The Scope of the Problem
Suicide rates are increasing among our military service personnel and veterans, and have been for some time. The Department of Defense (DoD) records a rising suicide rate for active duty military personnel: below is the DoD tally of military suicides from 2001 onwards
2001 – 10.3 suicides per 100,000 military personnel
2002 – 10.3
2003 – 11.0
2004 – 11.3
2005 – 11.3
2006 – 13.1
2007 – 13.8
2008 – 16.3
2009 – 18.5
2010 – 17.5
2011 – 18.0
Clearly the rate of suicide among active duty military has been increasing, with the greatest increases occurring during the years 2005 – 2009. Some other highlights from the 2010 DoD Suicide Event Report:
- in 2011, a total of 301 active-duty service personnel killed themselves
- firearms were the most common means of completed suicide for active-duty service personnel, used in 59.9% of completed suicides
- only a minority of suicides (10.1%) and suicide attempts (23.2%) occurred during Operation Enduring Freedom (OEF) and Operation New Dawn (OND) deployments. Most suicidal behavior occurred by US-based troops. However, around 50% of those who killed themselves had a history of deployment to Iraq or Afghanistan.
- only 16.7% of active-duty service personnel who killed themselves had received any sort of outpatient behavioral health services in the month previous to their suicide.
And according to the New York Times, more soldiers now die by suicide than are killed in combat.
The Veterans Administration (VA) tallies suicide among service veterans. The records of the VA hospitals and clinics only record data on those in the VA system, and so veterans who do not seek services at VA hospitals will not be included. The VA recently began examining VA records along with state records to get a more accurate understanding of suicidal behavior among all veterans. Their findings:
- during the period from 1999 – 2010, there were 27,062 suicides among service veterans, accounting for 22.2 % of all US suicides during that period
- the VA estimates that 22 veterans kill themselves every day
- suicide among US service veterans has been increasing; rising from an estimated 18 veteran suicides per day in 2007
- a clear gender bias exists: over 97% of all veterans who kill themselves are male, while for the non-veteran population, males comprised 74% of all suicides.
- for male veterans, there is a clear increase in the incidence of suicide with greater age; for female veterans, the distribution of suicides across age groups is more even (meaning that younger women vets kill themselves at rates similar to older women vets)
(Source)
The VA also tracks calls to the Veterans Crisis Line (a telephone hotline service for veterans): calls to the Veteran Crisis Line increased markedly between 2009 – 2012, with the largest jump after May of 2011. The VA launched a large public awareness campaign about the Veterans Crisis Line around May of 2011, so this large increase in calls may not reflect an actual increase in suicidal behavior among veterans.
So, the incidence of suicide for both active-duty service personnel and veterans has been increasing in recent years. The DoD attributes the rising number of suicides among active-duty service personnel to increases in operational demands on soldiers, repeated deployments, the reduced amounts and poor quality of time at home between deployments, and poor support, coordination, and effectiveness of military leadership at all levels of command.
Are you a military service veteran or concerned about one? The Veterans Crisis Line connects Veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1-800-273-8255 and Press 1, chat online, or send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year.
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Among clinicians/researchers, there exists some disagreement about the risk of suicide in military personnel and veterans compared to the civilian population. In a 2011 study of a national sample of 628 students with veteran status, 46% of the veteran students reported experiencing suicidal ideation, 20% had made a suicide plan, 10.4% reported “frequent” or “very frequent” suicidal thoughts, and 7.7% reported a previous suicide attempt. In contrast, the 2011 American College Health Association reported that 6% of college students reported “seriously considering suicide”, and 1.3% reported attempting suicide in the previous 12 months. The authors conclude that the risk for suicide is higher among student veterans compared to non-veterans.
Yet, in a 2011 study of male participants of the National Death Index–linked National Health Interview Survey (NDI-NHIS) – a nationally representative cohort study of 500,822 adult US males - the suicide rate for service veterans was 26.2 / 100,00 population, and for non-veterans the suicide rate was 18.8 / 100,000. This difference in suicide rates was found to be not statistically significant (i.e. the observed difference is due to random chance variation rather than an actual difference in suicidal behaviors among the two groups). Among veterans who killed themselves, 76% used a firearm, compared to the 62% of non-veterans who kill themselves with a firearm. The authors concluded there was no appreciable difference in the incidence of suicide when comparing service veterans and non-veterans
Another study examined patients withing the VA system during the years 2007-2008. During this period there were 1,920 suicides within this group, including 96 suicides occurring among veterans returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). The study did not find an increased incidence of suicide among veterans returning from OEF/OIF, compared to veterans with no OEF/OIF status. However, among veterans with OEF/OIF status and a diagnosed mental health condition (PTSD, Anxiety Disorder, Depression, etc) the data revealed a greater than four-fold increase in the risk of suicide, compared to veterans without OEF/OIF status. The authors concluded that, as a group veterans returning from OEF/OIF are not at an increased risk for suicide, while there may be smaller sub-groups of veterans with OEF/OIF status that are at higher risk for suicide.
It is estimated that over 900,000 OIF/OEF veterans have separated from military service since the beginning of the wars, with approximately 42% seeking care from the Department of Veterans Affairs (Kang, H. (2009) Analysis of VA Health Care Utilization Among US Global War on Terrorism (GWOT) veterans. Unpublished report, BHA Office of Public Health and Environmental Hazards)
In May, 2013, the Department of Health and Human Services and DoD issued a progress report on their efforts to boost mental health services for military service members, veterans, and their families. Among their cited gains: 1) increasing the capacity of the Veterans Crisis Line by 50 percent to help ensure that Veterans in crisis can readily reach help; 2) establishing pilot projects in seven states combining Va and community-based mental health providers to help Veterans access mental health services in a timely way; 3) increasing VA mental health services capacity through hiring of nearly1,400 mental health providers and over 248 new peer specialists; 4) implementing a national suicide prevention campaign to connect Veterans and Service Members to mental health services.
The President and the DoD are to be applauded for their efforts to prevent and reduce suicide among our veterans and military personnel.
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