November 26, 1999
Suicide — Continued FIGURE 2. Suicide rates,* by branch of military service — United States, 1990–1999
*Per 100,000 members of each service.
1999 data are annualized rates based on suicides through June 1999.
the leaders involved were easily identified and had substantial influence over the com- munity. A program of education and awareness training for all personnel, combined with integrated prevention services in every community, set out to modify the culture of the USAF community. Initiatives are ongoing, established by official policy requir- ing annual reporting of performance objectives.
Evaluation of the program’s effectiveness and its generalizability to other groups is subject to at least two limitations. First, although the decline in the suicide rate among USAF personnel corresponds temporally with the interventions, a causal relation be- tween the decline and the program has not been established conclusively nor have components that might have been responsible for the decline been identified. Second, differences exist in the characteristics of active USAF personnel and the U.S. civilian population. All members of the USAF community have completed secondary school, are employed and housed, and have comprehensive health-care benefits, including unlimited mental health care. Since 1974, members have been screened for mental illness before entry. Use of illicit drugs, a risk factor for suicide, is approximately 90% less frequent than in the civilian population after adjusting for age and sex (6 ). All members have a commander or a first sergeant whose job is to be interested in each member’s health and well being.
This study highlights that suicide is a preventable health problem and demon- strates the importance of using multiple agencies to address the issue. It also indi- cates that a communitywide, multiple-strategy program can be planned and implemented and can contribute to reducing self-directed violence. The USAF has