Suicide Among Veterans: Statistics, Risk Factors, Prevention & More

Key Takeaways

• Veteran suicide rates are significantly greater than nonveterans, especially among young veterans and female veterans.
• Combat exposure, PTSD, and substance use disorders are significant risk factors for veteran suicides.
• Mental health issues like PTSD and depression are closely linked to the increased risk of suicide among veterans.
• Substance misuse contributes to heightened suicide risk, with half of VHA veterans diagnosed with chronic pain.
• Prevention strategies include crisis care services, lethal means safety, and community-based grants.
• Therapy, counseling, and peer support networks are crucial in suicide prevention for veterans.

Statistical Analysis: Veteran Suicide Rates Compared to the General Population

The prevalence of suicide among veterans is a pressing concern, with data indicating a significant disparity between veteran and nonveteran populations. According to the US Department of Veterans Affairs, between 2017 and 2020, the suicide rates for veterans were 1.57 to 1.66 times greater than those of nonveterans after adjusting for age and sex. This stark contrast underscores the elevated risks veterans face regarding mental health and suicide.

The 2023 National Veteran Suicide Prevention Annual Report reveals an increase in veteran suicides from 2020 to 2021, with 6,392 veterans dying by suicide in 2021—an increase of 114 from the previous year. When adjusted for age and sex, the suicide rate among veterans rose by 11.6%, compared to a 4.5% increase among non-veteran US adults.

Further insights from RAND Corporation highlight the age group of 18-34 years old as having the highest suicide rate among veterans, with a rate of 45.9 per 100,000 in 2018. This figure is nearly three times higher than nonveterans of the same age bracket, at 16.5 per 100,000. Such data points to the need for targeted prevention strategies for younger veterans.

Moreover, the rate of suicide is reported to be 2.1 times higher among female veterans compared to the general population. These sobering statistics emphasize the critical need for comprehensive support and intervention programs tailored to veterans’ unique experiences and challenges.

Historical Trends in Veteran Suicide Rates

Historically, certain demographics within the veteran community have been particularly vulnerable. 

The historical trends in veteran suicides reveal both decreases and increases in suicide rates over the past two decades. The 2022 National Veteran Suicide Prevention Annual Report from the Department of Veterans Affairs (VA) indicates a decrease in veteran suicide deaths and rates for 2019 and 2020. Conversely, the 2023 National Veteran Suicide Prevention Annual Report highlights an 11.6% increase in the age- and sex-adjusted suicide rate among veterans from 2020 to 2021, suggesting that veterans continue to face elevated risks for suicide compared to the general population.

These fluctuations in suicide rates underscore the necessity for ongoing and targeted suicide prevention efforts, including the promotion of secure firearms storage and improving access to culturally relevant mental health care, as emphasized by the American Foundation for Suicide Prevention

The Impact of COVID-19 on Veteran Suicide Rates

The COVID-19 pandemic had a complex impact on veteran suicides. During the pandemic, there was a noted increase in suicidal thoughts and behaviors among veterans, as detailed in studies published in JAMA Psychiatry. This suggests that the stressors of the pandemic may have exacerbated underlying mental health conditions linked to past military service. However, there is also evidence of a decline in suicide rates among the general adult population during the pandemic, which raises questions about the specific vulnerabilities and needs of the veteran population.

The Influence of Combat Exposure on Veteran Suicide Rates

Studies have consistently indicated a concerning trend in the suicide rates among veterans with combat exposure. 

• The Department of Defense’s Annual Report on Suicide in the Military for the calendar year 2022 highlights the ongoing challenge of addressing suicide within the veteran community. A critical factor in these rates is the impact of different wars and the associated trauma that veterans carry with them long after their service.
• Research from the National Veteran Suicide Prevention Annual Report underscores the significant role that mental health issues, such as PTSD and depression, play in veteran suicides. 
• The aftermath of wars, as noted by the Costs of War Project and corroborated by other experts, has led to an increase in psychiatric admissions and suicide rates among veterans, especially those who served in recent conflicts like the post-9/11 era.

Understanding the nuances of how each war affects veterans is crucial for developing targeted prevention strategies. It is evident that the psychological toll of combat, alongside the unique stressors faced by veterans, necessitates a comprehensive approach to mental health care and suicide prevention within this community.

Risk Factors for Veteran Suicides

A complex interplay of factors contributes to the risk of suicide among veterans, including mental health disorders, substance use disorders (SUD), and the unique stressors associated with military service.

The Role of Mental Health in Veteran Suicides

Mental health issues, particularly post-traumatic stress disorder (PTSD) and depression play a significant role in the incidence of suicide among veterans:

• PTSD, a condition that can develop after exposure to traumatic events, is notably prevalent in military veterans, with its symptoms often persisting long after service. Research indicates that the stressors of military service, including exposure to combat and the associated trauma, can lead to an imbalance in brain energy, aggravating symptoms of PTSD and depression. This can significantly elevate the risk of suicide. The association between PTSD and increased suicidal ideation and attempts is well-documented. 
• Depression is another critical factor influencing veteran suicides. It is often characterized by a persistent feeling of sadness or loss of interest, which can lead to a range of emotional and physical problems. Veterans with depression may experience a sense of hopelessness, which is a potent risk factor for suicide. The National Center for Biotechnology Information highlights the importance of screening for depression and substance use disorders (SUDs) in veterans, as these are correlated with a higher likelihood of suicide attempts.

Ultimately, early detection and intervention are key in preventing veteran suicides. This involves not only mental health clinicians but also non-mental health providers who can identify signs of suicidal ideation and take appropriate action. The integration of comprehensive care and the adoption of new treatment methods that reduce suicide risk among military veterans are essential in addressing this critical issue.

Substance Abuse as a Contributing Factor to Veteran Suicides

Substance use is a significant risk factor for suicide among veterans, with evidence suggesting a strong link between substance use disorders (SUDs) and increased rates of suicidal ideation, attempts, and deaths. The National Center for Biotechnology Information reports that veterans accessing Veterans Health Administration (VHA) services who have mental health and substance use disorders, along with chronic medical conditions and pain, are at heightened risk for suicide. This is particularly concerning given that approximately half of VHA veterans are diagnosed with chronic pain, a condition often co-occurring with SUDs.

During periods of heightened stress, such as the COVID-19 pandemic, veterans have shown increased rates of psychiatric disorders linked to suicidal thoughts and behaviors, including alcohol use disorder. The pandemic has led to new-onset suicidal ideation and planning among veterans, underlining the importance of addressing mental health and substance use proactively. The 2023 National Veteran Suicide Prevention Annual Report and other resources emphasize the need for comprehensive strategies to manage SUDs among veterans to mitigate the risk of suicide.

Preventative measures include the integration of mental health services, substance use treatment, and pain management. By understanding the complex interplay between substance use and mental health, healthcare providers can tailor interventions that address the unique needs of veterans, potentially reducing the incidence of suicide within this vulnerable population.

Unique Stressors as a Contributing Factor to Veteran Suicides

Additional stressors such as exposure to combat, separation from support systems, and the challenges of reintegration into civilian life are unique to veterans and further exacerbate the risk of suicide. The cumulative effect of these factors can lead to a state of mental and emotional exhaustion that increases their vulnerability. To address this, the Department of Veterans Affairs emphasizes suicide prevention as a key area of focus, particularly in light of the rise in suicide rates during the conflicts in Iraq and Afghanistan. Effective prevention strategies must consider these multifaceted risk factors to provide targeted support for our veterans.

Strategies for Preventing Suicides Among Veterans

In the prevention of suicides among veterans, key strategies include the following:

• Availability and enhancement of services: Increasing availability of crisis care services and enhancing care transitions, particularly during high-risk periods, are important aspects of detection and prevention. It is vital to provide timely access to mental health services, particularly in rural communities where barriers such as geographic isolation and limited availability of specialized care exist.
• Lethal means safety: Improving lethal means safety methods can reduce access to the means most commonly used in suicides. This includes counseling on the safe storage of firearms, as mentioned in a brief by Disabled American Veterans. 
• Financial support for community organizations: Allocating grants to community-based organizations that provide suicide prevention services improves the quality and availability of services to veterans, including mental health screenings, case management, and emergency clinical services.
• Evidence-based interventions: Implementing evidence-based interventions adapted to the context of the COVID-19 pandemic and beyond help to mitigate the negative effects of targeted stressors on veterans.
• Peer support networks: Establishing peer support networks fosters connections and support among veterans, especially in rural and isolated communities.

The prevention of veteran suicides is a multifaceted endeavor that involves collaboration between the Department of Veterans Affairs (VA) and community organizations. 

The Role of the VA and Community Organizations in Veteran Suicide Prevention

The VA’s approach to reducing veteran suicides includes enhancing programs and training focused on community interventions to achieve a targeted 10% reduction in the veteran suicide rate from 2019 to 2024. This strategy aligns with the whole-of-government effort to decrease annual veteran suicide rates by 3% by 2028. Recent reports emphasize the need for a comprehensive public health approach addressing risk and protective factors at individual and societal levels.

Programs like the Wingman-Connect, an upstream suicide prevention program for Air Force personnel, which has been adapted for use in non-VA health care organizations, show promise in improving suicide-prevention services with a focus on health care systems and care coordination. The VA is also planning to hire community engagement and partnership coordinators to collaborate with communities in suicide prevention efforts, addressing the unique challenges faced by rural veterans, such as geographic isolation and limited access to health care. APA’s insights into these programs highlight their potential to make a substantial difference in the lives of veterans at risk of suicide.

Grants are also being offered to enhance mental health services for veterans, with an emphasis on case management and peer support, which are critical components of suicide prevention efforts.

Effectiveness of Therapy and Counseling in Veteran Suicide Prevention

Therapy and counseling are critical components in the prevention of veteran suicides, offering essential support and intervention services. Research indicates that psychosocial protective factors can significantly reduce suicidal ideation among veterans. These factors are often bolstered through therapy and counseling, which provide a space for veterans to process their experiences and develop coping strategies. A study published in the Journal of Affective Disorders by Elbogen et al., 2020, underscores the potential impact of these protective factors. 

The Role of Peer Support in Preventing Veteran Suicides

Peer support has emerged as a vital component in preventing suicides among veterans. Studies, such as the randomized control pilot study by Pfeiffer et al. (2019), have shown that veterans who engaged with peer specialists while admitted to psychiatric inpatient units for suicidal ideations experienced positive outcomes. The treatment involving peer sessions, with a median of four meetings over three months, suggests that regular interaction with peers can be beneficial alongside usual care.

Peer support is grounded in shared life experiences, creating a unique environment of understanding and empathy that can be particularly effective for veterans facing many challenges, including mental health issues and reintegration into civilian life. The Veterans Health Administration (VHA) has recognized the potential of peer support and is implementing interventions like PREVAIL, a peer-based suicide prevention program, to leverage this underused resource.

Peer support is and important part of a multi-faceted approach to suicide prevention, providing emotional support, helping navigate the healthcare system, reducing isolation, and promoting a sense of belonging among veterans.

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• Experienced clinicians trained in military culture and trauma-informed care
• Dual diagnosis to treat addiction and mental health disorders together  
• EMDR, a revolutionary treatment that alleviates trauma symptoms

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