Background  Military suicide is one of the current causes of noncombat attrition in the army, and it is necessary to explore the intrinsic relationship between military maladjustment and suicidal ideation to provide evidence for suicide prevention efforts in the military.

  Objective  To explore the relationship between military maladjustment and suicidal ideation as rated by People’s Armed Police (PAP) soldiers.

  Methods  A survey, including the Military Maladjustment Self-Assessment Scale, the Army Force Cohension Scale, the Military Psychological Help Seeking Disorder Scale, the Suicidal Ideation Scale and a self-administered general information questionnaire, was conducted to military police soldiers and officers from a department in the coastal region over a 2-week period in March 2021.

  Results  Totally 5002 male PAP soldiers and officers aged (22.52 ± 3.33) years were invited, and 4266 valid questionnaires were collected. There was no significant difference in age, nationality, origin, only child and identity category between the soldiers and officers with or without suicidal ideation (all P>0.05), but a significant difference existed in family types between the two groups (P<0.01). There were significant differences in the total scores of maladjustment, psychological help-seeking disorder and military cohesion between the soldiers and officers with or without suicidal ideation (P<0.001). Positive correlation was found between military maladjustment score and suicidal ideation score (r=0.467, P<0.001), military maladjustment score and psychological help-seeking disorder score (r=0.324, P<0.001), suicidal ideation score and psychological help-seeking disorder score (r=0.340, P<0.001), and psychological help-seeking disorder and unit cohesion score (r=-0.418, P<0.001); However, negative correlation was found between military maladjustment score and unit cohesion score (r=-0.304, P<0.001), and suicidal ideation score and unit cohesion score (r=-0.260, P<0.001). Soldiers' maladjustment, psychological help-seeking disorder and unit cohesion were independently correlated with suicidal ideation (OR=1.153, 1.052, 0.965, all P<0.05). Unit cohesion and psychological help-seeking disorder mediated the chain between military maladjustment and suicidal ideation. Military maladjustment could directly enhance the intensity of suicidal ideation in soldiers and also enhance the intensity of suicidal ideation in military personnel through psychological help-seeking disorders. Military maladjustment and psychological help-seeking barriers could reduce the intensity of suicidal ideation through unit cohesion.

  Conclusion  Facilitating the adaptation to military environment, eliminating psychological help-seeking barriers and consolidating troop cohesion are relevant to the prevention of suicide in the military.