JPP Applied to Rising Military Suicide Rates

Introduction

This paper uses the Joint Planning Process (JPP)[1] to address a hypothetical situation related to rising suicide rates of military personnel. The situation is described in the following problem:

You are the Commanding Officer of a squadron/battalion/destroyer who has experienced a significant increase in suicides over the past two years. Your immediate superior asks you to utilize the model of the Joint Planning Process with your leadership team to develop a course(s) of action to address the problem. How would you approach the issue? How would you define the problem? What courses of action would you propose? What criteria would you establish to grade your courses of action? How would you measure success?

For this paper, the recommendations are for a USMC or Army battalion. Unfortunately, the described course of action won’t transfer to squadrons or destroyers.

Marine Corps Community Services: How to Talk Openly About Suicide

Each of the seven steps of the JPP will be used. As specified in JP 5-0[2], the steps are:

1. Planning Initiation
2. Mission Analysis
3. COA Development
4. COA Analysis and Wargaming
5. COA Comparison
6. COA Approval
7. Plan or Order Development

Overall, this paper makes minimal assumptions about the causes of military suicides. It is assumed that such suicides are related to harrowing missions or rapid operational tempo. The choice for these factors was motivated by the observation that “the average warrior saw 40 days of combat during World War II and 240 days during the Vietnam War” and that “something changes inside a warrior the first time they take another's life or watch a comrade fall on the battlefield… Warriors feel rage and anger and want payback; but they also feel a sense of loneliness they have never experienced before.”[3]

All courses of action (COA) presented here propose collecting information on family history of mental health issues, prior symptoms of PTSD, etc. Focusing on family history is nothing new, as some research has performed statistical analyses only on demographic factors[4].

Research has compared suicide rates amongst the warfighters in different wars, and it is generally assumed that the suicide rates for World War II are lower than all wars from the Korean War to the GWOT[5] [6]. Additional studies have specialized in suicides only from the GWOT[7]. The study by Smith et al seemed to show that “War does not historically appear to increase suicide rates in active-duty U.S. Army soldiers or U.S. civilians.”[8] If this is true, veteran suicides are more common than active-duty suicides.

Step 1: Planning Initiation

Planning begins when the order to investigate the sudden increase in suicide rate of a particular battalion, and to use the JPP to devise a course of action that addresses this problem.

Step 2: Mission Analysis

Staff estimates: The battalion commander will have the following personnel available:

• The executive officer (XO) (a major)
• 4 company commanders, including HQ company (captains)
• 4 company XOs (first lieutenants)
• 1 battalion sergeant major
• 4 first sergeants, the company-level senior NCOs
• 1 or 2 medical specialists.

The enlisted personnel would be best at gathering information on those who committed suicide. Both officers and enlisted personnel should be involved in determining what changed two years ago. Finally, the XO will be charged with organizing the information that was collected.

Mission statement: The battalion experienced a substantial increase in the rate of suicides over the past two years. The mission is to reduce that rate to where it stood prior to two years ago, at least. These rates will be measured in terms of the percentage of the battalion lost in a single month.

Commander’s critical information requirements (CCIR): To determine the success of the mission, we must know the suicide rates prior to two years ago. It would be worth reviewing records as far back as possible, at least from five years ago.

The fundamental question that must be answered is: what changed approximately 2 years ago? Rates of suicide increased significantly starting two years ago, and that change must be understood. This is one part of the CCIR.

Another CCIR that can be collected prior to the implementation of the chosen COA are profiles of the troops who committed suicide over the previous two years. Information collected should include family life, family history of mental health issues, prior symptoms of PTSD, CPTSD, or TBI[9].

Information on suicides must be collected while the chosen COA is ongoing. This will allow the effectiveness of the COA to be measured. The implementation plan for the COA can be continually adjusted as needed.

Impact on other operations: The impact on other operations, either ongoing or future will depend on the chosen COA. At bare minimum, there would be minor personnel additions that should not change ongoing or future operations. Another COA could require significant changes to both ongoing and future operations.

Step 3 COA Development

COA 1: Reproduce techniques that were used in historical situations to reduce rates of suicide. For example, during the Battle of Verdun[10], Marshal Philippe Pétain rotated French troops after two weeks on the front lines. This was called the “noria system,” and the Germans practiced something similar. One consequence of this was that a larger number of troops gained combat experience. It is not clear what effect this system had on troop suicide, if any.

It may be worthwhile to examine historical techniques that resulted in increased suicide rates – and for us to do the opposite.

COA 2: Move psychological support closer to the battalion. This would allow troops to get help in a timely manner and can be done either permanently or on an as-needed basis.

COA 3: Determine what changed starting two years ago that could cause the increased suicide rates – and reverse it. Likely causes can include personnel changes, change in mission, and change in operational tempo. Retraining or reassigning personnel can fix the first cause. Changes in mission or operational tempo will require more substantial changes, say by using Pétain’s noria system.

Step 4 COA Analysis

COA 1: The initial stage of this COA is primarily historical research. It must be conducted by historians, and so by someone external to the battalion. If the pace of research is slow, this will delay implementation. If historical methods to reduce suicides are found, the implementation of the methods could involve major operational changes.

COA 2: This COA requires either that a psychiatrist or a medic with some appropriate training be added to the battalion. Psychiatrists are usually located at the division level or higher and are in short supply.

The assignment need not be permanent: it may make sense to assign a psychiatrist temporarily to the battalion depending on recent or upcoming harrowing activities. This can provide an immediate solution, at least in some cases.

COA 3: The goal of this COA is to make changes to the battalion based on the answer(s) to the “what changed” question. If the relevant difference was a personnel change, it will be necessary to investigate whether increased suicide rates happened at the previous locations where the personnel were assigned, then retrain or reassign the personnel.

If the increased suicide rate was caused by either a change in mission or a change in operation tempo, these hypotheses should be verified by examining other battalions in similar situations. Either of these two causes may significantly impact current or future operations.

Changes in personnel, mission, or operational tempo are not the only potential causes of the increase in suicide rates. Other potential causes include an interruption in family communications, or various changes that could be described as code of conduct or HR actions, etc. For those changes, it should be simple to reverse them with no impact on current or future operations.

Step 5 COA Comparison

COA 1 will require some research, and the required data may not be available. For example, the noria system was implemented to ensure fresh troops were available for the battle, not to minimize suicide rates, and there is a lack of data regarding such rates.

It may not be possible to execute COA 1 as historical data may not be available. If multiple historical methods are found, then they must be evaluated and compared, and the one(s) that show the most promise should then be implemented.

COA 2 may not be a practical solution depending on the level of hostility to those that have thoughts of suicide within the battalion. If the level is high, a troop experiencing suicidal thoughts may be too ashamed to seek help.

COA 3 is the most practical plan of action, in part because the scope of action is so limited in comparison to COA 1 and COA 2. Even if it is found that a change in mission or a change in battle tempo was the underlying cause, these can be corrected.

Both COA 3 and COA 1 can involve operational changes, and COA 1 might require the most such changes, depending on the historical approach used.

For COA 3, the staff size and their assigned roles will be the same as described in Step 2.

Using the “Course of Action Comparison” found in JP 5-0, a plus/minus/neutral comparison would be most appropriate[11].

Criteria	COA 1	COA 2	COA 3
Time to Implement	-	+	+
Personnel Changes	+	-	0
Mission Changes	-	+	+
Operational Tempo Changes	-	+	+

Step 6 COA Approval

The plan of action will be sent to the division commander for review and approval.

Step 7 Plan or Order Development

The steps needed to execute COA 3 are as follows:

1. Obtain records going back at least 3 - 5 years.
2. Look for changes in personnel, mission, and/or battle tempo immediately prior to the period of increased suicide.
3. For any of the changes, selectively examine similar changes in other battalions.
4. Once the change has been identified, reverse it when possible – see notes below on how to accomplish this.
5. Gather statistics.
6. Compare new state (post COA 2 implementation) with prior state (pre-COA 2). Was there a difference in suicide rate?
7. Repeat as needed, adjusting plans when desired results are not achieved.

Each of the three changes listed above (personnel, mission, and tempo) can be addressed.

1. One example of personnel change is as follows: suppose LT X transferred into the battalion prior to the increase in suicide rate. Was LT X’s prior assignment marked with increased suicide rate, and did that rate plummet after his departure? If so, LT X should be sent for additional leadership training.
2. Another situation is when LT X is good, but the LT he replaced was much better. Again, additional training and mentorship should fix this problem.
3. Suppose there was a change in mission, say from building roads to participating in a humanitarian rescue following a tsunami. The two-week rotation plan used by Marshal Pétain mentioned above should be effective in reducing stress levels and so result in a lower suicide rate.
4. Finally, a change in operational tempo can also be addressed by the two-week rotation plan.
Note: experimentation usually involves a control group. Depending on the comparison being made, it may be unethical to require a control group.

Conclusion

The goal of this planning document was to apply the Joint Planning Process to correct an increase in suicide rates for a battalion. The goal is to reduce the suicide rates in the battalion to the rate from two years ago. The COA proposed here can be implemented with minimal effect on mission or operational tempo, and results are measurable. The success or failure of the COA can be accessed, and it can be modified as needed. The COA (either in original or modified form) can be considered a success if suicide rates were reduced to the level prior to the increase, at least.

Footnotes

[1] Joint Chiefs of Staff, Joint Publication 5-0
[2] Ibid, Ch V.
[3] Fisher, “Vietnam vet shares coping skills with combat warriors.”
[4] Ramchand, The War Within, pp. 19-25.
[5] Smith, “A historical comparison of U.S. Army & U.S. civilian suicide rates, 1900–2020.”
[6] This hypothesis is debated in Pollock, “Estimating the number of suicides among Vietnam veterans.”
[7] Suitt, “High Suicide Rates among United States Service Members and Veterans of the Post9/11 Wars.”
[8] Smith, “A historical comparison of U.S. Army & U.S. civilian suicide rates, 1900–2020.”
[9] Ramchand, The War Within.
[10] Wikart, “Memories of Verdun.”
[11] Joint Chiefs of Staff, Joint Publication 5-0, Appendix G.

Bibliography

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Joint Chiefs of Staff. Joint Publication 5-0, Joint Planning. 16 June 2017. Retrieved 15 September 2024 from https://www.airforcespecialtactics.af.mil/Portals/80/prototype/assets/joint-pub-jpub-5-0-joint-planning.pdf

Pollock, D., Rhodes, P., Boyle, C., Decoufle, P., & McGee, D. “Estimating the number of suicides among Vietnam veterans.” Am J Psychiatry 147, no. 6 (June 1990). https://doi:10.1176/ajp.147.6.772

Ramchand, R., Acosta, J., Burns, R., Jaycox, L., & Pernin, C. The War Within: Preventing Suicide in the U.S. Military. RAND Corporation (2011). Retrieved 9 September 2024 from https://www.rand.org/content/dam/rand/pubs/monographs/2011/RAND_MG953.pdf

Smith, J., Doidge, M., Hanoa, R., & Frueh. “A historical comparison of U.S. Army & U.S. civilian suicide rates, 1900–2020.” Psychiatry Research 323 (May 2023). https://doi.org/10.1016/j.psychres.2023.115182

Suitt, T. “High Suicide Rates among United States Service Members and Veterans of the Post9/11 Wars.” Watson Institute for International and Public Affairs (21 June 2021). Retrieved 15 September 2024 from https://watson.brown.edu/costsofwar/files/cow/imce/papers/2021/Suitt_Suicides_Costs%20of%20War_June%2021%202021.pdf

Wikart, F. “Memories of Verdun.” Western Front Association. (2020). Retrieved 15 September 2024 from https://www.westernfrontassociation.com/world-war-i-articles/memories-of-verdun-by-francois-wikart/