event similar to prior self-injury Yes 2 4% 3 7%

No 1 2% 1 2%

Don’t Know 2 4% 0 0%

N/A 41 89% 37 90%

Note: Number of prior self-injuries not available for 2008.

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.”

Behavioral Health Disorders

Thirty percent (n=14) of Navy decedents had reported histories of at least one behavioral health 

disorder. As shown in Table 7.15, 17% (n=8) of Navy decedents were reported to have been diagnosed 

with a mood disorder, including major depression (n=4), dysthymic disorder (n=2), and other mood 

disorders (n=2). Thirteen percent (n=6) were reported to have been diagnosed with an anxiety disorder 

(Table 7.16). PTSD (4%, n=2) and other or unspecified anxiety disorders (6%, n=3) were rarely reported, 

and no reported instances of panic disorder, generalized anxiety disorder or acute stress disorder were 

evident. Furthermore, few decedents had reported diagnoses of personality disorder (4%, n=2) or 

history of substance abuse (17%, n=8), and no psychotic disorders were reported (Table 7.17). Six 
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 185

individuals (13%) were reported to have been diagnosed with more than one comorbid behavioral 

health disorders prior to suicide (Table 7.18).

Table 7.15 2009 AND 2008 NAVY DoDSER MOOD DISORDERS

2009 2008

Count Percent Count Percent

DX W/MOOD DISORDER Yes 8 17% 3 7%

No 26 57% 25 61%

Don’t Know 12 26% 13 32%

 Bipolar disorder Yes 0 0% 0 0%

No 32 70% 28 68%

Don’t Know 14 30% 13 32%

 Major depression Yes 4 9% 1 2%

No 29 63% 27 66%

Don’t Know 13 28% 13 32%

 Dysthymic disorder Yes 2 4% 0 0%

No 30 65% 28 68%

Don’t Know 14 30% 13 32%

 Other mood disorder Yes 1 2% 2 5%

No 31 67% 25 61%

Don’t Know 14 30% 14 34%

 Unspecified mood disorder Yes 1 2% 0 0%

No 33 72% 28 68%

Don’t Know 12 26% 13 32%

 Multiple mood DX Yes 0 0% 0 0%

No 34 74% 28 68%

Don’t Know 12 26% 13 32%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had a mood disorder.

Table 7.16 2009 AND 2008 NAVY DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

DX W/ANXIETY DISORDER Yes 6 13% 4 10%

No 30 65% 26 63%

Don’t Know 10 22% 11 27%

 PTSD Yes 2 4% 0 0%

No 33 72% 28 68%

Don’t Know 11 24% 13 32%
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 186

Table 7.16 2009 AND 2008 NAVY DoDSER ANXIETY DISORDERS

2009 2008

Count Percent Count Percent

 Panic disorder Yes 0 0% 0 0%

No 35 76% 28 68%

Don’t Know 11 24% 13 32%

 Generalized anxiety disorder Yes 0 0% 0 0%

No 35 76% 30 73%

Don’t Know 11 24% 11 27%

 Acute stress disorder Yes 0 0% 0 0%

No 35 76% 30 73%

Don’t Know 11 24% 11 27%

 Other anxiety disorder Yes 2 4% 1 2%

No 33 72% 28 68%

Don’t Know 11 24% 12 29%

 Unspecified anxiety DX Yes 1 2% 0 0%

No 35 76% 30 73%

Don’t Know 10 22% 11 27%

 Multiple anxiety DX Yes 1 2% 3 7%

No 35 76% 27 66%

Don’t Know 10 22% 11 27%

Note: Indented items were only asked in cases where the respondent indicated that the decedent had an anxiety disorder.

Table 7.17 2009 AND 2008 NAVY DoDSER OTHER BEHAVIORAL HEALTH DISORDERS

2009 2008

Count Percent Count Percent

DX W/PERSONALITY DISORDER Yes 2 4% 0 0%

No 32 70% 30 73%

Don’t Know 12 26% 11 27%

DX W/PSYCHOTIC DISORDER Yes 0 0% 0 0%

No 33 72% 30 73%

Don’t Know 13 28% 11 27%

HX SUBSTANCE ABUSE Yes 8 17% 6 15%

No 24 52% 23 56%

Don’t Know 14 30% 12 29%

(cont.)
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 187

Table 7.18 2009 AND 2008 NAVY DoDSER COMORBIDITY RATES

2009 2008

Count Percent Count Percent

NUMBER OF BEHAVIORAL HEALTH 

DIAGNOSES

No DX 32 70% 32 78%

1 DX 8 17% 5 12%

2 DX 5 11% 1 2%

3 DX 1 2% 2 5%

4 or more DX 0 0% 1 2%

Treatment

Table 7.19 shows the history of decedents’ visits to treatment programs and clinics prior to their 

suicides. In 2009, 39% of decedents were reported to have been seen in a military treatment facility 

(MTF) within 90 days of their suicides.

Table 7.19 2009 AND 2008 NAVY DoDSER TREATMENT HISTORY 

2009 2008

Count Percent Count Percent

SEEN AT MILITARY TREATMENT 

FACILITY

Yes 21 46% 12 29%

 Within 30 days 12 26% 9 22%

 Within 90 days (inclusive)* 18 39% 10 24%

No 15 33% 16 39%

Don’t Know 10 22% 13 32%

SUBSTANCE ABUSE SERVICES Yes 8 17% 4 10%

 Within 30 days 2 4% 1 2%

 Within 90 days (inclusive)* 3 7% 2 5%

No 28 61% 30 73%

Don’t Know 10 22% 7 17%

FAMILY ADVOCACY PROGRAMS Yes 3 7% 1 2%

 Within 30 days 0 0% 1 2%

 Within 90 days (inclusive)* 0 0% 1 2%

No 29 63% 28 68%

Don’t Know 14 30% 12 29%

CHAPLAIN SERVICES Yes 6 13% 6 15%

 Within 30 days 2 4% 1 2%

 Within 90 days (inclusive) 5 11% 3 7%

No 22 48% 16 39%

Don’t Know 18 39% 19 46%
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 188

Table 7.19 2009 AND 2008 NAVY DoDSER TREATMENT HISTORY 

2009 2008

Count Percent Count Percent

OUTPATIENT BEHAVIORAL HEALTH Yes 9 20% 5 12%

 Within 30 days 3 7% 2 5%

 Within 90 days (inclusive)* 3 7% 3 7%

No 26 57% 27 66%

Don’t Know 11 24% 9 22%

INPATIENT BEHAVIORAL HEALTH Yes 4 9% 3 7%

 Within 30 days 1 2% 0 0%

 Within 90 days (inclusive)* 1 2% 0 0%

No 33 72% 31 76%

Don’t Know 9 20% 7 17%

HX PHYSICAL HEALTH PROBLEM Yes 9 20% 3 7%

 Within 30 days 3 7% 2 5%

 Within 90 days (inclusive)* 4 9% 3 7%

No 30 65% 24 59%

Don’t Know 7 15% 14 34%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances. 

Table 7.20 shows psychotropic medications reported to have been used by Navy Service Members prior 

to taking their lives. In 2009, only 4% (n=2) of decedents were reported to have used psychotropic drugs. 

Both decedents were reported to have taken antidepressants, and one was reported to have also taken 

antianxiety medications.

Table 7.20 2009 AND 2008 NAVY DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

TAKEN PSYCHOTROPIC MEDS Yes 2 4% 4 10%

No 27 59% 26 63%

Don’t Know 17 37% 11 27%

 Antidepressants Yes 2 4% 3 7%

No 27 59% 26 63%

Don’t Know 17 37% 12 29%

 Antianxiety Yes 1 2% 3 7%

No 28 61% 27 66%

Don’t Know 17 37% 11 27%

(cont.)
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 189

Table 7.20 2009 AND 2008 NAVY DoDSER PSYCHOTROPIC MEDICATION USE

2009 2008

Count Percent Count Percent

 Antimanics Yes 0 0% 0 0%

No 29 63% 29 71%

Don’t Know 17 37% 12 29%

 Anticonvulsants Yes 0 0% 0 0%

No 29 63% 29 71%

Don’t Know 17 37% 12 29%

 Antipsychotics Yes 0 0% 0 0%

No 29 63% 29 71%

Don’t Know 17 37% 12 29%

Note: Indented items were only asked in cases where the respondent indicated that the decedent used psychotropic medication.

Historical/Developmental Factors

DoDSER data are collected on historical or developmental factors that precede a suicide event. These 

data include information about family histories and interpersonal relationships, legal, financial and 

administrative difficulties, and reports of prior abuse.

Family and Relationship History

As in 2008, many Navy decedents were reported to have experienced a failed intimate relationship 

before dying by suicide (57%, n=26) (Table 7.21). Thirty-three percent (n=15) had experienced the loss 

within 30 days of taking their lives, and another four within 90 days. Other influential events, such as the 

death of a spouse, family member or friend, were reported less frequently (Table 7.22).

Table 7.21 2009 AND 2008 NAVY DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX FAILED INTIMATE RELATIONSHIP Yes 26 57% 21 51%

 Within 30 days 15 33% 13 32%

 Within 90 days (inclusive)* 19 41% 16 39%

No 14 30% 10 24%

Don’t Know 6 13% 10 24%

HX FAILED OTHER RELATIONSHIP Yes 9 20% 6 15%

 Within 30 days 3 7% 5 12%

 Within 90 days (inclusive)* 4 9% 5 12%

No 26 57% 18 44%

Don’t Know 11 24% 17 41%

(cont.)
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 190

Table 7.21 2009 AND 2008 NAVY DoDSER RELATIONSHIP HISTORY

2009 2008

Count Percent Count Percent

HX ANY FAILED RELATIONSHIP Yes 27 59% 24 59%

 Within 30 days 15 33% 15 37%

 Within 90 days (inclusive)* 19 41% 18 44%

No 14 30% 8 20%

Don’t Know 5 11% 9 22%

*Data presented for “Within 90 days” includes all cases that reported the event “Within 30 days.” Therefore, summing the two time frames 

sums to more than the total number of cases in some instances. 

Table 7.22 2009 AND 2008 NAVY DoDSER FAMILY HISTORY

2009 2008

Count Percent Count Percent

HX SPOUSE SUICIDE Yes 0 0% 0 0%

No 42 91% 35 85%

Don’t Know 4 9% 6 15%

HX FAMILY MEMBER SUICIDE Yes 0 0% 2 5%

No 36 78% 21 51%

Don’t Know 10 22% 18 44%

HX FRIEND SUICIDE Yes 1 2% 0 0%

No 29 63% 21 51%

Don’t Know 16 35% 20 49%

HX DEATH OF SPOUSE/FAMILY

MEMBER

Yes 7 15% 1 2%

No 29 63% 22 54%

Don’t Know 10 22% 18 44%

HX DEATH OF FRIEND Yes 2 4% 2 5%

No 28 61% 19 46%

Don’t Know 16 35% 20 49%

HX SPOUSE/FAMILY ILLNESS Yes 3 7% 2 5%

No 34 74% 21 51%

Don’t Know 9 20% 18 44%

HX FAMILY BEHAVIORAL HEALTH 

PROBLEMS

Yes 2 4% 4 10%

No 18 39% 9 22%

Don’t Know 26 57% 28 68%

(cont.)
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 191

Administrative and Legal History

As shown in Table 7.23, Navy decedents were reported to have experienced relatively few legal or 

administrative difficulties prior to suicide. Few instances of courts martial, Article 15 proceedings, 

administrative separations, medical evaluation board reviews, or job selection or promotion concerns 

were reported. Civilian legal difficulties such as child custody disputes and civilian litigations were the 

most prevalent legal issues reported to have occurred prior to suicides (20%, n=9). Being absent without 

leave (15%, n=7) was less frequent but also noteworthy among suicides.

Table 7.23 2009 AND 2008 NAVY DoDSER ADMIN/LEGAL HISTORY

2009 2008

Count Percent Count Percent

HX COURTS MARTIAL Yes 2 4% 0 0%

No 43 93% 41 100%

Don’t Know 1 2% 0 0%

HX ARTICLE 15 Yes 4 9% 0 0%

No 22 48% 0 0%

Don’t Know 20 43% 41 100%

HX ADMIN SEPARATION Yes 4 9% 1 2%

No 42 91% 40 98%

Don’t Know 0 0% 0 0%

HX AWOL Yes 7 15% 0 0%

No 38 83% 41 100%

Don’t Know 1 2% 0 0%

HX MEDICAL BOARD Yes 3 7% 0 0%

No 42 91% 40 98%

Don’t Know 1 2% 1 2%

HX CIVIL LEGAL PROBLEMS Yes 9 20% 4 10%

No 32 70% 31 76%

Don’t Know 5 11% 6 15%

HX NON-SELECTION Yes 4 9% 2 5%

No 40 87% 35 85%

Don’t Know 2 4% 4 10%

Abuse History

A history of physical, sexual or emotional abuse, either as a victim or perpetrator, was rarely reported

for Navy Service Members taking their lives (Table 7.24). There were five known instances of decedents 

who had been victims of physical abuse.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 192

Table 7.24 2009 AND 2008 NAVY DoDSER ABUSE HISTORY

2009 2008

Count Percent Count Percent

HX VICTIM PHYSICAL ABUSE Yes 5 11% 1 2%

No 33 72% 22 54%

Don’t Know 8 17% 18 44%

HX VICTIM SEXUAL ABUSE Yes 1 2% 0 0%

No 36 78% 25 61%

Don’t Know 9 20% 16 39%

HX VICTIM EMOTIONAL ABUSE Yes 4 9% 1 2%

No 32 70% 23 56%

Don’t Know 10 22% 17 41%

HX VICTIM SEXUAL HARASSMENT Yes 0 0% 0 0%

No 37 80% 25 61%

Don’t Know 9 20% 16 39%

HX PERPETRATOR PHYSICAL ABUSE Yes 3 7% 1 2%

No 36 78% 25 61%

Don’t Know 7 15% 15 37%

HX PERPETRATOR SEXUAL ABUSE Yes 2 4% 2 5%

No 36 78% 25 61%

Don’t Know 8 17% 14 34%

HX PERPETRATOR EMOTIONAL 

ABUSE

Yes 2 4% 0 0%

No 34 74% 26 63%

Don’t Know 10 22% 15 37%

HX PERPETRATOR SEXUAL 

HARASSMENT

Yes 0 0% 1 2%

No 38 83% 28 68%

Don’t Know 8 17% 12 29%

Financial and Workplace Difficulties

A relatively small proportion of Navy decedents in 2009 (8 of 35 with available financial data) were 

reported to have had excessive debt or bankruptcy. Table 7.25 shows that job problems (job loss or job 

instability) preceding suicide was more prevalent (28%, n=13). Supervisory or co-worker issues and poor 

work performance reviews were less frequently reported.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 193

Table 7.25 2009 AND 2008 NAVY DoDSER FINANCIAL AND WORKPLACE DIFFICULTIES

2009 2008

Count Percent Count Percent

EXCESSIVE DEBT/BANKRUPTCY Yes 8 17% 3 7%

No 27 59% 28 68%

Don’t Know 11 24% 10 24%

HX JOB PROBLEMS Yes 13 28% 4 10%

No 32 70% 32 78%

Don’t Know 1 2% 5 12%

HX SUPERVISOR/COWORKER ISSUES Yes 6 13% 3 7%

No 37 80% 30 73%

Don’t Know 3 7% 8 20%

HX POOR WORK EVALUATION Yes 4 9% 2 5%

No 39 85% 34 83%

Don’t Know 3 7% 5 12%

HX UNIT/WORKPLACE HAZING Yes 0 0% 0 0%

No 42 91% 34 83%

Don’t Know 4 9% 7 17%

Deployment Factors

The 2009 DoDSER captured detailed information pertaining to the Service Member’s most recent three 

deployments. Data include deployment location information as well as a history of direct combat 

operations. Comparisons of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) suicide 

events to non-OEF/OIF suicide events are reported in Chapter 3.

Deployment and Combat History

Few Navy personnel who died by suicide in 2009 had been deployed to Iraq or Afghanistan (Table 7.26). 

Of the 46 Navy suicides reported for 2009, 41 (89%) decedents did not have histories of OEF/OIF 

deployment, three had served in Afghanistan or Iraq, and combat experiences were reported for only 

one decedent, as shown in Table 7.27.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 194

Table 7.26 2009 AND 2008 NAVY DoDSER EVER DEPLOYED TO OEF/OIF

2009 2008

Count Percent Count Percent

HX DEPLOYMENT OEF/OIF AFGHANISTAN 1 2% 0 0%

IRAQ 2 4% 2 5%

KUWAIT 1 2% 0 0%

MULTIPLE OEF/OIF LOCATIONS 1 2% 0 0%

NO HX OEF/OIF DEPLOYMENT 41 89% 39 95%

Note: Data regarding multiple OEF/OIF deployments unknown for 2008.

Table 7.27 2009 AND 2008 NAVY DoDSER COMBAT HISTORY

2009 2008

Count Percent Count Percent

COMBAT HISTORY HX DIRECT COMBAT 1 2% 0 0%

 Witnessed Killing in Combat 1 100% 0 0%

 Saw Dead Bodies in Combat 1 100% 0 0%

NO DIRECT COMBAT HX 45 98% 41 100%

Note: Indented items were only asked in cases for which the respondent indicated that the decedent had participated in direct combat.

Percentages for these items reflect proportion of those with combat experience.
DoDSER 2009 Annual Report

Chapter 7 Navy Results for Completed Suicides

Page | 195

Summary

This annual report of the Navy DoDSER provides descriptive statistics for Navy suicides that occurred in 

2009. The AFMES indicates a total of 47 suicides confirmed or pending for 2009. DoDSERs were received 

for 46 of the suicides (the one outstanding DoDSER was not past due at the time of this writing). Suicides 

in 2009 were most common among young, Caucasian, married, enlisted, active component Service 

Members. Non-military firearms and hanging were the most frequent methods of suicide. Suicides were 

frequently deemed to have been planned or premeditated, but only a minority of decedents was 

reported to have communicated their intent to others.

Off-base housing was the most common place of residence at the time of suicide in 2009. Suicides most 

frequently occurred in Service Members’ own residences. Alcohol was reported to have been used in 

only a minority of suicides for which substance use or non-use was reported.

Thirty-nine percent of decedents were reported to have been seen in MTFs within three months prior to 

taking their lives. Behavioral health treatment histories were reported for less than one-fifth of suicide 

decedents, with mood and anxiety disorders most commonly reported. The most frequently reported 

stressors included failed or failing spousal or other intimate relationships, and job related problems. Of 

the 19 decedents who had a history of deployment to OEF/OIF, there was only one report of combat 

experiences.
DoDSER 2009 Annual Report

References

Page | 196

REFERENCES

[1] Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting 

System (WISQARS). Fatal Injury Reports. Atlanta, GA: National Center for Injury Prevention and 

Control. Last accessed 2010 June 29.

[2] DoD Instruction 1300.18 “Department of Defense Personnel Casualty Matters, Policies, and 

Procedures.” January 8, 2009.

[3] Silverman M. M., Berman A.L., Sanddal N.D., O’Carroll P.W., & Joiner T.E. (2007). Rebuilding the 

tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 2: 

Suicide-related ideations, communications, and behaviors. Suicide and Life-Threatening Behavior, 

37(3):264-77.

[4] Under Secretary of Defense for Personnel and Readiness Memorandum, “Standardized DoD Suicide 

Data and Reporting,” June 18, 2006.
DoDSER 2009 Annual Report

Abbreviation, Acronym and Initialism List

Page | 197

ABBREVIATION, ACRONYM, AND INITIALISM LIST

ADMIN – administrative

AF – Air Force

AFIP – Armed Forces Institute of Pathology

AFMES – Armed Forces Medical Examiner 

System

AWOL – absent without leave

CAC – common access card

CDC – Centers for Disease Control

CY – calendar year

DMDC – Defense Manpower Data Center

DoD – Department of Defense

DoDSER – Department of Defense Suicide Event 

Report

DoNSIR – Department of the Navy Suicide 

Incident Report

DX – diagnosis

GED – general equivalency diploma

HX – history

MEB – Medical Evaluation Board

MTF – medical treatment facility

OEF – Operation Enduring Freedom

OIF – Operation Iraqi Freedom

OSI – Office of Special Investigations

OTC – over the counter

POC – point of contact

PTSD – Posttraumatic Stress Disorder

RR – rate ratio

SESS – Suicide Event Surveillance System

SPARRC – Suicide Prevention and Risk 

Reduction Committee

SPPM – Suicide Prevention Program Manager

SRMSO – Suicide Risk Management & 

Surveillance Office

T2 – National Center for Telehealth &

Technology

TDY – temporary duty

USMC – United States Marine Corps
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In a continuing effort to provide an annual DoDSER that is useful to the DoD community it serves, we 

solicit your feedback on the information we’ve provided and your suggestions for ways we could make it 

more useful.

Please return your completed survey by mail, fax, or email to:

National Center for Telehealth & Technology (T2)

OMAMC, BLDG 9933C West Hayes, Tacoma WA 98431

Fax: 253.968.4192

suicide.reporting@us.army.mil

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