The effect of the Suicide Prevention Program (SPP) on the characteristics of Israeli soldiers who died by suicide after its implementation

Abstract

Abstract Background: Suicide is major cause of death in the IDF. The Suicide Prevention Program (SPP) led to significant reduction in yearly rates of suicide. A study regarding demographic changes of those who died by suicide was done to further investigate its affect. Method: Nested case control retrospective study based on medical and HR data gathered between 1992 and 2016. Participants were divided into four groups: soldiers who died by suicide and non-suicidal soldiers, before and after SPP implementation. Results: Multivariate analysis with suicide as the binary logistic dependent variable before and after implementation of the SPP among four groups revealed that before SPP the OR was higher for males (OR, 7.885; 95% CI, 5.071–12.259;p < 0.001) compared to after (OR, 3.281; 95% CI, 1.600–6.726; p = 0.001). For support unit soldiers the values before SPP were OR, 14.962 and 95% CI, 8.427–26.563 (p < 0.001) while after SPP they were OR, 6.304 and 95% CI, 3.334–11.919 (p < 0.001). After SPP, OR was higher for psychiatric diagnosis at recruitment (OR, 5.830; 95% CI, 2.046–16.612; p = 0.001) than before SPP (OR, 2.422; 95% CI, 1.526–3.842; p < 0.001).For soldiers from Ethiopian ethnicity, after SPP values were higher (OR, 8.130 and 95% CI, 2.868–23.047 (p < 0.001) compared to before (OR, 3.522; 95% CI, 1.2891–6.650; p < 0.001). For those of Druse religion before values (OR, 4.027; 95% CI, 2.211–7.331; p < 0.001) were significant but not after. Conclusions: While the SPP succeeded in reducing risk of suicide in situational factors, dispositional risk factors were not affected by the SPP. The OR decreased in critical masses and rose in unique and smaller groups.