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Why Are Veterans at a Higher Risk of Suicide?

Military veterans are more likely than the civilian population to develop specific mental health problems, like post-traumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI). They are also at higher risk for developing associated substance use disorders.1

Both of these conditions contribute to an increased risk of suicide among U.S. military veterans.

Over 22% of the annual suicides in the United States are veterans of the U.S. Armed Forces. 90% of those who die due to suicide—civilians and veterans alike—also have a diagnosable mental health disorder at the time of their death.2

Suicide Among Veterans of the U.S. Armed Forces

veteran funeral soldier handing woman folded flagAccording to a recent report from the U.S. Department of Veterans Affairs (VA), an average of 20 veterans died every day in 2014 due to suicide. The report also shares that:

  • 6 of those 20 deaths were recent users of VA hospital services.
  • About 67% of veteran suicide deaths involve firearms.
  • Approximately 65% of veterans who died due to suicide in 2014 were 50 or older.
  • The risk of suicide among male veterans is 19% higher compared to adult male civilians.
  • Suicide risk among female veterans is 2.5x higher than among female civilians.
  • In 2014, veterans who were 18-29 years old had the highest rate of suicides.

Rates of suicide among all veterans who use VA services have remained relatively stable, although rates have gone slightly up among women and slightly down among men. Females in general are less likely than males to use firearms in suicide but that female vets are more likely than female civilians to have access to and use firearms.3

Although many veterans seek and receive help, some still struggle with suicidal thoughts, suicide attempts, or death from suicide. The VA noted that 70% of veterans who lost their lives due to suicide had not been connected to healthcare through the VA.4

Access to evidence-based help from physicians, therapists, and addiction specialists can reduce the risk of suicide by treating underlying issues.

Risks & Warning Signs of Veteran Suicides

The reasons behind suicidal thoughts or attempts are complex, but among veterans, the most commonly cited factors leading to an increased suicide risk include:

  • Living predominantly in rural areas, so experiencing more social isolation.5
  • Limited access to healthcare. 5
  • Gun ownership.5
  • Increased risk of mental health and substance use disorders, especially opioid addiction.6

Know the signs of a potential suicide attempt in veterans. These may include:7

  • Loss of sleep.
  • Anxiety, agitation, irritability, or mood swings.
  • Feeling like there’s no reason to live.
  • Anger or rage.
  • Engaging in risky behaviors, like drunk driving.
  • Increased drinking or drug abuse.
  • Withdrawing from family or friends.
  • Talking about suicide or wanting to die.
  • Looking for ways to attempt suicide, like obsessively maintaining firearms.
  • Feeling like there is no purpose in life.
  • Other self-destructive behaviors or an obsession with death.

Substance Abuse & the Risk of Suicide Among Veterans

In both military service members and the civilian population, mental health disorders like substance abuse disorders increase the risk of suicidal thoughts, suicide attempts, and death by suicide. Several studies have found that:8

  • Suicidal thoughts are higher among people with depression who drink alcohol.
  • A lower drinking age increases the risk of deaths by suicide among young adults.
  • People who had a depressive disorder and a substance abuse disorder (SUD) were much more likely to have at least one suicide attempt in their lives.

Veterans with problems abusing drugs or alcohol are twice as likely to die from suicide compared to civilians.9

The highest rates of suicide among veterans occur among people who abuse specific drugs like prescription sedatives, opioids, and alcohol. Many have specific mental disorders, such as depression, PTSD, bipolar disorder, or schizophrenia.10

A study on veterans and risks for suicide found that:11

  • 6 out of 100,000 veterans with a diagnosed SUD completed suicide compared to 34.7 out of 100,000 veterans overall.
  • Sedative abuse increased the risk greatly, as 171.4 per 100,000 veterans died due to suicide.
  • Women who misused opioid drugs were very high-risk, with 98.4 out of every 100,000 dying from suicide.
  • Male veterans who misused amphetamines also had a high rate of suicide, at 95 out of every 100,000.

One out of every 3 veterans seeking treatment for substance abuse has PTSD. Among returning veterans from Iraq and Afghanistan, one in 10 going to the VA for treatment will have a problem abusing drugs or alcohol.

The VA reports that the percentage of veterans receiving care through the VA healthcare system for mental health and substance use disorders has increased.12

  • In 2001, 27% of patients at VA centers had a diagnosed mental health or substance use disorder.12
  • By 2014, that amount rose to 41%.12

This may be due to changes in demographics, an increased number of veterans seeking care, changes in how these conditions are diagnosed and treated, or other causes.

Rates of suicide among veterans who receive care through the VA who have a mental health condition or substance use disorder have declined since 2001.13 This suggests that treatment works.

Treatment for Veterans with Mental Health Disorders

soldier receiving medical and mental health helpSAMHSA reports that at least half of the returning service members who need treatment for mental health struggles like PTSD look for help, but few receive adequate care.14

The VA healthcare system offers several evidence-based approaches to supporting veterans who struggle with suicidal ideation and reducing their risks of attempting suicide.

VA hospitals and healthcare facilities offer:

  • Inpatient and residential psychiatric and substance abuse treatment programs.
  • Outpatient options, including group and individual counseling.
  • Medication.
  • A special focus on PTSD and its impact on veterans.
  • The Veterans Crisis Line.
  • Local suicide prevention coordinators.

For veterans who have suffered sexual abuse, VA facilities offer counseling and support for military sexual trauma experiences.

Because so many veterans live in rural areas and struggle to access care through VA facilities, the VA is expanding telemental health services, which can include counseling services over the phone and online.

There are also several community-based counseling centers called Vet Centers, which provide many social and psychological services, including help readjusting to civilian life.

Counseling based in cognitive behavioral therapy, medication for psychiatric conditions as needed, and mutual support groups are the foundation of treating depression, PTSD, substance abuse, and suicidal ideation.

The VA supplies these services to veterans regardless of health insurance status. For veterans who may not be within easy reach of a VA hospital, many private facilities offer specialized treatment to veterans.

In these instances, facilities like Recovery First can provide treatment for veterans with co-occurring disorders like substance use disorder and other mental health disorders like PTSD and depression. Its Salute to Recovery program is specifically formatted for veterans, with veteran staff and group therapy options that only contain former service members.

References:

  1. U.S. Department of Veteran Affairs. (2017). VA releases suicide statistics by state.
  2. American Foundation for Suicide Prevention. (2016). Suicide: 2016 facts and figures.
  3. U.S. Department of Veteran Affairs. (2017). Facts about suicide among women veterans: August 2017.
  4. CBS News. (2017). Suicide among U.S. military veterans higher in certain states.
  5. Hirsch, J.K. & Cukrowicz, K.C. (2014). Suicide in rural areas: an updated review of the literature. Journal of Rural Mental Health, 38(2), 65-78.
  6. Larson, M.J., Wooten, N.R., Sayko Adams, R., & Merrick, E.L. (2011). Military combat deployments and substance use: review and future directions. Journal of Social Work Practice in the Addictions, 12(1).
  7. U.S. Department of Veterans Affairs. (2019). Suicide prevention.
  8. U.S. Department of Health and Human Services. (2008). Does alcohol and other drug abuse increase the risk for suicide?]
  9. University of Michigan, Michigan Medicine. (2017). Drug and alcohol problems linked to increased veteran suicide risk, especially in women.
  10. National Institute on Drug Abuse. (2019). General risk of substance use disorders.
  11. Bohnert, K.M., Ilsen, M.A., Louron, S., McCarthy, J.F., & Katz, I.R. (2017). Substance use disorders and the risk of suicide mortality among men and women in the US Veterans Health Administration. Addiction, 112(7), 1193-1201.
  12. U.S. Department of Veterans Affairs. (2019). PTSD and substance abuse in veterans.
  13. U.S. Department of Veterans Affairs. (2016). VA releases report on nation’s largest analysis of veteran suicide.
  14. Reisman, M. (2016). PTSD treatment for veterans: what’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10), 623-627, 632-634.
About The Contributor
Laura Close
Senior Web Content Editor, American Addiction Centers
Laura Close is a Senior Web Content Editor at American Addiction Centers and an addiction content expert at Recovery First Treatment Center. She has a bachelor’s degree in English and has nearly a decade in professional editing experience... Read More