FOND DU LAC -- A few years ago, as the war in Iraq was winding down and fighting continued in Afghanistan, the number of Marines killing themselves spiked.
The U.S. Marine Corps wants to know why.
Though the Corps has previously studied suicides and attempted suicides, it is launching a project this year to examine the complex reasons that Marines are dying by their own hand.
A team of researchers, including a professor at Marian University in Fond du Lac, will interview relatives and friends of active-duty Marines who died by suicide between 2010 and 2012. Their reports for the Marine Corps Suicide Prevention Psychological Autopsy Project will be used to identify suicide risk factors or trends that might be unique to Marines.
The reasons for suicide are often complex and can't be shoehorned into a simple explanation. But multiple deployments in more than a decade of war have taken a toll on military members and their families. And many are reluctant to ask for help because it could be considered a sign of weakness that could derail their military careers.
Other military branches also are coping with an increase in suicides.
In March, Lt. Gen. Howard Bromberg, the Army's deputy chief of staff, told a House subcommittee that the Army is expanding confidential services for behavioral health care.
"While physical injuries may be easier to see, invisible wounds such as depression, anxiety and post-traumatic stress take a significant toll on our soldiers," Bromberg said.
Last year, the Army reported that more soldiers died by suicide than by enemy attack -- 182 by suicide and 176 in combat. The Army Study to Assess Risk and Resilience in Servicemembers is collecting information on Army suicides.
The Corps has started programs to encourage people who are suffering from depression, stress, anxiety and moral injury to seek help, including Never Leave a Marine Behind, an annual training program to recognize the warning signs of suicide. The psychological autopsy study results may lead to better training.
"Over the last several years, the Marines have made a lot of progress in changing attitudes so Marines are more likely to come forward. They know that to become a fit Marine is to continue to work on their psychological fitness," said Navy Cmdr. Andrew L. Martin, who works in community counseling and prevention for Marine and Family Programs.
The number of Marine suicides began increasing several years ago, from 33 in 2007 to 42 in 2008 and 52 in 2009 before falling back to 37 in 2010 and 32 in 2011. Last year, 48 active-duty Marines died by suicide, including six suspected suicides that have yet to be confirmed.
Marian professor helping
Letters have been sent to next of kin asking if they want to be part of the study. However, because military families tend to be more mobile than the civilian population, researchers are getting envelopes returned as undeliverable, said Joan Fischer, research analyst in the Marine Suicide Prevention Program.
"At the same time, it's really heartwarming how many folks have responded just from a letter in the mail. This is something we see quite a bit in military research, that families have a high participation rate," Martin said. "The No. 1 reason they give for participating is because the project will help other military members and families."
The American Association of Suicidology trains researchers to conduct psychological autopsies. Among them is Janet McCord, associate professor of thanatology in Marian University's School of Nursing and Health Professions.
While medical autopsies determine how someone died, psychological autopsies are done "to broadly address the questions why, why now and why this way," McCord said in an interview on campus.
McCord and other researchers will meet with families of Marines in informal interviews to build a narrative of the deceased. They'll ask who else they should talk to, which could include friends, Marine buddies or acquaintances. When scheduling interviews, they avoid anniversaries of births and deaths.
Families and friends of those who kill themselves often feel a great deal of guilt. But McCord said many are willing to talk about their loved one to answer the question that haunts most -- why?
"People are often ready to talk. In some cases, it can be healing," said McCord, who wrote her PhD dissertation about Holocaust survivors who became writers and later died by suicide.
Study looks for trends
Of the 117 Marines who died by suicide between 2010 and 2012, researchers are hoping to get a group of at least 30 to 40 for the study, said Lanny Berman, executive director of the American Association of Suicidology.
"We'll look for parallel findings -- what might stand out. It might be 60% showed signs of substance abuse or it might show 40% talked about suicide and nobody noticed," Berman said. "Things that would lead us to say we have enough information about a significant proportion of these people and we have to be more attentive to substance abuse, or educating fellow Marines as to what to do if somebody talks about suicide.
"It might be other symptoms like insomnia, which is increasingly identified among young people. It may mean any number of things they're struggling with that could be a factor in suicides."
McCord and other researchers will compile their information into reports sent to the American Association of Suicidology. Each case will be numbered and all identifying information will be blocked out; when the final report is finished, information released to the public will be reported as a group with no specifics on individuals.
Where to get help
The National Suicide Prevention Lifeline, staffed 24 hours, is (800) 273-8255. Also, the DSTRESS Line -- (877) 476-7734 -- provides stress counseling to Marines, sailors and family members.