Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 1997 to 2021

The Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 1997 to 2021 report is a statistical report that presents both counts and incidence rates of suicides for members of the ADF who have at least one day of service between 1 January 1985 and 31 December 2021, with the suicides monitored over the period 1 January 1997 to 31 December 2021. Information in the report is presented by age, sex, rank, length of service, time since separation and reason for separation.

The previous edition included members with at least one day of ADF service between 1 January 1985 and 31 December 2020 with a suicide monitoring period between 1 January 1997 and 31 December 2020. The previous report included a Cox proportional hazards model and analyses of psychosocial risk factors associated with suicide.

An additional 78 suicide deaths are reported here compared with the 2022 report. The breakdown of changes in the number of suicide deaths reported is as follows:

• 69 suicide deaths that occurred in 2021
• 9 additional suicide deaths identified in 2020 (and/or 2019) due to a lag in reporting cause of death
• 7 additional suicide deaths identified in 2007 (1), 2012 (2), 2013 (1), 2015 (3) due to updated information in the NDI or newly identified linkages
• 7 fewer deaths in 2011 (2), 2014 (2), 2016 (2), 2019 (1) due to updates in cause of death information

Despite these changes in suicide totals the rates of suicide amongst serving and ex-serving members of the ADF remain largely consistent between this report and ones previously published. Due to changes in monitoring period and study cohort care should be taken in comparing data in this report with previous AIHW publications. It is more useful to focus instead on suicide rates, as these give a better indication of the risk of suicide to different groups within the ADF population.

This report uses information from the Defence Personnel Management Key Solution (PMKeyS) which started on 1 January 2001 together with a range of Defence historical personnel systems used prior to 2001 to develop a list of all members who had served at least one day since 1 January 1985. This is then linked to the National Death Index. Deaths are reported from 1 January 1997 to 31 December 2021.

Suicide rates are not provided prior to 1997 due to data in the NDI being incomplete or otherwise unusable before this date, meaning the linkage between the Defence personnel data and the deaths data is liable to miss deaths. As such it was deemed unworkable to extend the death analysis earlier than 1997 for population analysis study purposes.

Due to limitations in historical Department of Defence personnel records, the study population does not include ADF members with service prior to 1 January 1985.

The assembling and national reporting of deaths by suicide has up to a two-year time lag. Deaths that are referred to a coroner (including deaths by suicide) can take time to be fully investigated by the relevant State or Territory jurisdiction. To account for this, all coroner-certified deaths registered after 1 January 2006 are subject to a revisions process. This allows cause of death for open coroner’s cases to be included at a later stage where the case is closed during the revision period. Cause of death data compiled by the ABS are deemed preliminary when first published, with revised and final versions of the data being historically published 12 and 24 months after initial processing.

A person who is serving or has served at least one day in the ADF since 1 January 1985.

Overall, males serving in a permanent capacity and males in the reserves are about half as likely to die by suicide as Australian males.

Ex-serving ADF members are at a higher risk of suicide than Australian males though this group is not homogeneous, with likely other factors contributing to differing rates of suicide for subpopulations.

Notably, ex-serving males who separate for voluntary reasons are no more likely to die by suicide than the general Australian male population. Those ex-serving males who separate involuntarily are more likely to die by suicide than the Australian population.

Compared with the Australian population, suicide rates (after adjusting for age) between 1997 and 2021 were: 49% lower for male permanent ADF members; 45% lower for reserve ADF males; 26% higher for ex-serving ADF males; and 107% (or 2.07 times) higher for ex-serving ADF females.

To understand whether ADF members have differing characteristics and experiences as well as risk factors for suicide, it is important to compare them with the general Australian population. It is also important to note the ADF population age and sex demographics are different from the Australian population ¹ and may be a contributing factor to observed differences.

These age and sex differences are considered when examining differences in suicide levels between these populations, and comparisons are presented where these differences are controlled. In this report comparisons to the Australian population are presented for analysis of ADF sub-groups of age, sex, service status (permanent, reserve and ex-serving), prior service status (permanent ex-serving and reserve ex-serving) and reason for separation.

There are measures under study which are less meaningful when compared with Australian population due to underlying factors such as service (Army, Navy, Air Force), rank, length of service and time since separation. For these ADF sub-groups this study compares them to categories within the same sub-group (for example, Army is compared with Navy and Air Force).

A challenge for further investigation is improving data on ADF comparator populations, for instance, to enable comparing involuntary medical separations to people with similar medical conditions, or including comparisons between other socio-economic factors such as employment-status, income, household situation, etc. These analyses are currently out of scope for this report series.

1. To illustrate, the permanent, reserve and ex-serving ADF populations have different age structures with median ages of 31, 37 and 52 years respectively compared with 38 years for the Australian population. While the permanent, reserve and ex-serving populations are 84% male, and the Australian population is 50% male.

The ‘at-risk’ groups are those who had a higher rate of suicide than other ADF groups: higher rates were associated with ex-serving members who left involuntarily, were aged under 50 years, and had served for less than one year. In particular, the suicide rate of males who left for involuntary medical reasons was 3 times higher than those who separated voluntarily (67.1 compared with 21.5 per 100,000 population per year in ex-serving males).

Multi-factor analysis was performed in the previous edition of this series which investigated the risk factors with more detail (AIHW 2022).

The cohort of members with reliably recorded operational experience is quite small compared with the other variables considered in this report. Operational experience was only recorded with accuracy from 2001 onwards, and since we are interested in a full account of a member’s operational history that means we must confine our analyses to ex-serving members who were hired during or after 2001. This means 24% of the total 1985–2021 study cohort can be considered in these analyses. Moreover, of this reduced cohort only 28% have more than zero operational experience. And of this group 43 died by suicide. This significantly curtailed cohort of interest is the reason this calculation has proved so difficult.

Univariate analysis of the suicide rates of these zero and greater than zero operational experience cohorts is unable to find any statistical differences between them.

The following is sourced from the Phoenix Australia ADF members and ex-members suicide literature review: An update | Royal Commission into Defence and Veteran Suicide (17 Oct 2023).

For serving defence force members there is evidence from the United Kingdom (UK) and New Zealand that corresponds with Australian evidence that suicide rates are lower amongst current serving military males than in the general male population, though this is not universal. In Canada, Germany and the United States (US), evidence suggests that rates of suicide amongst current serving males are equivalent to or higher than those in the general male population, with younger soldiers and those serving in the Army at particular risk.

For male ex-serving defence force members, in concurrence with evidence from Australia, rates from the US and Canada suggest that male ex-serving defence members are at higher risk of dying by suicide than the general male population, though this is not universal. The UK, the Netherlands, and to an extent Sweden are notable in that suicide mortality was lower for ex-serving military males than in the general male population.

For female ex-serving defence force members, those in the Canadian Armed Forces had an increased rate of suicide compared to the general female population, as similarly observed among Australian female ex-serving members.

On March 2020 the World Health Organisation (WHO) declared COVID-19 as a pandemic (WHO 2020). As of 31 July 2023, 19,510 Australians have died with or from COVID-19 where COVID-19 became the third leading cause of death in Australia in 2022 (ABS 2023, ABS 2022). While there has been a rise in the use of mental health and crisis services during the COVID-19 pandemic, the pandemic was found not to be associated with a rise in suspected deaths by suicide in 2020 and 2021 among the general Australian population (AIHW 2023). Similarly, using preliminary mortality data for deaths information from 2020 and 2021, findings in this report show that the suicide rates among ADF permanent, reserve, or ex-serving males and ex-serving females in the 3-year period of 2019–2021 were not significantly different to the respective suicide rates of the previous 3-year period of 2016–2018 (see Figure 2). This trend was also observed among US veteran cohorts (US Department of Veteran Affairs 2023).