Suicide Now the Primary Cause of Death among Active Duty US Soldiers
Army veteran and BU PTSD expert James Whitworth on what’s behind the troubling numbers

Suicide is now the leading cause of death among US soldiers, according to a new report by the Defense Health Agency. Photo via iStock/JOHNGOMEZPIX
Suicide Now the Primary Cause of Death among Active Duty US Soldiers
Army veteran and BU PTSD expert James Whitworth on what’s behind the troubling numbers
A recent study released by the Pentagon revealed a sobering statistic: US soldiers are now more likely to die from suicide than any other cause. The report, which examined the deaths of 2,530 active duty Army soldiers between 2014 and 2019, showed that soldiers are nearly nine times more likely to die by suicide than they are in combat.
The numbers reflect an increased rate of suicide in general across the United States. In 2022, the provisional estimate for suicide deaths in the US was 49,449, according to the Centers for Disease Control and Prevention—an increase of 2.6 percent from the year before, and an increase of more than 37 percent since 2000. In all cases, firearms were the leading cause of death.
The Brink spoke with James Whitworth, an assistant professor of psychiatry at BU’s Chobanian & Avedisian School of Medicine and a US Army veteran, about the Pentagon data and what more needs to be done to address the crisis. Whitworth served with the 172nd Stryker Brigade Combat Team from 2003 to 2006 as an infantryman, designated marksman, and fire team leader, including two years in Iraq. During that time, he regularly exercised to cope with the stress of combat.

After being honorably discharged, he began to explore the human-performance side of exercise in his graduate and doctoral research. The death by suicide of a close friend who had served with him in Iraq led Whitworth to refocus his research on how modifiable lifestyle behaviors like exercise can be used to reduce, treat, and prevent the disability associated with post-traumatic stress disorder (PTSD) and other mental health disorders. Today, he is an exercise physiologist with specialized training in PTSD, working extensively with veterans.
Q&A
with James Whitworth
The Brink: The numbers cited in the Pentagon study mirror the increase in suicide rates among all sectors of society in the US, but are there unique challenges that put military personnel at greater risk of taking their own life?
Whitworth: There has been a precipitous rise in the rate of suicide nationwide across most demographics. Since the early 2000s, this has included US military veterans and soldiers and Marines and aviators—it’s a specific demographic. When we see big rises in these trends across the country, we’re probably going to see it in our service members as well. That said, there are unique challenges and stressors that our service members and their families face on a day-to-day basis: notably, deployments, training cycles. There’s a lot of hardship, and the culture of the military is quite a bit different than the culture of nonmilitary life.
The Brink: The study analyzed deaths of Army soldiers from 2014 to 2019, a period that predates a number of initiatives the Department of Defense has launched to improve access to mental health and counseling. Is there any indication those efforts are having an impact on reducing the risk of suicide among active duty soldiers?
Whitworth: We know that safe storage of firearms and firearm prevention education are important tools for preventing suicide. Safely storing firearms—separating the ammunition from the firearm, locking it up, and not leaving firearms around the house where they’re easily accessible—slows down the time someone has to get access to the firearm. That’s additional time for someone else to intervene or for the soldier to ask themselves whether or not this is something they want to go through with. Time is important when someone is in acute crisis. Often, it doesn’t take a whole lot of time to intervene. I’ve been a first responder to an acutely suicidal veteran and it took just a matter of minutes to talk them off the ledge. When I speak to other veterans and people that I work with in my programs of research, I ask them, “Do you have a license to carry? Do you have a means to store your firearms safely? Do you have gun locks?” They need gun locks. And if they don’t have them, I’m happy to provide them for them.
So, I’m very supportive of these efforts that the military and other institutions are doing, but clearly, there’s more to be done. This is still a national crisis, both for military folks, veterans, and nonmilitary populations. While some of these programs are effective, implementation is important. How do we roll these programs out? What are the best strategies? Are they rolled out so that they’re equally effective across different branches of the military and across the country?
The Brink: What more needs to be done?
Whitworth: We need to continue reducing stigma. Big institutions like the military are slow to change. When I was serving, we didn’t talk about mental health. We, as service members, were fearful of reprisal if we came out and said we had an issue. I know for a fact that the culture of the military has changed, that there are active initiatives to encourage people to seek help, but it may take time for those to set in and service members may not always know where to turn. So, continuing to work to destigmatize PTSD, depression, suicide ideation, and other mental health issues is important. I want veterans to know that these things are not a sign of weakness. PTSD can happen to anybody. Depression can happen to anybody. Trauma can happen to anybody.
Just like PTSD and depression, suicide ideation is treatable. We have evidence-based treatments out there—everything from psychotherapy to medications—and not all of them work the same way. For someone who has tried one of these, if it worked, great; if it didn’t work, they should try another one, because there are a variety of different options. And talking to a mental health provider is a really good starting point to figure out what could work for someone. If someone feels down or desperate, there are lots of options. They aren’t alone. Tell someone you know what you’re feeling, talk to a friend or family member, talk to a colleague, a healthcare provider. There are resources out there, like the Veterans Crisis Line or the Suicide & Crisis Lifeline. If you’re a veteran, call 988 and push 1. You can talk to a trained specialist. And it works. These people save lives.
If there are veterans or active service members reading this, check on your buddies, ask them how they’re doing. If you think someone is in crisis and acutely suicidal, asking them about it, asking them how they’re feeling, is not going to push them over the edge. Most people who are acutely suicidal want to talk about it. It’s a misconception that asking someone if they’re thinking about harming themselves is going to push them over. If anything, they say “yes,” and you can then ask them: “Well, can I take you to an emergency room? Can I call someone? Can I call your doctor or can we call the Veterans Crisis Line and speak with someone about this? How can I help?” Be concerned. Care. Just talk to your buddies.
The Brink: Are you optimistic that 5 or 10 years from now when we’re talking about suicide rates among active duty service members we’re going to see a significant improvement?
Whitworth: I am optimistic. As I said earlier, when I first started serving, many years ago, we didn’t talk about PTSD. We didn’t talk about depression. Those were taboo subjects. They’d get you kicked out if you raised them. Now, if you’re a soldier with PTSD or a substance use problem, you say, “Hey, first sergeant, I need to talk to somebody about something I’m struggling with. Can you help me get help?” That person then goes to rehab or gets help, and once they’re better, they come back to the line and continue serving. So it’s moving. It’s moving slowly, but it’s moving in the right direction. There are some great minds who are putting blood, sweat, and tears into this stuff.
The Brink: Can you talk briefly about what you’ve seen in your own research, working with veterans with PTSD?
Whitworth: PTSD, suicidal thoughts, mental health problems are often isolating. These disorders themselves make it difficult to engage in society. People may be fearful of going out of their home, it may be difficult for them to engage at work or at school or carry on the activities of daily living as a result of their disorders. What I’ve seen is that reaching out, connecting with other folks, talking to folks, getting involved—and that could be something as simple as getting active, joining a gym, moving your body, going for walks—can start to move the needle in the right direction, start alleviating some of those depression symptoms, even start to improve sleep quality, and possibly even reduce PTSD symptoms. Health-building activities improve not only your physical health, but [also] your mental health, and that can be a foot in the door: once you’re starting to feel a little better, maybe then there’s an opportunity to go in and talk to someone about these issues.
This interview has been edited for length and clarity.
Those seeking confidential mental health counseling can call, text, or chat with the 988 Suicide & Crisis Lifeline or go to 988lifeline.org for 24/7 access to free and confidential services. Members of the BU community can also contact Student Health Services Behavioral Medicine, the Center for Psychiatric Rehabilitation, the Center for Anxiety & Related Disorders, the Samaritans of Boston suicide hotline, and BU’s Faculty & Staff Assistance Office.
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