Critical Conversations in SOF: Suicide in the Military

Frank Larkin is a friend. A former Navy SEAL and a decorated federal law enforcement officer, he is among those who have chosen to speak openly and advocate on behalf of the men and women who serve in special operations. He also carries a loss no parent should ever have to endure. His son, Ryan Larkin, also a decorated Navy SEAL, took his own life in 2017.

Two months after Ryan asked him to donate his brain for traumatic brain injury research, Frank found his son in the basement of their home, dressed in his SEAL Team 7 shirt, a shadow box of his medals and ribbons illuminated beside him. Like many, Frank has chosen to transform his grief into advocacy, not only to understand what happened to his own son, but to help ensure that fewer families endure the same loss.

This article is written in that spirit. Because for those of us who have served, and those continuing to serve, there is no more sacred promise than this: No man is left behind.

Ryan’s story is one of hundreds, most of them untold. Before we talk about science, prevention, or solutions, we pause. We honor those we have lost to suicide across the SOF community and beyond. We recognize the families, teammates, and friends who carry that loss forward every day. This is not an abstract issue. It is personal, it is present, and it is felt across the force in ways that are both seen and unseen.

There are many individuals and families whose stories and advocacy have shaped this work. While not all can be named here, this is written in the spirit of honoring all of them.

The Promise Beyond the Battlefield

There is no more difficult conversation in this work than the one that follows suicide. Suicide is not about a single loss. It is about the ripple effects that extend across teams, families, and the broader community. It changes families. It stays with teammates. It challenges leaders. It leaves questions that do not resolve quickly or cleanly.

This is what makes the issue both deeply personal and operationally relevant. It requires a clear, disciplined approach, one grounded in understanding what is driving risk and what meaningfully reduces it.

“Leadership needs to understand,” Frank says. “You can’t stand up in front of your force and say, ‘we’re here for you, we’re going to take care of you, we’re not going to leave anybody behind’ and not mean it. That’s not just on the battlefield. That’s throughout the career.”

This is the standard.

Meeting it requires more than intention. It requires systems aligned to the realities of the force, grounded in evidence, and capable of supporting operators, families, and leaders over time.

Suicide in the Military: A Complex Problem

This is not a story about weakness. It is a story about complexity, about the convergence of factors we are still working to fully understand.

Ryan Larkin deployed multiple times to Iraq and Afghanistan, accumulating blast exposure across years of combat and training that left microscopic damage in his brain, damage that would not be confirmed until a posthumous examination at Walter Reed Bethesda. While he was alive, what was visible were the symptoms: fractured sleep, deepening anxiety, slipping memory. He sought help. But without the diagnostic tools to see the underlying injury, the full picture remained hidden.

His experience reflects one path, not a single pattern. Brain injury does not present the same way across individuals. In many cases, signs are subtle, inconsistent, or only fully recognized in hindsight, after they have already taken hold. Brain injury is also just one of many risk factors, so-called invisible injuries, related to military service and SOF work. While military service was once considered a protective factor, over the last two decades suicide rates have quietly ticked up across the armed services and within Special Operations. Veteran suicide rates are now nearly 72% higher than non-veteran peers.

“Serving in the military has become a risk variable that is clearly linked to 25-plus years of heightened operational tempo,” explains Dr. M. David Rudd, a Gulf War veteran who has spent three decades developing and testing treatments for military populations.

What lies behind this increase? SOF operators share many suicide risk factors with the general population, including relationship stress, financial and legal problems, and conflict with superiors and colleagues. But they also have Risk factors unique to their profession, often amplified in SOF. These include:

• Cumulative combat exposure. SOF operators are engaged in conflict repeatedly during compressed windows, making their aggregated exposure considerably higher than other service branches.
• Blast exposure and TBI. Veterans with a history of traumatic brain injury, including repeated sub-concussive blast exposure, show significantly elevated suicide attempt rates compared to peers.
• Sleep and circadian disruption. Insomnia is a significant independent risk factor for suicide, even when controlling for depression and hopelessness.
• Moral injury and unprocessed grief. Combat creates experiences that challenge identity and meaning, including morally complex decisions, loss of close friends, and survivor’s guilt.

These factors do not operate in isolation. They accumulate. They interact. They often remain invisible until very late. Two points in the operator's lifecycle carry particular risk, and both occur away from the battlefield.

The first is reintegration after deployment. Both operators and families change during separation. Families adapt out of necessity, sometimes creating patterns that inadvertently exclude the service member. Operators return changed as well, especially after combat. They may carry experiences that are difficult to share and hard for families to understand. These changes are not always negative, but they can create disconnection and strain reintegration. Even with available resources, families may struggle to support their returning loved one.

The second is transitioning out of service. Operators leave tightly bonded units that provided structure, identity, and meaning. Treatment gaps can emerge during this transition, whether due to lack of awareness, delayed access, or administrative friction. This period is among the highest risk windows for suicide.

What makes SOF populations particularly complex is that risk does not follow expected patterns. Suicide completion rates reveal a troubling paradox. Research shows that SOF operators have lower rates of suicidal ideation and attempts than other military members, likely reflecting the selection effect of rigorous screening for cognitive and emotional resilience. But when they do attempt suicide, completion rates are far higher. The ratio of attempts to deaths among SOF operators is roughly 2:1.

This suggests that traditional prevention approaches, which rely on identifying warning signs and prior attempts, may be insufficient for SOF populations. Early detection and intervention are critical. As Rudd notes: "If you get intervention early in the cycle, the response rates are 80, 85, 90%. If you get treatment late in the cycle, the response rates drop by 60 to 70% because the problems are more chronic."

Seeing the Whole Operator

We owe it to every operator, and to every family standing beside them, to build systems that can see the whole picture. Suicide prevention in SOF cannot rely solely on crisis identification. It must be proactive, responsive, and integrated, addressing the full needs of the operator well before a crisis occurs. The objective is to get left of crisis, to identify degradation before it becomes irreversible.

This requires:

• Tracking early indicators such as sleep disruption, performance shifts, and isolation
• Longitudinal surveillance across units
• Confidential, routine screenings connected directly to care
• Leadership education that normalizes human response to combat and cumulative stress
• Suicide-specific treatments delivered early
• Family education and intervention

This is what initiatives like Preservation of the Force and Family (POTFF) and the broader human performance enterprise were designed to do. They reflect a recognition that operator wellbeing spans integrated domains of human performance: physical, cognitive, psychological, spiritual, and social.

Embedded teams, behavioral health providers, family support programs, and chaplains are doing meaningful work across the force every day and saving lives. Targeted cognitive behavioral treatments developed for military populations have demonstrated significant reductions in suicide attempts, often with only a few hours of focused intervention. That work matters. But the complexity of this problem requires more than strong programs operating in parallel. It requires integration.

This is where data becomes a force multiplier. When longitudinal information flows across domains, patterns become visible that no single provider would see alone. Early signals are identified sooner. The right intervention reaches the right person at the right time. What works in one unit can be understood, validated, and scaled.

At Battelle, we are working to strengthen that integration by aligning diagnostics, longitudinal data, and leadership decision-making so that the full human system is monitored with the same rigor applied to operational capability. Because better intelligence enables better decisions. And earlier decisions save lives.

Sacred Certainties

Tobias Gutteridge writes in Never Will I Die: “We give thanks for sacred certainties. No man is left behind. That is the cardinal rule. I was dragged out of the compound by a mate and a medic. They were the closest to me, and they saved my life. It was business, but it was deeply personal.”

That principle must extend beyond the battlefield. In my years supporting the Naval Special Warfare community, I came to believe that this work requires us to be both “mate” and “medic.” Whole warrior health is not episodic care delivered in crisis. It is a sustained commitment across a career. That conviction remains. This work is business. It is also deeply personal.

The promise that no one is left behind is not enforced by policy alone. It is sustained by action.

By leaders who normalize early intervention.
By families who are equipped and supported.
By systems that identify risk before crisis.
By teammates who refuse to ignore the quiet signs.
By institutions willing to apply science, discipline, and accountability to the protection of human life.

Gordon Battelle, founder of Battelle Memorial Institute, articulated a charge that has guided more than a century of work: to use science and technology “to do the greatest good for humanity.” That charge extends to the operators who serve with extraordinary courage, and to the families who stand beside them.

This is not sentiment. It is mission alignment.

Preserving the promise requires courage, not only in combat, but in conversation. And this is one of the conversations we must be willing to own.

Ready to learn more? Explore Battelle’s military health optimization capabilities.

If You or Someone You Know Is in Crisis
For confidential, 24/7 support:
Veterans Crisis Line
Call or text 988, then press 1
Text 838255

Chat at VeteransCrisisLine.net
Military Crisis Line (active-duty, Guard and Reserve)
Call 988, press 1

Visit MilitaryCrisisLine.net
For those outside the military community, the 988 Suicide and Crisis Lifeline connect anyone in the United States to trained crisis counselors. Help is available. Confidentially. Immediately.

And If You’re Not in Crisis, But Something Feels Off
Reach out anyway. Call someone you trust. Tell your spouse that you’re not sleeping. Tell your commander you’re not yourself. You don’t need the right language. You don’t need to wait for certainty. You only need to take one step. And if you are reading this as a teammate, a leader, a spouse or a friend – make the call first. Check in. Ask directly. Stay present. Sometimes being the “mate” means simply refusing to let someone carry the silence alone.