Timothy Lineberry

ROCHESTER, Minn. — As the nation marks Veteran's Day to honor those who have served their country, it's important to remember that many soldiers battle mental health conditions such as anxiety, post-traumatic stress disorder and depression long after they return from combat. In fact, in recent years the lasting effects of military combat have become quite dire. Suicide rates in the U.S. Army now exceed the rate in the general population, and psychiatric admission is now the most common reason for hospitalization in the Army. These are concerning trends says Timothy Lineberry, M.D., a Mayo Clinic psychiatrist, an Air Force veteran and a suicide prevention expert for the Army.

MULTIMEDIA ALERT: For audio and video of Dr. Lineberry talking about military suicide, visit the Mayo Clinic News Network.

"Even though large-scale military operations in Afghanistan and Iraq are ending, the effects on the mental health of active-duty service members, reservists, and veterans are just beginning to be felt," Dr. Lineberry says. "Moreover, the potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses." By some estimates, 1 in 5 veterans returning from Iraq and Afghanistan experience symptoms of PTSD or major depression. Many do not seek treatment because they fear it will harm their careers, Dr. Lineberry says. Untreated, PTSD and depression can lead to drug use, marital problems, unemployment and even suicide. For veterans and their families and friends, Dr. Lineberry says it's best to see a medical professional if these warning signs begin to occur:

• Sleep disturbances. Complaints of insomnia or other sleep problems in otherwise healthy soldiers, reservists, or veterans may signal the need for mental health screening.
• Disturbing thoughts and feelings for more than a month. Usually these thoughts will be severe, and the person will be having trouble keeping his or her life under control.
• Self-medication. Turning to alcohol or drugs to numb feelings isn't healthy, even though it may be a tempting way for a veteran to cope. It can lead to more problems and prevent healing.
• Flashbacks, or reliving a traumatic event for minutes or even days at a time. Upsetting dreams about the traumatic event and avoiding thinking or talking about the event are also warning signs of PTSD.

ROCHESTER, Minn. — September 10, 2012.  The suicide rate in the U.S. Army now exceeds the rate in the general population, and psychiatric admission is now the most common reason for hospitalization in the Army. These concerning trends are described by Timothy Lineberry, M.D., a Mayo Clinic psychiatrist and suicide expert for the Army, in the September edition of Mayo Clinic Proceedings. In the article, he also outlines steps to assess and address military suicide — an issue he calls a major public health concern. Dr. Lineberry proposes greater use of gun locks, improving primary care for depression, and better monitoring for sleep disturbances, among other steps.

MULTIMEDIA ALERT: Video of Dr. Lineberry is available on the Mayo Clinic News Network.

"Despite the anticipated end of large-scale military operations in Afghanistan and Iraq, the effects on the mental health of active-duty service members, reservists, and veterans is only just beginning to be felt," Dr. Lineberry says. "Moreover, the potential effect on service members of their war experiences may manifest indefinitely into the future in the form of emerging psychiatric illnesses." In the article, Dr. Lineberry integrates published research on increased rates of psychiatric illness in the military during the past decade and highlights the need for ongoing resources for prevention, diagnosis and treatment. While the National Institutes of Health and the Department of Defense have already invested millions of dollars into military suicide prevention and research, some key clinical steps can also be taken to tackle the problem. Dr. Lineberry outlines four steps based on past research and emerging evidence that he believes could help begin curbing military suicide:

• Reduce access to guns and other means of suicide. Nearly 70 percent of veterans who commit suicide use a gun to do it. Veterans are more likely to own firearms. All veterans with psychiatric illness should be asked about their access to firearms and encouraged to lock up guns, giving someone else the key, or remove them from the home altogether. Just slowing down gun access by a few minutes may be enough to stop the impulse.
• Watch for sleep disturbances. Complaints of insomnia or other sleep disturbances in otherwise healthy soldiers, reservists, or veterans may signal the need for taking a careful history and screening for depression, substance misuse and post-traumatic stress disorder. Sleep disturbances have been previously identified as a risk factor for suicide. These complaints may also serve as opportunities for referring those potentially needing more intensive treatment.
• Prescribe opioid medications carefully and monitor. Unintentional overdose deaths, primarily with opioids, now outnumber traffic fatalities in many states. Individuals with psychiatric illness are overrepresented among those receiving prescriptions for opioids and those taking overdoses. This same trend has been seen in former military personnel. A recent study found that Iraq and Afghanistan veterans with a diagnosis of post-traumatic stress disorder who were prescribed opioids were significantly more likely to have opioid-related accidents and overdoses, alcohol and non-opioid drug-related accidents and overdoses, and self-inflicted and violence-related injuries.
• Improve primary care treatment for depression. Research suggests that patients who die by suicide are more likely to have visited a primary care physician than mental health specialist in the previous month. Programs developed to improve primary care physicians' recognition and treatment of depression could help lower suicide rates.

ROCHESTER, Minn. — May 4, 2012.  A suicide study will be among the research presented by Mayo Clinic psychiatry and psychology experts at the [...]

ROCHESTER, Minn. — Physicians, researchers, psychologists, social workers and educators are gathering April 18-21 at the American Association of Suicidology Conference in Baltimore to discuss and present the latest in suicide prevention and research on topics such as post-traumatic stress disorder, college and youth mental health and bullying. "This meeting is a gathering of some of the great minds in the fields of suicide prevention, clinical practice, postvention and research," says Timothy Lineberry, M.D., Board Chair, American Association of Suicidology and a Mayo Clinic psychiatrist who specializes in suicide prevention. "Suicide is a significant public health problem in the United States and there are treatments and interventions that can make a difference." Every 15 minutes, someone dies by suicide in the United States, according to the Centers for Disease Control and Prevention. For every person who dies, many more think about, plan or attempt suicide. In 2008, a total of 36,035 people died as a result of suicide, and about 666,000 visited hospital emergency departments for nonfatal, self-inflicted injuries, the CDC found in a recent nationwide study. The conference will include presenters from national organizations such as the United States Department of Defense, Veterans Affairs Medical Centers, the Substance Abuse and Mental Health Services Administration and the National Institutes of Health. New research and presentations also will stem from a gamut of medical institutions including Johns Hopkins University, the University of Washington and Mayo Clinic. U.S. Surgeon General Regina Benjamin, M.D., also is slated to attend and give a presentation on suicide prevention Thursday, April 19. New research of note (for a complete conference agenda with all new research posters and presentations, or to request a copy of a study, Email Amy Kulp at ajkulp@suicidology.org):

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