ARLINGTON, Va. - The suicide rate for active-duty U.S. military members declined 15% in 2021, with the National Guard rate essentially unchanged as new suicide prevention initiatives roll out across the 54 states, territories and the District of Columbia.

The Department of Defense Annual Report on Suicide in the Military showed there were 117 National Guard deaths by suicide in 2021 compared to 121 in 2020 — 102 among the Army National Guard and 15 in the Air National Guard. Both figures remain relatively unchanged from 2020, with 105 and 16 suicides, respectively.

The statistics show the National Guard Bureau is taking a comprehensive and integrative approach to tackling the problem, said Army Maj. Gen. Eric Little. 

“We are committed to reducing the number of suicides out there,” said Little, director of manpower and personnel at the bureau. “Because one is too many.” 

Little said NGB’s top initiative this year to reduce suicides involves creating an integrated primary prevention workforce – people in psychology, sociology and social work with expertise in preventing harmful behavior like suicide and sexual assault.

According to the Pentagon report released Oct. 27, the Army is rolling out the Integrated Prevention Advisory Group to help commanders address harmful behavior at every level. 

The Army Guard will add 325 personnel as part of the implementation plan.

“They’re there to provide the analytics of what’s going on in their particular state,” said Little. “They’re there to establish prevention programs. They’re there to advise the command of problem areas, per se, that they can provide resources to.”

Little said suicide is a complex issue that is not fully understood, as fluctuations in data make it difficult to identify root causes and effective preventive measures. 

But behavioral research has linked military suicides to various personal issues, including financial and marital stress. 

The Defense Department report showed the most common interpersonal stressor identified in suicide and suicide attempts was intimate relationship problems. Little said that continues to be one of the leading risk factors for the Guard, along with work stress, substance abuse and sexual abuse.

Firearms continue to be the primary method of suicide for service members, their spouses and dependents. Suicide attempts with guns are overwhelmingly more likely to result in death than other methods. At 72%, firearm use was the most common mechanism of injury cited in Guard reports.  

“We know that if we can increase the time in space before someone pulling the trigger, for example, by putting a lock on a weapon to give them 5 to 6 seconds of pause before taking action, research has shown that we might be able to prevent a suicide,” said Little. 

Service members at risk for suicide frequently practice unsafe firearm storage, and the report said people with ready access to a firearm are at increased risk of dying by suicide. In addition, putting time and space between a person in crisis and their access to lethal means, such as medications, firearms and sharp instruments, is an effective way to prevent suicide.

Given such evidence, promoting lethal means safety is a critical component of suicide prevention in the National Guard, Little said.

Another Guard initiative involves fostering a supportive environment and destigmatizing mental health care. 

“In the Army [if] you get hurt, you sprain an ankle, you go get help. We’re trying to make that something similar to if you have a mental health issue, it’s no big deal for you to go get help and for that to not impact your career,” said Little. 

Little said that counseling could affect service members’ security clearance or flying eligibility in some cases. But Guard officials are working to change those policies.

Little acknowledged that access to health care is a challenge for the National Guard, which serves in more than 2,200 communities across the United States and its territories. Some service members can encounter lengthy delays before seeing a provider.  

“Sometimes the wait is two, three months that we’re seeing out there,” he said. “Not helpful if you’re having a mental health crisis.” 

Unlike their active-duty counterparts, part-time Guard members aren’t entitled to health care based on military affiliation.

Army Gen. Daniel Hokanson, chief of the National Guard Bureau, is pushing to change that, making universal health care for the Guard one of his top priorities.

“Today, there are approximately 60,000 Guardsmen who don’t have health insurance – so they don’t get the health care they need when they aren’t in a duty status,” Hokanson said during an August speech. “Even our Guardsmen who have health care coverage through their civilian employer face challenges when they change duty status. This can cause stress and undue financial and medical hardships for our Soldiers and Airmen and their families. All of these things impact our readiness – and not in a good way.”

Hokanson called health care coverage a strategic and moral imperative for every person who serves in uniform. 

“Lost readiness costs more than the price of health care,” he said.

Veterans, service members, and their families can reach the National Suicide Prevention Hotline by dialing 988 and pressing “1” to be connected to the Veterans Crisis Line. Alternatively, they can text 838255 or visit VeteransCrisisLine.net for assistance.