More than a quarter of U.S. soldiers met the criteria to be diagnosed with some of the most common mental disorders — depression, panic disorder or attention deficit hyperactivity disorder (ADHD) — prior to enlisting in the Army, and more than 8 percent considered killing themselves at one time or another, according to a series of studies published in JAMA Psychiatry on Monday.
The reports come amid growing concern over high suicide rates among members of the U.S. armed forces.
The studies state that those who are most at risk of attempting suicide, 1 in 10 of those surveyed and interviewed, also have a history of impulsive anger, a condition known as "intermittent explosive disorder." That is more than five times the rate found in the civilian population, according to the reports.
A combination of this impulsive behavior, stress developed as a result of deployment and other mood disorders increase the potential for a soldier to act on suicidal thoughts. Intermittent explosive disorder is the most common disorder among Army personnel and the second most common in the general population, coming in behind general "phobias," experts say.
The three research papers are the culmination of five years of collaborative work by academic, government and military researchers who have been investigating the numerous military suicides.
Ronald Kessler, a sociologist at Harvard University who led one of the three studies, called the problem a "blind alley" and said the solution isn’t as simple as just excluding people with common mental illnesses from the military.
"If I said to your news organization, what you should do is just have people who have never been ill, you wouldn’t have anybody to hire," Kessler said.
"The kinds of disorders that are the very common ones, you just can’t have a business and say I’m not going to take anybody like that," he added. "Already, close to one third of the population is ineligible to enlist in the army. Now go into that two thirds and take the half who have had a mental illness — there’s nobody left."
In an email to Al Jazeera, Lt. Col. Cathy Wilkinson, a Defense Department spokesperson, said the Army was "reviewing the results of the Army STARRS article," one of the three reports, and that the Department of Defense will "work to incorporate these lessons learned and future Army STARRS findings into our resilience efforts."
Lt. Col. Alayne Conway, an Army spokeswoman, told Al Jazeera that the Army "continues to aggressively combat stigma associated with help seeking behaviors, which adversely impacts readiness," and noted that the Army did see a modest decrease in the number of suicides in 2013.
Army suicides decreased 19 percent last year, from 185 confirmed and suspected suicides to 150, according to Army figures.
If the Army were to intensify its screening process, it could lead new recruits to hide their mental health issues, and some experts have suggested it may be better to screen people after enlistment, so there is less incentive to hide any problems and those who need help can get it.
"A small minority of soldiers are responsible for a disproportionate amount of suicidal behavior," Dr. Matthew J. Friedman of the National Center for PTSD (post-traumatic stress disorder) wrote in an editorial that accompanied the reports. "Better identification of and intervention with the cohort are likely to have the best payoff."
Experts have suggested that the military should take a preventive step and invest in training courses that would tackle the issue of mental readiness across the board, but the Army tried that in 2009 and found the program to be unsuccessful.
"You have to live with the reality that having these common mental disorders is part of life," Kessler said.
"The way you handle it is to recognize it exists, to say to people that your job when you come in is to get yourself strong, trained and do what you need to do, and that doesn't mean just lifting weights and being able to take your weapon apart in the dark — it means getting your head straight," he said.