Message from the Chair: Addressing the High Suicide Rate in Troops

New figures released by the Pentagon show that one American soldier on active-duty commits suicide each day

For years, the statistics have shocked us: every day, 18 veterans commit suicide. And now, new figures released by the Pentagon show that the problem is surging among active-duty troops with one American soldier committing suicide each day.

The Department of Psychiatry and the James J. Peters Veterans Affairs (JJPVA) Medical Center at Mount Sinai School of Medicine are committed to addressing this pressing problem in servicemen and women. The Clinical Care Center at the JJPVA provides state-of-the-art primary, tertiary, and long-term care for soldiers and veterans in areas such as psychiatry, physical medicine and rehabilitation, and surgery. Directed by Rachel Yehuda, PhD, Professor of Psychiatry and Neuroscience, the Center treats more than 7,000 patients each year. Since 2007, the U.S. Department of Veterans Affairs, which includes the JJPVA, has adopted a series of national suicide prevention measures for soldiers and veterans including maintenance of a high-risk suicide list and the hiring of suicide prevention coordinators.

Building on the JJPVA’s extraordinary clinical services, many of our investigators are also conducting research in suicide prevention. Marianne Goodman, MD, Associate Clinical Professor of Psychiatry, developed the suicide research program at the JJPVA. She oversees clinical trials, supported by the U.S. Department of Defense, which are testing the efficacy of new treatments designed specifically to prevent suicidal behavior. Physician-scientists in the clinical program are also exploring how environmental and genetic factors contribute to the development of post-traumatic stress disorder (PTSD) and suicidal tendencies in soldiers.

Dr. Yehuda and Leo Sher, MD, Director of Inpatient Psychiatry at the JJPVA and Associate Professor of Psychiatry, are studying hormones and other biological features in veteran suicide attempters. Their goal is to develop a diagnostic test that would be used as a prevention tool to detect soldiers at risk for suicide, and distinguish between those who attempt and complete suicide. Currently, Dr. Yehuda is working with Janine Flory, PhD, Associate Professor of Psychiatry, and Julia Golier, MD, Associate Professor of Psychiatry and Director of Mental Health at the JJPVA, to conduct a genome-wide analysis of patients who have made suicide attempts and compare their genes with those who have not.

Dr. Sher is also a principal investigator in a multicenter trial called project SAFE VET — an initiative designed to diminish suicidality in veterans by implementing a clinical safety intervention plan in emergency departments and mental health clinics. The JJPVA is currently a participating control site in the study.

Our researchers are also testing new psychotherapeutic treatments that may help prevent suicide. Dr. Goodman who directs the award-winning JJPVA Clinical Dialectical Behavioral Therapy (DBT) Program and Antonia S. New, MD, Associate Professor of Psychiatry, are investigating the efficacy of DBT in veterans at high-risk for suicide. DBT is a form of psychotherapy that has been shown to reduce suicidal behavior in borderline personality disorder (BPD), but it has not yet been studied in veterans without BPD. Recently, Drs. Goodman and New set up the first randomized clinical trial in veterans, which is being funded by the U.S. Department of Defense.

Drs. Goodman and New, along with David Banthin, PhD, Mental Illness Research, Education & Clinical Center Fellow at the JJPVA, are also involved in developing new forms of psychotherapy that may be used more broadly throughout the VA health system to help suicidal veterans. In addition, Drs. Goodman and New are also exploring several factors such as exposure to combat, difficulties with social relationships, and other underlying vulnerabilities that might make soldiers more susceptible to emotional difficulties when they return from service.

Dr. Goodman is also working with Erin Hazlett, PhD, Professor of Psychiatry, on a project funded by the Department of Defense examining affective startle modulation during emotional and neutral pictures in veterans at high and low risk for suicide. Preliminary findings indicate this psychophysiological measure is a promising biomarker of suicidal behavior and response to DBT treatment response. Suicide rates have continued to climb this summer despite the military’s efforts to hire hundreds of additional psychiatrists and implement additional screenings of personnel. For over two decades, clinicians at the JJPVA have provided quality patient care and our researchers have conducted groundbreaking studies that have led to a better understanding of PTSD, mental illness, and suicidal behavior. With unparalleled medical resources and dedicated clinicians, we are learning to better identify who is at risk for suicide, and ultimately, develop better therapies to treat mental illness in this highly susceptible population.

Wayne K. Goodman, MD
Chair of the Department of Psychiatry
Esther and Joseph Klingenstein Professor of Psychiatry
The Mount Sinai Medical Center

http://www.bronx.va.gov/

We Can Help

The Veterans Crisis Line is a confidential service staffed by qualified, caring responders. Veterans in crisis and their family and friends can call 1-800-273-8255 and press 1, text 838255, or chat online at: www.veteranscrisisline.net.