Mental Disorders,Comorbidity, and Pre‐enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre‐enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6–8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention‐deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre‐enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.     

Confidentiality in crisis counseling: a philosophical perspective

Crisis interventionists frequently confront a moral dilemma when violating client trust seems necessary if self-destructive behavior is to be prevented. Two fundamental moral values conflict in such cases: concern for client welfare and respect for client rights and autonomy. Each of these values is grounded in one of two important Western ethical traditions: Utilitarianism and Kantian Formalism, respectively. Following critical examination of each of these theories, attention is given to a series of hypothetical cases involving the confidentiality dilemma.