A new taxonomy for understanding factors leading to suicide in the military.

In the years since 2005, suicides among U.S. military personnel have risen dramatically, and continue to rise despite significant leadership attention to suicide awareness and prevention. Prevention efforts have proven unsuccessful, perhaps because they have focused on associated factors, rather than the underlying more fundamental contributing ones. Current suicide prevention and education programs in the military address the symptoms, while ignoring the underlying problem. This paper presents a new taxonomy for organizing and thinking about the multitude of factors associated with suicide in the military. We distinguish four sets of factors associated with suicide: (1) Formative factors are the long-term, fundamental causative factors in suicide, contributing to alienation and powerlessness; (2) Background factors are associated with suicide, but are not clearly causative, as for example age and sex; (3) Precipitating factors are the near-term causative factors, acute stressful events that can plunge the individual into sudden despair, such as a broken marriage; (4) Enabling factors are those that facilitate the act of suicide, but are not underlying causes. This includes for example alcohol and drugs, and easy access to weapons. To succeed, efforts to prevent suicide in the military should be directed to the formative factors. A model is presented in which military-specific formative factors are shown to contribute to alienation and powerlessness, key factors that can lead to suicide. Drawing from the hardiness model of resilience, some recommendations are provided for building up the sense of commitment (vs. alienation) and control (vs. powerlessness) in military personnel as a strategy for reducing suicide.