The promotion of mental health and the reduction of suicide risk are important goals for Americans from all walks of life. Historically, the suicide rate among Army personnel has been lower than that of the civilian population. Since 2002, however, the suicide rate among Soldiers has risen significantly, reaching record levels in 2007 and again in 2008 and 2009. (The Army has had modest success in reducing the number of suicides among Soldiers serving on active duty in 2010.) These numbers prompted the Army to engage the National Institute of Mental Health (NIMH) in helping to address this issue. Army STARRS is a direct response to the Army’s request that NIMH enlist the most promising scientific approaches to better understand psychological resilience, mental health, and risk for self-harm among Soldiers.

Army STARRS has four separate study components: the Historical Data Study, New Soldier Study, All Army Study, and Soldier Health Outcomes Study.

In the early stages of Army STARRS, investigators will conduct the Historical Data Study. This study component will involve the examination of tens of thousands of de-identified historical health and administrative records to detect risk and protective factors related to psychological resilience, mental health, risky behaviors, and suicide.

Beginning in 2011, the research team will gather information from Soldiers (including Army Reserve and National Guard Soldiers) who volunteer to participate in the All Army Study. This component of Army STARRS will assess Soldiers' psychological and physical health; events encountered during training, combat, and non-combat operations; and life and work experiences across all phases of Army service. Researchers will use this information to determine how these various factors affect Soldiers’ psychological resilience, mental health, and risk for self-harm.

Army STARRS researchers also will invite new Soldiers entering the Army to participate voluntarily in the New Soldier Study. The information gathered will assess the health, personal characteristics, and prior experiences of new Soldiers as they begin their Army service.

The fourth Army STARRS component, the Soldier Health Outcomes Study, is comprised of two case-control comparison studies. In these two studies, investigators will attempt to identify characteristics, events, experiences, and exposures that predict negative or positive health and behavior outcomes. To do this, researchers will compare information from study participants across all phases of Army service.

In all of the study components, Soldiers' personal information will remain strictly confidential and individual Soldiers will not be identifiable. A participant's answers will never be shared with anyone in the Army unless the Soldier indicates that s/he is in imminent danger of self-harm or harming someone else. Some Soldiers will participate once, while others may be asked to participate over a longer period of time. This approach will allow researchers to identify factors that predict which individuals may experience mental health challenges.

NIMH has assembled a group of renowned experts to carry out this research including teams from the Uniformed Services University of the Health Sciences (USUHS), the University of California, San Diego, University of Michigan, Harvard Medical School, and NIMH. Additional Army and NIMH program staff will contribute to the oversight and implementation of the study. This research team brings together international leaders in military health, health and behavior surveys, epidemiology, suicide, and genetic and neurobiological factors involved in psychological health.

The interdisciplinary team is led by Robert J. Ursano, MD, of the Uniformed Services University of the Health Sciences and Murray Stein, M.D., M.P.H., of the University of California, San Diego. The study's other investigators are:

• Steven G. Heeringa, Ph.D., University of Michigan
• Ronald C. Kessler, Ph.D., Harvard Medical School

NIMH Scientists include:

• Lisa J. Colpe, Ph.D., M.P.H., NIMH
• Michael Schoenbaum, Ph.D., NIMH

NIMH and Army oversight and implementation leadership include:

• Deborah Konopko, J.D., Army Executive Director, Army STARRS
• Philip Wang, M.D., Dr.P.H., NIMH Study Director, Army STARRS
• Kevin Quinn, Ph.D., NIMH Program Official, Army STARRS
• LTC Steven Cersovsky, M.D., M.P.H., Preventive Medicine Consultant, Army STARRS
• Kenneth Cox, M.D., M.P.H., Medical Informatics Consultant, Army STARRS

Taken together, the depth and breadth of the research team, the tremendous scale of the project, and the timely reporting of the research findings make Army STARRS truly groundbreaking research that will benefit members of the armed forces and the nation for decades to come.