Statistical Monitoring of Suicides in the U. S. Armed Forces

This study develops a methodology that assists military commanders and health professionals in making decisions on when and where to apply intervention techniques based on shifts in suicide rates. The software package that incorporates the methodology for statistical process control provides rapid detection of an out-of-control suicide rate situation. Furthermore, it minimizes the potential for unwarranted reaction to usual variation. The study models DoD suicides as a Poisson process to detect departures from usual variation using a self-starting control chart scheme. Methods are implemented in a Microsoft Excel spreadsheet with Visual Basic macros for ease of use. For the United States Army, persistent shifts in the process mean are detected in August 1985 (increase), September 1987 (decrease), April 1991 (increase), November 1997 (decrease), and September 2001 (decrease). The increase in April 1991 follows the commencement of Iraqi combat operations under Operation Desert Storm in January 1991. With regard to Operation Iraqi Freedom, which began in March 2003, this study does not reveal a change in the Army's suicide rate commensurate with more soldiers being deployed to an environment of combat stress. For the Navy, persistent shifts in the process mean are detected in December 1990 (decrease), January 1993 (increase), May 1994 (decrease), July 1995 (increase), and March 1996 (decrease). Apparently, no relationships to wartime environments or high operational tempos are evident in these shifts. For the Marine Corps, persistent shifts in the process mean are detected in January 1993 (increase) and March 1998 (decrease). For the Air Force, persistent shifts in the process mean are detected in January 1988 (increase), April 1990 (decrease), November 1994 (increase), November 1998 (decrease), and April 1999 (decrease). Once again, no relationships to wartime environments or high operational tempos are evident for these two service components. (25 figures, 13 ref7Naval Postgraduate School Monterey CA is the author of 'Statistical Monitoring of Suicides in the U. S. Armed Forces', published 2004 under ISBN 9781423520276 and ISBN 1423520270.