Lessons Learned from Psychological Autopsies in Armed Forces

BACKGROUND: Suicide in armed forces is a matter of concern despite adequate prophylactic measures that have been adopted to reduce it. Military psychiatrists routinely conduct psychological autopsies. It may reveal various biopsychosocial factors leading to suicide and may be helpful in suicide prevention too. A few studies have been done in Indian Armed Forces but all of them involve cases of attempted suicide. Our study is different as it uses the methodology of psychological autopsy to find out various psychosocial factors of suicide in armed forces. METHODS: The present study was carried out in a large service hospital and included all suicide cases occurring in a particular strategic location from February 2014 to July 2017. A total of 16 suicide cases were investigated, and information was collected through visiting the scene, detailed semistructured interviews, the perusal of mobile call records, social website activities, notes in a social diary, bank statements, service record, and health records. RESULTS: The majority (nine of sixteen) of suicide victims were less than 30 years of age. The most common method of suicide (ten of sixteen) was use of firearms. Family history of mental illness/suicide was seen in three of them. Three had a past history of mental illness. Two were abusing substance in the recent past. Behavioral change was noticed in three, and suicide notes were available in three cases. Five had expressed their intent to die. CONCLUSIONS: Strain of serving in frontiers is not a common stressor associated with suicide as commonly perceived.