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Suicide Risks in Veterans

Written by Dr. Ramon Martinez III
Published on August 30, 2022
Research Highlights

Approximately 280,000 of the 17.4 million U.S. veterans (or 1.6%) have attempted suicide.

In 2020, nearly 6,500 veterans died by suicide nationwide.

Caucasian male veterans and veterans under the age of 25 are at the highest risk of suicide.

Missouri ranks eighth in most veteran suicides in the nation as of 2019.

Veterans are at an increased risk for suicide & some veteran demographics are especially vulnerable.

Military veterans account for about 13.7% of suicides among adults in the U.S. [CDC, 2022] In 2018, the suicide rate among veterans was approximately 1.5x greater than the non-veteran U.S. adult population (Figure 1a).

  • Suicide risk in female veterans is more than twice as high as civilian women. [VA, 2014]

In 2018, around 46 per 100,000 veterans died by suicide, which represents a higher suicide rate compared to 2005-2017 (32 per 100,000). [Suitt, 2021]

  • White males have the highest rates of suicide among U.S. veterans. [VA, 2021]
  • From 2009-2019, veterans between 18-25 years old had higher rates of suicidal plans and attempts than older veterans; suicidal thoughts were more prevalent in older veterans. [SAMHSA, 2019]

Suicide rates among Missouri veterans are 40% higher than the national average, however specific demographic breakdowns are still lacking. [VA, 2018]

 

Mental Health

Suicidal behavior in veterans can be attributed to a complex interplay of: (1) post-traumatic stress disorder, (2) traumatic brain injury, (3) loss of a sense of purpose, (4) loss of a sense of belonging, and (5) substance use disorders. [American Legion, 2018]

  • Mental health risk factors associated with suicide include, anxiety, depression, schiz-ophrenia, bipolar disorder, and substance use disorders. [Lemaire, 2011]
    • Contemplation and preoccupation with suicide is increased in veterans with a history of suicide attempts or have a diagnosed depressive disorder.
  • Anecdotes from veterans cite traumas, the influence of a masculine culture that avoids help-seeking behaviors, access to guns, and difficulty of reintegrating into civilian life as some factors affecting their mental health and risk of suicide. [Suitt, 2021]
  • Other risk factors identified through academic studies include financial distress, relationship problems, and legal issues.
    • To date, there is no evidence that the COVID-19 pandemic has raised suicide rates among veterans. [VA, 2021]

While a majority of veterans are assessed for suicide risk, many do not receive treatment or rehabilitation services to reduce this risk. [Watkins, 2011] However, higher levels of social support can reduce suicide risk. [Lemaire, 2011]

 

Firearms are the most commonly used lethal means in veteran suicide.

In 2018, 68.2% of U.S. veterans who died by suicide used a firearm. Other common lethal means include suffocation (17%) and poisoning (9%)(Figure 1b).

  • In Missouri, approximately 76% of veteran suicides used a firearm, 12% by suffocation, and 12% by other methods. [VA, 2018]

 

Federal and state governments have used a range of programs to reduce suicide among veterans.

The National Suicide Hotline Designation Act of 2020 established a nationwide suicide prevention crisis hotline (“988”), which includes integrated support for the Veterans Crisis Line.

U.S. Veterans' Affairs Programs & Studies

In 2018, the VA and CDC adopted a 10-year national strategy for preventing veteran suicide.[VA, 2018]

State Programs

Law enforcement response: Green Alert programs in DE, KY, TX, and WV allow the public to locate missing veterans who could potentially be at risk for self-harm.

Access to lethal tools: Some states allow voluntary programs for veterans to temporarily (CO, WA, MD, MS) or through visitation from an advocate (CO) to relinquish lethal tools such as firearms and medication during times of crisis.

Retailer education: Gun shop programs (NH and UT) provide resources for stores to provide suicide prevention materials and training on how to identify persons who may be suicidal.

Higher education: Suicide prevention training (WA) for higher education professionals to identify students who are veterans at risk of suicide.

Treatment: Many local municipalities participate in a veteran treatment court model, where veterans in substance use judicial proceedings are connected with treatment options. [NCSL, 2021]

 

Supplemental Table 1 lists the types of U.S. Veterans' Affairs programs and the data supporting their utility.

 

MOST Policy Initiative is a 501(c)3 nonprofit organization that provides nonpartisan research information to members of the Missouri General Assembly upon request. This Science Note is intended for informational purposes and does not indicate support or opposition to a particular bill or policy approach. Please contact ramon@mostpolicyinitiative.org with any questions.

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