“To do suicide prevention well, we have to do more than just stop people from dying–we also have to make life worth living.”
–Dr. Craig Bryan, Rethinking Suicide
Today’s Marines and sailors face a daunting battle. Death by suicide in the U.S. armed forces has seen a steady increased since 2011, making it the second-leading cause of death among all military service members. Suicide has been designated a national security crisis and service members identified as a high-risk group, yet suicide rates have not significantly declined despite increased awareness and investments by the Department of Defense (DoD). However, there is a path forward. One proposed strategy is to aim prevention efforts at the community level and encourage service members’ pursuit of purpose and meaning through supportive leadership and unit cohesion.
By its nature, suicide is difficult to address. Tackling one cause often unveils another, unexpected problem. This is especially important to understand when examining major contributors of stress for service member—including legal problems, victimization, financial trouble, interpersonal issues, and separation/divorce—all of which have been associated with suicide attempts. Unfortunately, mental illness and individual-level treatment remain the focus of suicide prevention efforts, even though research shows that nearly half of service members who die by suicide have no history of mental illness, and the root cause of suicide goes beyond mental health.1
Lives Worth Living
So, how does one better understand why some Marines do not die by suicide despite facing adversity? First, consider a person’s belief about what makes a life is worth living. Philosopher Dr. Frank Martela and psychologist Dr. Michael F. Steger concluded:
In order to live in the world as reﬂective beings, humans seem to need three things: they need to comprehend the world around them, they need to ﬁnd direction for their actions, and they need to ﬁnd worth in their lives.
Lives worth living can be shaped by two main ideas: coherence, or clarity and the ability to make sense in one’s life, and purpose, or having core goals and direction. Helping Marines and sailors understanding that they have direction, meaning, and purpose in both their lives and their roles in the military should be a critical element of suicide prevention efforts.
Although joining the armed forces can instill a sense of purpose and meaning, there are likely still some Marines who have questions or challenges in these areas. A strong sense of purpose is associated with a reduction in suicidal ideation. Viktor E. Frankl, an Austrian psychiatrist and concentration camp survivor, found that those with a “will of meaning” (Der Wille zum Sinn) were more likely to survive in the camps.2
A recent study of hospital patients admitted for suicidal ideations and suicide attempts found that family, social support, and interpersonal connectedness are elements strongly connected to meaning in life and can be leveraged to protect against suicidal behaviors. Dr. Craig Bryan, a former Air Force psychologist and suicidology researcher, suggested treatments that foster a sense of meaning and self-compassion could give service members a buffer against the emergence of suicidal thoughts and behaviors and supports an improved overall sense of resiliency, health, and well-being. Furthermore, happiness and meaning can encourage a sense of coherence and positive coping mechanisms, leading to better mental health outcomes.
Military leaders are uniquely positioned to promote the health and well-being among service members and enhance unit cohesion. After all, creating lives worth living is not an individual feat, but rather an organization working together with collective responsibility. Service members who feel valued and important help build strong social networks and a sense of belonging among their comrades, which can increase resilience and reduce suicide risk and ideation. Furthermore, high levels of unit cohesion play a role in military performance, combat readiness, and resilience against PTSD and depression.
Time spent discussing the purpose of military service with subordinates can increase their sense of belonging and is associated with less severe suicidal ideation. Notably, the DoD Suicide Prevention Response Independent Review Committee (SPRIRC) found that supportive and transformational leadership were top factors in suicide prevention; when such leadership was absent, service members felt vulnerable and prone to low morale and self-worth, which are associated with a higher suicide risk. In other words, leaders who highlight purpose and foster a cohesive unit are critical to reducing suicidal behaviors.
Opportunities for Change
The SPRIRC found that preventing suicide is difficult in the military “in part because many of its own systems, rules, and cultural norms get in the way of well-intentioned efforts that inadvertently create stress in the daily lives of service members and family.” These findings, along with support from suicidology experts, signal the urgent need to recalculate current methods. Marine Corps leaders have daily opportunities to influence their subordinates by engaging with each service member in their units. They can support, connect, inspire, and reinforce meaning and purpose in the lives of their subordinates. If these approaches are paired with the Marine Corps’ current efforts to encourage help-seeking behaviors, it could have a profound effect on reducing the risk of suicide among service members.
The DoD-funded Airman’s Edge peer-to-peer suicide prevention program could offer a model for future efforts. The program is designed to move Air Force culture toward improved health and well-being and could potentially be adapted by the Marine Corps. This program focuses on upstream crisis prevention of suicidal events, reducing the need for specialized individual-level treatment (for which resources can be scarce), and lessening the stigma against seeking care. By intentionally building purpose, making meaning, cultivating unit cohesion, and improving morale, this program aims to eliminate conditions that can hinder one from enjoying a high quality of life.
Marines and sailors have been facing a crisis of purpose and meaning for years. Luckily, we have the necessary tools and understanding to support them in developing a sense of purpose, meaning, and connections with their leaders. Suicide prevention teams are needed to serve Marines and sailors—we cannot fail them.
1. Craig J. Bryan, Rethinking Suicide: Why Prevention Fails, and How We Can Do Better (Oxford University Press, 2021).
2. Viktor Frankl, A Man’s Search for Meaning: From Death-Camp to Existentialism, An Introduction to Logotherapy (Boston, MA: Beacon Press, 1946).