A Persistent Problem

Historically, the suicide rate among Army personnel was lower than that of the civilian population. Beginning in 2002, the suicide rate among Soldiers rose significantly, reaching record levels in 2007, and again in 2008 and 2009. This prompted the Army to seek academic scientists who could design and implement a large and complex research project to assist the Army in addressing the long-standing and persistent problem of suicide among Service members.

Army STARRS – A Comprehensive Response

Army STARRS was designed to comprehensively investigate risk factors and protective factors for suicide, suicide-related behavior, and other mental/behavioral health issues in Army Soldiers. It is the largest research study of mental health risk and resilience ever conducted among Army personnel.

Army STARRS was designed and conducted by an interdisciplinary team of researchers from the Uniformed Services University of the Health Sciences (USUHS), the University of California, San Diego (UCSD), Harvard Medical School (HMS), and the University of Michigan (UM). Army STARRS began in July 2009 and ended in June 2015. Primary funding for Army STARRS came from the U.S. Army, with supplemental funding from the National Institute of Mental Health (NIMH).

The Army STARRS research team was led by two Co-Principal Investigators: Robert J. Ursano, MD (USUHS) and Murray B. Stein, MD, MPH (UCSD). The team included Ronald C. Kessler, PhD (HMS), Steven G. Heeringa, PhD (UM), Lisa J. Colpe, PhD, MPH and Michael Schoenbaum, PhD (two collaborating scientists from NIMH), and COL Steven Cersovsky, MD, MPH and Kenneth Cox, MD, MPH (two consulting scientists from the U.S. Army Public Health Command).

Army STARRS consisted of eight separate studies. Click here for more information about the eight studies

The research team developed ground-breaking, diverse, vast, representative, and complex data sets that emphasized the creation of practical and actionable information to guide mental health resilience-building in, and beyond, the Army.

Army STARRS activities included:

  • Obtaining and compiling historical administrative data from 37 Army and DoD sources involving more than 1.1 billion records representing more than 1.6 million Soldiers on active duty from 2004 to 2009
  • Collecting data directly from more than 100,000 active-duty Soldiers (including regular Army, Army National Guard and Army Reserve Soldiers) in 2010 through 2014. These data were collected using:
    • More than 177,000 questionnaires, and
    • Approximately 400,000 neurocognitive tests
  • Obtaining administrative data from 2011 through 2015 from Army and DoD sources for Soldiers who completed questionnaires and provided consent to link their Army STARRS data to their Army and DoD administrative data
  • Collecting approximately 77,000 tubes of blood from approximately 52,000 Soldiers
  • Conducting more than 24,000 genetic and other laboratory assays for biomarkers using DNA, RNA, and plasma from blood samples

What Army STARRS Produced

Army STARRS resulted in a vast amount of valuable data from a very large number of Soldiers. The groups of Soldiers established in Army STARRS include a sample of Soldiers at entry into the Army, a representative sample of Soldiers across the entire Army, and a sample of Soldiers in Brigade Combat Teams as they were about to be deployed. The design of Army STARRS included follow-up of these three groups using administrative data from the Army and DoD.

The timeframe of Army STARRS only allowed follow-up contacts with Soldiers for one of the groups (the Brigade Combat Teams group) and the follow-up period was relatively brief (about 2 years). Longitudinal follow-up studies of the other groups, and continued longitudinal follow-up of the deployed Brigade Combat Teams group, will provide important information needed by the DoD about the careers of Soldiers and the transition of Soldiers back into civilian life.

The continuation of Army STARRS, through STARRS-LS, will allow the researchers to continue producing actionable information needed by DoD leadership to address important mental, behavioral, and other health issues in the military.