Suicide Prevention

By Emily Winter, LCSW, CADC

September is Suicide Prevention Awareness Month, an initiative aimed at raising awareness and fighting the stigma surrounding this complex issue. Suicide prevention is an ongoing effort, but this dedicated month provides a time to come together with passion and energy to tackle the challenges. As we recognize National Suicide Prevention Month, it's crucial to bring attention to the ongoing epidemic affecting our veterans and take action to provide support. Numerous veterans face challenges reaching out and seeking mental health services due to the negative perception attached to asking for help. This can have severe consequences for veterans, their families, and the communities they are a part of. Talking openly about mental health and suicide can benefit everyone, as even a single conversation can save a life. This month, we aim to change public perception, inspire hope, and share important information with those affected by suicide.

The factors contributing to suicidal ideation among veterans in the United States are complex. Despite the diverse demographic makeup of this population, research has established a strong correlation between suicide and untreated or undertreated substance abuse disorders and mental health conditions that often stem from their military service. Additionally, ongoing stressors like financial difficulties, legal issues, and relational problems play a significant role in this phenomenon. Upon leaving military service, veterans face a heightened susceptibility to suicide, not only in the immediate aftermath but also over the course of their lifetimes. This is due to a combination of factors, including a challenging transition to civilian life, which can result in increased suicidal ideation and attempts and a deterioration of mental health and social functioning.

The 2022 National Veteran Suicide Prevention Annual Report offers a comprehensive analysis of veteran suicide data from 2001 to 2020, providing valuable insights. Additionally, this report is the first to examine the impact of the COVID-19 pandemic on veteran suicide during its early stages. The VA's annual report on veteran suicide shows promising changes, with a decrease in both the numbers and rates of suicides. However, there’s still a need for continued efforts in this area. In 2020, the suicide rate among US veterans was 31.7 per 100,000. This number is not adjusted for any factors. However, when taking into account age and sex, it was found that the suicide rates for veterans were at their highest in 2018, before decreasing in 2019 and 2020. After adjusting for age and sex, the suicide rate for veterans decreased by 9.7% in the two years following 2018. From 2019 to 2020, the suicide rate among veterans decreased by 4.8% when adjusting for age and sex. During this same time period, nonveteran US adults saw a 3.6% decrease in their adjusted suicide rate. Between 2019 and 2020, the suicide rate among male veterans decreased by 0.7%, while the suicide rate among female veterans decreased by 14.1%. In comparison, the suicide rate among nonveteran men decreased by 2.1%, and among nonveteran women, it decreased by 8.4%. There’s no evidence to suggest that the COVID-19 pandemic influenced veteran suicide mortality when compared with trends in veteran suicide and COVID-19 mortality across various veteran demographic and clinical subgroups throughout 2020. In 2020, there were 6,146 veteran suicides—343 less than the previous year.

It’s concerning that the suicide rate among veterans is significantly higher compared with nonveterans, and this gap remains despite a recent decline in the rate among veterans. The suicide rate among veterans had increased consistently from 2001 to 2018, before declining at a faster rate compared with nonveterans from 2018 to 2020. This disparity could be attributed to differences in experiences and circumstances between the two groups. For instance, veterans are more likely to have experienced childhood trauma, such as physical or emotional abuse, bullying, or sexual assault. Additionally, the exposure to situations during their military service, such as combat or morally ambiguous circumstances, may increase the likelihood of suicidal thoughts or actions.

Preventing suicide among veterans is a crucial task that necessitates raising awareness of the availability of assistance and the fact that they are not alone. It is a disservice to veterans and others who may suffer silently to neglect mental health treatment and social and economic stressors. It’s necessary to close the gap between honoring veterans and taking practical steps to end this national crisis and to work together to ensure that veterans receive the support and resources they need.

If you or someone you know is having thoughts of suicide, contact the Veterans Crisis Line to receive free, confidential support and crisis intervention. It's available 24 hours a day, seven days a week, 365 days a year. Dial 988, press 1, chat online at VeteransCrisisLine.net/Chat, or text 838255.

— Emily Winter, LCSW, CADC, has a Master of Science in Social Administration from Case Western Reserve University and is a doctoral candidate at the University of Kentucky College of Social Work. Her dissertation is focused on the biopsychosocial implications of chronic PTSD in female veterans. She’s also an LCSW at the VA in Maine and an adjunct professor for the University of Massachusetts' MSW program.