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ABERDEEN PROVING GROUND, Md. – Suicide is a significant public health issue that impacts individuals, families, communities and society at large. The issue is also tied to what the U.S. Surgeon General, Dr. Vevek Murthy, called an “Epidemic of Loneliness and Isolation” in a May health advisory that calls for a National Strategy to Advance Social Connection.

According to the U.S. Department of Health and Human Services, even before the onset of the COVID-19 pandemic, approximately half of U.S. adults reported experiencing measurable levels of loneliness. Disconnection fundamentally affects mental, physical, and social health. In fact, loneliness and isolation increase the risk for individuals to develop mental health challenges in their lives, and lacking connection can increase the risk for premature death to levels comparable to smoking daily.

According to the Department of Defense Annual Report on Suicide in the Military, suicide rates amongst the active-duty component have gradually increased since 2011. In 2020, 519 service members and 202 military family members died by suicide. Data indicated that men, enlisted service members, and active-duty service members under the age of 30 had a higher risk for suicide compared to the population average. The most common method of suicide death was by firearm, followed by hanging/asphyxiation. There are many risk and protective factors that play an integral role in the prevention of suicide, to include the concept of social connectedness.

“Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health,” said Murthy. “Our relationships are a source of healing and well-being hiding in plain sight – one that can help us live healthier, more fulfilled, and more productive lives. Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders. Together, we can build a country that’s healthier, more resilient, less lonely, and more connected.”

Social connectedness occurs when people or groups engage in relationships that create a sense of belonging and being cared for, valued and supported. The impact of suicide is far-reaching, and social connectedness is an important component of building meaningful relationships and fostering a community of resources to improve both help-seeking services and prevention efforts.

Promoting Social Connectedness

According to the Centers for Disease Control and Prevention, connectedness is the degree to which an individual or group is socially close, interrelated or shares resources with other individuals or groups.

Examples of positive social connectedness include:

  • Friendships

  • Family bonds

  • Mentorship

  • Leadership/role models

  • Involvement with trusted groups

  • Involvement with community organizations; and

  • Involvement with faith-based networks

Increased positive relationships not only serve as a protective factor against both suicidal thoughts and behaviors but also contribute to decreased levels of social isolation and loneliness. These positive attachments can:

  • Impact a person’s sense of belonging

  • Strengthen their sense of purpose

  • Build their sense of community

  • Enhance opportunities to access support services.

Being connected to others, particularly during periods of stress, helps an individual to not feel alone; they have access to a trusted network that can provide support and assistance. Miguel Sierra, a suicide prevention program manager with the Army Substance Abuse Program, says when people think about social connectedness, especially in the context of suicide prevention, they often complicate it unnecessarily.

“In reality, connectedness is quite simple: a smile, eye contact when saying 'good morning,' genuinely asking someone how they're doing, or engaging in a small conversation about a baseball game or a TV show can foster a sense of connection and pave the way for more meaningful and, if necessary, difficult conversations about any struggles a person may be facing,” says Sierra.

Sierra recognizes the importance of leaders being supportive of those they lead and familiar with available community resources.

“Being mindful and purposeful in creating an atmosphere of understanding and support for those within our professional, family or social circles can help shape how a person approaches seeking help and caring for their mental health,” says Sierra.

Stigma, which is one of the most frequently reported barriers to mental health help-seeking, includes:

  • Concern about being negatively viewed by others;

  • Experiencing family opposition to seeking outside help;

  • An unwillingness to disclose mental illness to others; and

  • Fear of burdening family.

Psychological, social and cultural factors impact stigma and help-seeking behaviors. Eliminating stigma requires individuals, their support network (family, friends, and colleagues) and the broader community to understand that mental health is an element of overall health, and seeking care is both a preventative and protective factor.

Leadership Engagement – How to increase connectedness in the military setting

Healthy social relationships and community connections play a critical role in suicide prevention by serving as a barrier for the negative impact of risk factors in a persons’ life. In the military, it is important to remember that suicide prevention starts before a service member is in crisis.

Leadership is a powerful tool, and leaders at all levels play an integral role in shaping the way service members feel connected, prioritize their mental health, are knowledgeable of supportive resources and engage in help-seeking behaviors. According to the Army’s Leaders Suicide Prevention Safe Messaging Guide, an integral part of proactive leadership in prevention is open and effective messaging, which helps service members feel more comfortable reaching out for help and guidance for themselves or a fellow service member. Through caring language, a leader can break down myths and stigma, reinforce hope, encourage treatment, prevent a crisis and reduce suicide clusters.

The Army’s suicide prevention leader guide recommends leaders create an environment that promotes healthy social connectedness and openness about suicide, managing stress and addressing mental health challenges. It also offers some recommendations on the leader’s role in suicide prevention. The tips below reflect the guide’s recommendations along with some practical application for how leaders can action the advice.

  1. Suicide prevention programs should promote practices leading to positive and supportive relationships. Leaders can promote connectedness by encouraging a buddy system and involvement in social gatherings like organizational days.

  2. By fostering open dialogue from the top down and bottom up, leaders can help guide service members in the right direction by routinely discussing behavioral health and community resources, as well as incorporating discussions about suicide prevention and stress into the training calendar. Discussing psychological health as often and openly as physical health may help service members feel more comfortable reaching out to leadership and seeking professional help.

  3. Become familiar with crisis and help-seeking resources, both in clinical and non-clinical settings, from DOD internal and external service providers.

  4. Visibly practice self-care and share stories of success about other service members who successfully reached out for support and care during challenges. Stories of resilience through help-seeking and positive coping skills are powerful and can be especially helpful when coming from trusted leaders and individuals.

  5. Create outreach and engagement opportunities in peer support programs such as Better Opportunities for Single Soldiers (BOSS).

Here are some DOD- and service-based suicide prevention resources:

The Defense Health Agency supports our Nation by improving health and building readiness—making extraordinary experiences ordinary and exceptional outcomes routine.

NOTE: The mention of any non-federal entity and/or its products is for informational purposes only, and not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.

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