Veteran Suicide: Risk, Warning Signs & Prevention

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Veteran suicide is a serious problem impacting the United States Armed Forces. According to a 2019 report from the Veterans Affairs Medical Center, the veteran suicide rate is twice as high as non-veterans in the same age group. This alarming statistic highlights the challenging experiences of those who have served our country and emphasizes the need for improved mental health care for veterans in order to reduce suicide rates within the veteran population.1

Veterans’ suicide is an issue that goes beyond statistics and deserves national attention. While the report highlights the alarming prevalence of suicide among veterans, it fails to capture the personal stories of those who have experienced mental health issues and taken their own life.1

The high veteran suicide rates highlight the importance of improving mental health care for veterans. This encompasses veterans’ suicide prevention and providing therapeutic support and coping mechanisms to manage stressors and trauma related to their time in service.1

In this article, we will discuss the risk factors associated with veteran suicide, warning signs to be aware of, and strategies for preventing suicide among veterans.

What are the Causes of Veteran Suicide?

Veteran suicide is a complex issue with no single cause. The risk of suicide among veterans and active duty personnel can increase due to stressors such as military trauma, traumatic brain injury, post-traumatic stress disorder (PTSD), combat experiences, depression, anxiety, substance use disorder (SUD), and chronic pain.2

A lack of access to mental health services, social isolation, and other psychological problems can compound these factors. The suicide rate for veterans is consistently higher than the non-veteran population and has been increasing since 2001.2

There are many risk factors associated with veteran suicide, including:2

  • Mental Health Issues: Being diagnosed with mental illness, such as depression, post-traumatic stress disorder (PTSD), or substance use disorder (SUD), increases the risk of suicide. Mental health problems can lead to feelings of hopelessness and despair which can be difficult to cope with. 
  • Social Isolation: Veterans may feel isolated due to a lack of social support or difficulty connecting with others. Social isolation can lead to feelings of loneliness and alienation, which can make it harder for veterans to reach out for help.
  • Combat Experiences: Exposure to combat can increase the risk of suicide due to PTSD, depression, and other mental health issues.
  • Substance Abuse: Misusing drugs or alcohol can lead to feelings of despair and hopelessness, which can increase the risk of veteran suicide
  • Access To Care: Veterans may struggle to access mental health services and addiction treatment services or have difficulty navigating the healthcare system, leading to a lack of treatment and support.

Understanding these factors is essential in veteran suicide prevention by providing effective treatment and support for veterans struggling with mental health and other issues. Veterans should be encouraged to reach out for help and access the services they need. It is also important to create an environment where veterans feel supported and accepted, which can go a long way in preventing suicide.3

What is the Average Suicide Rate For Veterans?

From 29,580 suicides in 2001 to 45,861 in 2019, suicide rates in the US have risen rapidly. At the same time, suicide rates for veterans increased at a slightly slower rate, rising to 6,261 in 2019 from 5,989 in 2001. While the overall number of veteran suicides fell from 20.2% to 13.7%, the number remains too high, considering veterans make up 6.86% of the nation’s adults.4,5

The veteran suicide rate in 2016 was 1.5 times higher than the suicide rate among other adults when adjusted for gender and age. The number of suicides among veterans in 2019 averaged 17.2 per day. The Veterans Health Administration estimates that 6.8 suicides per day were committed by veterans who had asked the organization for assistance in 2018 and 2019, highlighting the need to address this problem across the board.4

What Are The Risk Factors For Suicide Among Veterans?

Based on available data, veteran suicide rates were higher for active duty personnel, deployed as well as non-deployed, within the first three years following their discharge from active duty. The suicide risk among deployed veterans was lower than that of their non-deployed peers. This may be caused by the fact that veterans struggle to return to daily life after military service.6

The transition from military service to civilian life can be challenging for many veterans. According to a study conducted by the U.S. Department of Veterans Affairs, difficult transitions are associated with an increased risk of veteran suicide. This includes factors such as difficulty adjusting to new roles and responsibilities, mental health issues such as depression and PTSD, feelings of loneliness and isolation, and substance abuse.2, 6

In addition to the difficult transition from military service to civilian life, other risk factors for veteran suicide include:3

  • A personal history of suicidal behavior
  • A family history of depression or suicidal behavior
  • Depression and substance abuse
  • Chronic pain caused by an injury in the line of duty
  • A history of abuse, including physical and sexual violence, in the family.
  • PTSD resulting from life-threatening experiences, scenes of extreme violence, stress, and other traumatic events in the line of duty.
  • The stigma of seeking mental health treatment.
  • Having an argument with a close family member or friend, especially a member of the military.
  • The loss of a loved one, divorce, terminal illness, loss of a job, and many other intense events which can cause psychosocial stress.
  • Taking a life or being a victim of violence.

What are Some Common Warning Signs of Suicide in Veterans?

Veterans are a unique population that often faces a different set of challenges when compared to the general population. As such, it is important to be aware of certain warning signs of suicide so that quick action can be taken to provide appropriate levels of care and support for those veterans in need.7

One common warning sign of veteran suicide is a sudden change in behavior or attitude. This may include speaking often of wanting to die, an increase in risky behaviors, procuring items that can be used for suicide, and a loss of interest in activities that were once enjoyable. Other warning signs of suicide include talking about feeling trapped, withdrawing from friends and family, expressing feelings of hopelessness or worthlessness, amending their will, gifting their possessions, and expressing feelings of guilt or shame.7

Veterans who are showing signs of suicide may be more likely to turn to drugs or alcohol as a form of self-medication. They may also become very agitated, especially when faced with life’s challenges. This can include outbursts of anger or aggression that are out of character for them.7

Other warning signs of suicide among veterans may include:7

  • Expressing feelings of hopelessness or purposelessness.
  • Being easily agitated or experiencing bouts of anxiety.
  • Frequent and sudden mood changes.
  • Sleep deprivation or disturbed sleep patterns.

It is important to note that all veterans have unique experiences, and there may be additional warning signs that are not listed here.7

How are Substance Abuse and Suicide Among Veterans Linked?

Substance abuse is one of the leading causes of veteran suicide in the United States. The substance abuse problem among veterans is more complex than just a single cause, as veterans are exposed to numerous traumatic experiences that can lead to substance misuse and addiction, including combat-related trauma, post-traumatic stress disorder (PTSD), other mental health issues, and social isolation. When veterans suffer from substance abuse in addition to these other conditions, it can lead to a cycle of worsening mental health, physical health, and even suicide.2

Studies have shown that veterans with PTSD are more likely than those without the disorder to misuse alcohol or drugs. Substance abuse can trigger underlying mood disorders and other mental health conditions, leading to a greater risk of veteran suicide. In addition, substance abuse can lead to isolation from friends and family, further exacerbating the veteran’s struggles with PTSD and other mental health problems.2 

According to a study published in the National Library of Medicine in 2017, alcohol or drugs have been involved in 30% of veteran suicide cases since 2003. Furthermore, veterans with a substance abuse disorder have a higher risk of death by suicide than those without an addiction problem. Substance abuse can also lead to legal and financial issues, which can cause additional stressors that could increase the veteran’s risk for suicide.8

Veterans And Mental Health Care

Veterans face a unique set of mental health challenges. Research has shown that veterans are more likely than non-veterans to suffer from certain psychiatric mental health disorders, such as post-traumatic stress disorder (PTSD), anxiety, and depression, which are all warning signs of suicide among veterans.2

Military service can be an incredibly difficult experience for many veterans, resulting in physical and mental health challenges that require specialized care. For example, veterans may have difficulty adjusting to civilian life after deployment or struggle with the emotional effects of war trauma. Additionally, they may also face other issues, such as substance use problems caused by self-medication, or difficulties with interpersonal relationships.2

Research indicates that approximately 3.1 million veterans experienced mental health issues in 2019. A staggering 833,000 veterans reported serious mental health disorders, but 26.8% did not receive any mental health care or treatment. In addition, a staggering 85% of the 1.3 million veterans with SUD never received substance abuse treatment.9

How can we Determine Risk Factors for PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur after experiencing or witnessing a traumatic event. It often includes symptoms such as intense fear, flashbacks, nightmares, difficulty sleeping, and avoidance of certain situations or people. While PTSD can happen to anyone who experiences trauma, veterans are especially at risk for developing the disorder due to their experiences in the military.10

There are several risk factors that increase a veteran’s likelihood of developing PTSD, such as:10

  • Being exposed to extreme violence or combat-related stressors.
  • Having experienced a physical or sexual assault.
  • Experiencing a traumatic event in childhood before joining the military.
  • Having a personal or family history of mental illness.
  • Experiencing social isolation or loneliness. 
  • Engaging in heavy alcohol and/or substance use.

Post-traumatic Stress Disorder can increase the risk of veteran suicide by impairing a veteran’s ability to cope with the difficult emotions associated with trauma and war-related stressors. Studies have found that veterans with PTSD are more likely to experience suicidal ideation, which is when someone has ongoing thoughts of death or suicide.2

Choosing The Right Treatment Option For Veterans Suicide Prevention

Veterans’ suicide prevention is a serious issue and requires comprehensive treatment plans that address both mental health and any underlying trauma or addiction. The most common veterans suicide prevention treatment includes mental health and substance abuse counseling, psychotherapy, and medication management. Depending on the individual’s needs, a combination of these treatments may be necessary for effective suicide prevention.4

There are several veteran suicide prevention treatment options available, including:11

  • Inpatient care provides a safe and structured environment for veterans to recover from suicidal thoughts and receive treatments like cognitive behavioral therapy, dialectical behavior therapy, group counseling, and support groups. Treatment can also include safe medical detox, medication management, environmental changes such as anger management techniques or occupational therapy, dual diagnosis or co-occurring disorder treatment,  family therapy, and other methods to help them cope with their mental health issues.
  • Outpatient treatment may be recommended for veterans who are able to manage daily activities but may require more intensive treatment and/or support. Treatment options can include one-on-one counseling with a therapist, group therapy, anger management classes, substance abuse rehabilitation programs, peer mentoring, or support groups. Medication management may be recommended if needed.

In addition to certain treatments available at inpatient and outpatient facilities, the Department of Veteran Affairs also offers other resources to help prevent veteran suicide. These include 24/7 crisis lines, access to mental health support, resources for finding employment and housing, substance abuse programs, and other services that can help address underlying issues that may be contributing to a veteran’s mental health struggles.12,13

The Mission Act, passed in 2018, is an important part of veterans’ care. This legislation aimed to overhaul and improve the Veteran’s Affairs health care system by providing more access to mental health care for veterans. The main focus of the Mission Act was to provide greater access to care through more options available to veterans. This includes expanding the Choice program, which allows veterans to receive care from providers outside of the VA system and insurance plans such as Tricare. This can be beneficial for veterans who live in rural areas or are unable to access the same quality of care from a VA facility.14

Through the mission act, veterans may be eligible to join a program such as the Salute to Recovery. This program is specifically designed for veterans who struggle with substance abuse and suicide risk issues. It was developed, developed, and managed by veterans who have recovered from substance abuse issues. Veterans’ recovery communities provide support and guidance as the program uses evidence-based methods of treatment. The admissions navigator teams at one of the American Addiction Center’s facilities that offer this program may be reached out via their substance abuse hotlines, where veterans may get help verifying their insurance coverage, getting additional details on the admissions process, and more.

How to Connect to a Veterans Suicide Hotline?

A veteran suicide hotline is a toll-free, confidential helpline that provides free and anonymous support to veterans who are struggling with suicidal thoughts or feelings. Veterans’ suicide hotlines provide veterans with a safe space to talk about any issues they may be facing and connect them to resources that can help.13 

Reaching out for help can be scary, especially if you’re a veteran. But it’s important to remember that the people answering the phone on these hotlines are there to listen and provide support and resources. Here’s how to connect with a veteran’s suicide hotline:13

  1. Call the Veterans Crisis Line at 988, then press 1. The Lifeline operates 24/7 and is staffed by trained professionals who can provide information, resources, and referrals to local veterans crisis centers. 
  2. Reach out for help online. The Veterans Crisis Line website provides a web chat option that allows veterans to connect with a counselor in real time anonymously.
  3. Text 838255 to connect with a crisis counselor through the Veterans Crisis Line.
  4. Contact the VA for more information about local resources and services, such as support groups, counseling, or mental health treatment options.

If you or someone you know is having thoughts of suicide, it’s important to reach out for help right away. Veterans’ suicide hotlines provide an invaluable resource for those in need, so don’t hesitate to reach out and get the support you need.13

Frequently Asked Questions