Suicide and Life-Threatening Behavior 31(1) Spring 2001 103  2001 The American Association of Suicidology Are UN Peacekeepers at Risk for Suicide? ALBERT WONG, MD, MICHAEL ESCOBAR,PHD, ALAIN LESAGE, MD, MICHEL LOYER, MA, CLAUDE VANIER, MD, AND ISAAC SAKINOFSKY, MD Media reports connecting UN peacekeeping duties by Canadian soldiers to their subsequent suicide prompted this study of peacekeeping as suicide risk. In a case-control design we retrospectively compared 66 suicides in the Canadian mili- tary between 1990 and 1995 with two control groups: (a) 2,601 controls randomly selected from the electronic military database and (b) 66 matched controls with complete personnel and medical data. We found no increased risk of suicide in peacekeepers except among a subgroup of air force personnel. Here confounding individual factors, isolation from supports, and possibly inadequate preparation for deployment elucidated their suicides. Theater of deployment (e.g., Bosnia) did not affect the suicide rate. Military suicides experienced psychosocial stresses and psychiatric illness more often than their matched controls. We conclude that al- though peacekeeping per se does not increase overall suicide risk, military life- styles may strain interpersonal relationships, encourage alcohol abuse, and con- tribute to psychiatric illness and suicide in a minority of vulnerable individuals irrespective of peacekeeping assignment. Careful selection, and preparatory mili- tary training that encourages intragroup bonding and mutual support, may protect against suicide risk. Even as we enter the 21st century there mor. Peacekeeping duty seems here to stay; between 1992 and 1994 the number of UN seems no end to endemic regional conflicts. Military forces of UN member nations will peacekeepers mushroomed internationally from 11,500 to 72,000 (Trager, 1994). foreseeably be indispensable to monitoring peace agreements, such as those recently po- Surprisingly little is known about the impact of peacekeeping on the peacekeepers liced in Bosnia-Herzegovina, the Middle East, Rwanda, Somalia, Kosovo, and East Ti- themselves. Several studies have highlighted ALBERT WONG, MD, is Research Fellow in the Department of Psychiatry and the Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. MICHAEL ESCOBAR,PHD, is Asso- ciate Professor in the Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada. ALAIN LESAGE, MD, is Associate Professor, MICHEL LOYER, MA, is Research Associate, and CLAUDE VANIER, MD, is Psychiatrist-in-Chief at the Louis-H. Lafontaine Hospital, Fernand-Seguin Research Center, University of Montreal, Montreal, Quebec, Canada. ISAAC SAKINOFSKY, MD, is pro- fessor in the Departments of Psychiatry and Public Health Sciences, University of Toronto, Toronto, Ontario, Canada. This research was supported by Department of National Defense (Canada) Contract 5784-18 (DHPP 3). Special thanks are due to Lieut.-Col. Martin Tepper (Ret.), Col. Ruth MacKenzie, Messrs. Richard Mitchell, Ron Nitschke and Stephane Pharand, Capt. Krista Simonds, Capt. Stephanie McKin- non, Sgt. Clara Frey, Cpl. Dana Beattie, Mme. Christiane Montgiraud, and Ms. Joan Santiago. Address correspondence to Isaac Sakinofsky, Suicide Studies Program, Clarke Division, Center for Addiction and Mental Health, 250 College St., Toronto, Ontario, Canada, M5T 1R8, E-mail: isaac. sakinofsky@utoronto.ca.