Stardate 20031119.0124

(Captain's log): Earlier today I answered a letter and my reader seemed to appreciate the reply, so I thought I would post it, in hopes that others might find it interesting. Eric wrote:

This is a fairly tenuous link, I admit, but the sister (who is, apparantly, in Military Intelligence) of an e-friend of mine told her that there have been a whole slew of suicides amongst the soldiers currently in Iraq. I told her that something like that would be lept upon by the media like hungry wolves on a cow, to which she replied "not if it's listed as a 'friendly fire incident.' "

Of course, the only thing the media likes more than reporting US casualties in Iraq is casualties caused by our own people. I know I haven't been able to find much in the way of such coverage, and I HAVE looked. Have you heard anything, or expect any such information to come out?

I do know that suicides amongst troops in the field occur; I'm talking about large numbers of them here. Something like that couldn't easily be kept out of the press, I'd think.

I haven't seen any direct reports of deaths which were categorized as suicides, but there have been a couple of cases where soldiers were reported to have died from gunshots which did not have hostile origin, and the report was that "investigation was ongoing"; I don't recall seeing any followups in such cases, and I generally assumed that those were suicides. (Had they been homocide there would have been more coverage, and it didn't seem likely that they were accidental, because that would have been apparent and they'd have said so.)

What you have to understand is that statistically speaking there's going to be some of that in any case where a hundred thousand people are put in a stressful situation. (Or 170,000 people.) It's not really surprising that there have been suicides. There are suicides all the time. In the US, suicide is one of the leading causes of death. In 2000, the CDC says that 23,618 men and 5,732 women committed suicide; that makes it the 8th biggest cause of death for men overall.

Of the various breakdown categories for death statistics in that report, the one which is closest to the mode for the US Army is "White, male, 20-24", and in 2000 that group had a suicide rate of 22.8 per 100,000, making it the second leading cause of death, exceeded only by accidents. ("White, male, 25-34" had a suicide rate of 22.4; "Black, male, 20-24" was 19.2, and 25-34 was 16.2.)

However, the rate is actually higher than that, because a lot of people who decide to commit suicide also try to make their deaths look accidental. For instance, a pretty common means of suicide is for someone to deliberately crash their car at high speed, but such a death will be reported as a "fatal car accident". One of the reasons someone might want to make it look as if their death was mischance is that life insurance policies don't pay off on suicide but do pay off on deaths in car accidents. Another reason is shame; they don't want others to know they committed suicide.

Even soldiers in garrison in the US sometimes commit suicide. Actuarially speaking, there will be a certain reasonably steady rate of suicides in any group of people as large as the US Army; and the rate will rise in certain kinds of circumstances, such as being away from home for months, in a war zone, in a crummy hole somewhere, with lousy food and no recreation and dreadful weather and shitty facilities; the suicide rate always goes up in such situations.

It's unfortunate, but it's also pretty much unavoidable. There's a certain rate of depression in the population, and some of those in the military suffer from it, and depression kills if it's not detected and treated. The medical screening for recruits tries to reject those who might be at risk of depression, and conscientious officers will try to watch for it in their men, but all that does is to reduce the numbers; it isn't possible yet to unambiguously determine if any given person is at risk.

However, quantities like a whole slew of are rather indistinct, and will be interpreted differently by different people. We know the total non-combat death toll, and we know that a lot of those deaths were truly accidental. I would be surprised if there had been as many as a hundred suicides. Whether you think that's a whole slew of is up to you; but there are really only a small number of questions to ask:

1. Is it unexpectedly high? Frankly, no.

2. Should it be lower? Obviously we'd all like it to be zero, but it's not clear that it can be made a lot lower except by compromising the mission. (And we can't even reduce the suicide rate to zero for civilians here in the US.)

3. Is it a sufficiently serious problem to justify giving up? Absolutely not. It's one part of the price we're paying for the strategy we've chosen in this war, but it is small compared to the price we'd pay if we gave up. There was never any doubt that this strategy would cost us both treasure and blood, but the price in both treasure and blood would be much higher if we were not doing this.

Think of it this way: how many suicides are you willing to accept in order to prevent another attack like the one in September of 2001, let alone one which might be far worse?

By the way, two things which will reduce the suicide rate a lot are bars and brothels, but we can't encourage either of those in Iraq.

Another thing that helps is mail from home. It's perfectly fine if it's mundane and trite; it's a link back to normalcy for the soldiers. If you know someone who's serving there, write to them; write often; write regularly. Tell them what's happening in your life. Don't wait for something big to happen; keep writing. A letter from home is a lifeline, a promise that all the insanity around the soldier will eventually end, and a way of keeping hold of what "normal" life is like, because after a while it starts getting hard to remember. It also tells the soldier that someone cares, that he isn't just a piece of a machine, but still a person that someone misses. And when that mail stops coming, that lifeline breaks and hangs limp, leaving that soldier adrift, abandoned. So keep writing.

Even if he doesn't write back. He's busy, you know; there's a war to fight. email is good, but paper mail is better; soldiers carry their letters from home with them, and reread them when the situation is getting them down.

Don't write to him about what he's doing; he knows what he's doing. Write to him about the stuff he wishes he could do but can't: write about movies you've gone to see, and how your favorite football team should draw and quarter its quarterback but still managed to pull it out and win the big game, and about trips to the store, and what you bought, and about people you've talked to, and why the new television season is the worst ever. Think "Lileks writing about Gnat" and write about that kind of stuff. Write about all the things that you take for granted that a soldier in a combat zone can't do. He can read your letter, and vicariously do them through you. As he's reading, he's home again, if only for a few minutes. And he will read it, more than once.

There's never enough mail from home.

Update 20031119: The Blaster says that as of mid-October, the official number of suicides was 14, an effective annual rate of 17 per 100,000. That's less than the CDC's statistic for white men aged 20-24, 22.4 per 100,000.

Update: Several people have written to point out that most life insurance policies only exclude payment for suicide during the first two years. The reason is to prevent someone who had decided to commit suicide from taking out a big policy and then killing themselves. Of course, during that two year window a suicide disguised as an accidental death still causes the policy to pay off.

It wasn't something I wanted to delve into in detail because it was unimportant to the overall point of this post. Sometimes I deliberately gloss over such details when they're not necessary for the point I'm trying to make. In this case it is an empirical fact that there's a significant rate of suicide among Americans; and it's also widely recognized that the official rate is too low and that some "accidental deaths" are actually suicides.

Speculation about why someone might try to disguise their suicide wasn't really important to this article. It could have been omitted entirely without damaging the primary argument I made, and in such cases I do not attempt to write rigorously and often deliberately leave out intricate and unimportant detail.

When I posted my response, I also left out a paragraph from my letter where I talked about "suicide by cop", a fascinating subject which only distracted from the primary argument I was making.

Update: In comments to this post, veterans who served overseas describe just how important it was to them to receive mail from home.

Update 20031120: Porphyrogenitus comments.