Saturday, October 20, 2012

Some preliminary conclusions on research into the "psychiatric epidemic" of suicide in the miltary 2000 - 2012

Some preliminary conclusions on research into the "psychiatric epidemic" of suicide in the military 2000 - 2012

The true picture, including the epidemiological one, in the area of suicides in the military and the true state of affairs in the military mental health field is not known to us yet. The deaths suspicious of suicide and the incidents of self-injurious behavior, as well as homicides and other relevant occurrences should be included into the statistics. The sophisticated data collection system needs to be established, socio - and psychometric instruments to be developed and used; theoretical models conceptualised and tested, etc. The riddle might not be solved to provide more or less satisfactory causal explanation for some time, if at all; in the end, all attempts at the explanation are just interpretational hypotheses, due to the specifics of the subject matter: suicide, and the mental health field. Regardless of all the possible hypothetical explanations (which do have to be developed and tested), the general sociotherapeutic sanation measures, including the changes in the military subculture, if needed, should be implemented and continuously improved and refined, with the aim of improving, making more healthy and humane and maximally consistent with the values and norms of larger, mainstream culture, the general emotional climate in military communities and units, and providing the range of various relevant services. This approach might be just as, if not more productive, than the specific "suicide prevention measures", which can continue to stay in place.

Military Psychiatry and Psychology Review

Military Psychiatry and Psychology Review

Suicidology Review: Durkheim, Typology of Suicides

Military Suicidology Review

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Topics Review:

Unit Cohesion

Individual and Groups

Military Groups

Structure and Function of Hierarchies
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Protective and destructive effects of groups | Typology of Suicides | Suicidal Behaviors as an Escape and Emotional and Social Protest

Protective and destructive effects of groups - GS

The sociological hypothesis of military suicides causation as a destructive effect of a military group (1): a conflict between an individual soldier and his group, his military unit; does not contradict the Durkheim hypothesis of protective effect of groups, as the authors try to prove, but confirms it as a more general paradigm. The authors of this interesting and valuable paper base their thinking on Durkheim's theory and try to disprove it in a particular case of suicides in the military "from within": by operating this theory's own postulates and general conceptual framework (a "paradigm"). This reminds a proverbial "fight with your own shadow". The whole Durkheim's typology of suicides and its value and utility, especially for clinical purposes, should be questioned. It is not used in practical clinical settings. It seems to me that the the simple division of suicides into psychotic and nonpsychotic might be introduced (whatever these terms mean). Suicides in the military are mostly nonpsychotic. They should be divided further, according to the relative preponderance of causative factors into:
- Situational:
caused mostly by external circumstances and as an escape from them.
- Emotional:
due to severe and continuous stresses of various kinds, when the capacity for psychological resilience is stretched to a limit, to a "breaking point". Suicide thus, paradoxically, saves the psyche's integrity, protects the"immortal soul" from its destruction by pain and demoralisation.
- As a form of a conscientious social (and/or political) protest
The latter two are interconnected and practically are the same, since they have both components.
The circumstances of various kinds are also almost always present. Therefore we can try to conceptualise various forms of suicidal behaviors as an Escape and as an Emotional and Social Protest.
Therapeutic intervention should be attempted in all three dimensions and geared specifically to them. For example, a soldier with suicidal thoughts, if they are in any way detected or suspected, might be helped with his/her bank loan, offered individual or family therapy for his/her personal and/or family problems and offered to attend an educational group if he/she does not agree with certain policies or attitudes; overtly or covertly, with the understanding that his/her disagreements or grievances will be heard and their input in resolution of the general issues like these will be appreciated.
The interventions should be attempted at earlier stages, when it did not come to suicidal thoughts yet, and should be of general, mass and routine nature. In other words this is an issue of general and preventive sanation of emotional climate in a military unit or community, including the attitudes, policies and relationships.
Due to centralised structure of military services, the TeleTherapy option with centrally managed referral, recordkeeping, sophisticated data collections and training and and research departments might be the most beneficial option.

References and Links


emory.academia.edu/.../Suicide_Social_Integration_and_Masculinity...Cached
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Notes

Individual and Groups

Military Groups

Structure and Function of Hierarchies

Durkheim

Typology of Suicides