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Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

What was Army STARRS?

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was the largest study of mental health risk and resilience ever conducted among military personnel.

Launched in 2008, Army STARRS was a partnership between the U.S. Army and the National Institute of Mental Health (NIMH). The project's goal was to identify, as rapidly as possible, risk and protective factors that can help the U.S. Army develop effective strategies to reduce rising suicide rates and address associated mental health problems among soldiers.

The Army STARRS research team developed diverse and comprehensive datasets that provided practical and actionable strategies to enhance mental health resilience in both military and civilian life.

Why was Army STARRS a priority for NIMH?

Historically, the suicide rate among U.S. Army personnel was lower than that of the civilian population. However, the suicide rate of active-duty Army soldiers roughly doubled between 2004–2009 and tripled between 2004–2012. During that time, the suicide rate in demographically similar U.S. civilians changed very little. In 2004, the Army suicide rate was about half that of corresponding civilians; by 2012, it was approximately 50% higher.

To address the rising suicide rates among service members, NIMH and the U.S. Army funded six coordinated, integrated studies across multiple institutions. The studies aimed to generate actionable, evidence-based recommendations to reduce deaths by suicide and increase knowledge of risk factors.

The groups studied in Army STARRS included:

  • New soldiers assessed just before beginning basic combat training
  • Active-duty soldiers
  • Soldiers in brigade combat teams about to be deployed

Over 5 years, Army STARRS researchers:

  • Obtained historical administrative data from 37 Army and Department of Defense (DoD) sources involving more than 1.1 billion records and representing more than 1.6 million soldiers
  • Obtained administrative data from 2011–2015 from soldiers who completed questionnaires and provided consent to link their Army STARRS data to their Army and DoD administrative data
  • Collected questionnaires and neurocognitive data from 2010–2014 from more than 100,000 active-duty soldiers (including Army, Army National Guard, and Army Reserve soldiers)
  • Collected blood samples from approximately 52,000 soldiers and used them to conduct more than 24,000 genetic and other laboratory tests to look for biomarkers of suicide risk and resilience

What was the impact of Army STARRS?

Army STARRS provided vast amounts of information about the risk and protective factors that influence a soldier’s mental health and well-being.

For example, data from these studies showed that:

  • Suicide rates from 2004–2009 increased among all soldiers, even if they had never been deployed.
  • Nearly half of the soldiers who attempted suicide did so before they enlisted.
  • Soldiers had higher rates of certain mental disorders than civilians, including attention-deficit/hyperactivity disorder (ADHD), intermittent explosive disorder (recurrent episodes of extreme anger or violence), and substance use disorder.

Data from Army STARRS not only provided a deeper understanding of suicide risk within the military but also identified evidence-based strategies to reduce suicides in civilian populations.

Additionally, the Army STARRS component study design demonstrated the value of coordinating studies to generate and test hypotheses, develop targets for interventions, and evaluate the outcome of those interventions. Though the methodologies of the individual studies were relatively conventional, coordinating the studies allowed researchers to draw conclusions more broadly. The Army STARRS study design now serves as a model for studying events like suicide.

To continue the work started by the Army STARRS project, the DoD funded the Study to Assess Risk and Resilience in Servicemembers—Longitudinal Study (STARRS—LS)  in 2015. The study—conducted in partnership with the DoD, U.S. Army, NIMH, and the U.S. Department of Veterans Affairs—aims to produce practical, actionable information to help people build resilience and reduce their risk of suicide, suicide-related behavior, and other mental/behavioral health issues.

STARRS—LS researchers continue to analyze Army STARRS data and collect new data from Army STARRS participants to learn more about their experiences. Researchers are conducting follow-up studies with soldiers throughout their Army careers and as they transition back to civilian life.

Approved to continue through 2025, STARRS—LS allows researchers to build on Army STARRS findings to gain a deeper understanding of suicide risk and mental health among current and former soldiers. Study findings will help Army leaders address important mental and behavioral health issues in the military.

Learn more about Army STARRS

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