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Objectives. We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. Methods. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N=8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Results. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF=46.6%; 95% confidence interval [CI]=27.3, 62.7; women: PAF=23.6%; 95% CI=9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF=9.3%; 95% CI=0.4, 18.1; women: PAF=6.1%; 95% CI=0.0, 13.4), and a perceived need for information (men: PAF=12.3%; 95% CI=4.1, 20.6; women: PAF=7.9%; 95% CI=1.3, 15.5). Conclusions. A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health. doi:10.2105/AJPH.2008.134205

There has been increasing concern about suicide in active service members. In the US military, suicide is the second most common cause of death [I]. Although mental health problems have [...]

Objective: Suicide prevention remains a challenge across communities in North America and abroad. We examine a suicide prevention effort that is widely used, termed gatekeeper training. There are 2 aims: review the state of the evidence on gatekeeper training for suicide prevention, and propose directions for further research.Method: Studies were identified by searching MEDLINE (PubMed) and PsycINFO from inception to the present for the key words suicide, suicide prevention, and gatekeeper. In addition, a manual scan of relevant articles' bibliographies was undertaken.Results: Gatekeeper training has been implemented and studied in many populations, including military personnel, public school staff, peer helpers, clinicians, and Aboriginal people. This type of training has been shown to positively affect the knowledge, skills, and attitudes of trainees regarding suicide prevention. Large-scale cohort studies in military personnel and physicians have reported promising results with a significant reduction in suicidal ideation, suicide attempts, and deaths by suicide.Conclusions: Gatekeeper training is successful at imparting knowledge, building skills, and molding the attitudes of trainees; however, more work needs to be done on longevity of these traits and referral patterns of gatekeepers. There is a need for randomized controlled trials. In addition, the unique effect of gatekeeper training on suicide rates needs to be fully elucidated. [ABSTRACT FROM AUTHOR]

Introduction: There is a significant amount of research demonstrating that the rate of completed suicide among Aboriginal populations is much higher than in the general population. Unfortunately, there is a paucity of research evaluating the risk factors for completed suicide and suicidal behavior in this population. There is an even greater shortage of research on evidence-based interventions for suicidal behaviour., Method: A literature review was conducted to facilitate the development of an approach to the study of this complex problem., Results: An approach to developing a research program that informs each step of the process with evidence from the previous steps was developed. The study of risk factors and interventions is described., Conclusions: Research into the risk factors and evidence-based interventions for Aboriginal suicidal behavior are required. A programmatic approach is described in detail in this paper. It is hoped this informed approach would systematically address this important public health issue that afflicts a significant proportion of the Canadian population.