Authors
Benjamin T Paul, Catherine G Greeno, Jonathan B Singer
Published in
Military medicine. Volume 191. Issue Supplement_1. Pages 613-620. Aug 01, 2026.
Abstract
A historical comparison by Smith et al (2023) found that current U.S. Army soldiers are at greater risk for suicide compared to civilians. U.S. Army Behavioral Health Officers (BHOs) and Commanders (CDRs) are closely involved in the care of soldiers with suicide-related incidents; however, little is known about their observations of predictors of suicidality, or their views of barriers and facilitators to care for suicidal soldiers. Well-established theoretical frameworks (Interpersonal Theory of Suicide, Psychache, and Military Transition Theory), have been shown to better predict suicidality over psychiatric diagnoses. This study sought to examine BHOs' and CDRs' views on the observance and rating the importance of these theories, nominating a soldier with reported suicide-related incident. Additionally, these officers were asked to identify barriers and facilitators to delivering care.
Current and former BHOs and CDRs were emailed surveys using convenience and snowball sampling. Participants identified soldiers with suicide-related incidents, rated the importance of theory constructs in predicting or explaining incidents, and potential barriers and facilitators to care were assessed. Descriptives, chi-square tests, and independent sample t-tests were performed with Stata/SE 17.0.
Fifty BHOs and 48 CDRs participated. Officers endorsed the importance of theory constructs predicting suicidality but described having limited information to assess them. BHOs tended to endorse the importance of interpersonal theory of suicide perceived burdensomeness and psychache more highly than CDRs, likely related to their clinical experience. Barriers to care: Stigma specific to receiving BH care was the most important barrier identified. Soldiers' fear of negative career impacts and long waiting lists for BH were also barriers. Facilitators to care: Engaged peers, leadership, and family support were leading facilitators.
The objective of this study use the recollection of officers to assess their knowledge and utilization of theories. Army officers responsible for implementing suicide prevention strategies and postvention efforts believed that theory constructs were observed at the time of incidents. Utilization of these theories could enhance suicide prevention and intervention efforts, future training and policy.
PMID:
42560278
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.
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