Panelists at Hinckley Institute urge public-health approach to military suicide

SALT LAKE CITY — Experts at a Hinckley Institute forum at the University of Utah on mental health in the armed forces on Friday urged policymakers to treat military suicide as a public-health problem that requires data-driven, systemwide responses rather than single explanations or quick fixes.

"Suicide when it happened was very difficult to predict," said Dr. Harold Cuddler, a former Veterans Affairs mental-health leader, summarizing years of VA and DoD work that shifted his emphasis from individual clinical encounters to population-level prevention. Cuddler described VA crisis lines, suicide-prevention coordinators and predictive analytics as vital tools, but he warned that many people who die by suicide are not captured by VA systems.

The panel, moderated by Corey Weathers, a clinical adviser on military morale and leadership, gathered clinicians, veterans-affairs leaders and an epidemiologist to examine trends and policy implications. Weathers opened the discussion by asking a central question: "Who is responsible?" — individuals, the military or the nation — and urged the audience to frame answers that connect clinical care with command responsibilities and societal supports.

Retired Brig. Gen. Dr. Zanakis, a military psychiatrist, said leaders and clinicians hold a ‘‘dual loyalty’’ to mission readiness and patient welfare and argued that mental health is integral to force effectiveness. He highlighted that a large share of the force is young and that many diagnosed conditions concentrate in that age group, calling for careful observation, tailored training and leadership attention to service members’ lives and relationships.

Dr. Michael Shoenbomb, an economist and epidemiologist on the panel, urged caution about common explanations for rising military suicide rates. Drawing on DoD and service-level data, he said the Army’s suicide rate doubled between 2004 and 2009 and rose further in subsequent years, but that commonly cited drivers — deployment cycles, housing changes, recruiter waivers and stop-loss policies — did not fully account for the trend when tested empirically. "We need to be rigorous in asking what we know and why we think we know it," Shoenbomb said, warning that aggregated DoD summaries can mask service-specific increases and lead to misleading policy choices.

Audience questions focused on stigma, confidentiality and command climate. Dominique, a Navy veteran in the audience, asked how culture that discourages seeking help affects readiness. Panelists agreed stigma remains a barrier and noted that confidentiality rules differ across settings; a chaplain currently provides full confidentiality in uniformed services, the panel said, and some urged expanding protections for clinician–patient conversations where feasible.

Panelists emphasized two parallel paths: (1) strengthen clinical and system-level tools — crisis response, follow-up coordinators and whole-person models such as the VA’s "Whole Health" program — and (2) change culture through commander engagement and grassroots peer efforts. Cuddler noted that data lags — national suicide reports typically reflect data two years earlier — and that much of prevention requires reaching people outside VA care.

The forum closed with an appeal to students and attendees to carry the conversation forward: build community, check on peers and press leaders for evidence-based policies that bridge clinical care, command responsibility and public-health strategies. The panelists stayed after the formal session to take additional questions.