The United States Marine Corps has now acknowledged that, in 2018, they suffered the most active-duty Marine suicides in 10 years, inviting some difficult questions about suicide prevention initiatives and once again shining a light on longstanding misconceptions about mental health for service members and veterans.

According to the Marine Corps, as many as 57 active-duty Marines ended their lives in 2018, as well as 18 more in the Reserves. A large percentage of the Marines who took their own lives in 2018 had not deployed, nor had they seen combat—a trend that’s held true across all four branches, with both active duty and veteran suicides, despite an enduring misconception that service member suicide is an issue tied directly to combat-related trauma. Hard data was already being used in 2015 to show that combat deployments have little effect on the likelihood of a service member choosing to end their life; now, researchers at the Defense Department’s National Center for Telehealth and Technology have published a study contending precisely that. Still, the pervasive stereotype of a troubled veteran struggling to cope with his combat experiences remains ever present in the media and even in many suicide prevention endeavors.

“It can be a disservice to service members to misrepresent the nature of the population,” said Mark Reger, the study’s lead author. “We need to be clear that the deployed force overall adjusts well and is not at increased risk for suicide.”

The service member suicide question, it would seem, requires a far more complex answer than simply engaging with those struggling with post-traumatic stress related to difficult combat experiences. With suicide rates among combat veterans roughly equal to those among service members who never deploy, circumstances now invite some difficult questions regarding the ways in which the military is engaging with suicide internally.

“I am personally compelled to say something about suicide and mental health,” Marine Corps Commandant General Robert Neller said following this recent revelation. “If you need help, please ask or speak up. We will be there for you. Consider the lasting impact on your family, friends, and unit—none of whom will ever truly recover. Don’t choose a permanent solution to a temporary problem that can be resolved with the help of your teammates.”

Unfortunately, the odds don’t improve for service members leaving active duty. Suicide rates among veterans ages 18-34 have gone up in recent years and, in a surprising turn, the Veterans Administration has seen a sharp downturn in suicide prevention outreach efforts in the the media. Despite being allocated millions to produce suicide prevention messaging for television and radio last year, the VA did not produce a single piece of content for that purpose. The VA also dramatically reduced the number of social media posts focused on suicide prevention compared to previous years. According to officials within the VA, the decline in suicide prevention outreach efforts has been the result of rotating leadership at the upper echelons of the organization.

“While there is no dishonor in coming up short, or needing help, there is no honor in quitting,” Neller said. “For those who are struggling, our Marine Corps, our families, and our Nation need you; we can’t afford to lose you.”