Suicidal behaviors common in U.S. veterans, yet most receive no mental health care
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Study results published in Journal of Clinical Psychiatry indicated that suicidal behaviors were common among U.S. veterans, especially among young veterans.
However, researchers noted that nearly two-thirds of veterans who had current suicidal ideation were not receiving mental health treatment.
“A significant body of literature has characterized the prevalence and correlates associated with suicidal behavior (eg, suicidal thoughts, plans and attempts) among veterans,” Brandon Nichter, PhD, of the department of psychiatry at the University of California San Diego, and colleagues wrote. “Collectively, this work suggests that the prevalence of suicide-related outcomes varies considerably depending on a host of methodological factors, such as the timeframe and specific population studied (eg, age group). Recent prevalence estimates range from 6% to 15% for past-2-week suicidal ideation, 5.9% to 13.7% for lifetime suicide planning and 1.7% to 9.5% for lifetime suicide attempt.”
According to the researchers, data are sparse regarding the prevalence and correlates of suicidal behaviors among the general U.S. veteran population. To address this research gap, they analyzed data of 4,069 U.S. veterans who participated in the National Health and Resilience in Veterans Study, a representative survey conducted between 2019 and 2020. In the analyses, the researchers estimated the prevalence of current suicidal ideation, lifetime suicide plans and lifetime suicide attempts; pinpointed related sociodemographic, military, DSM-5 psychiatric and other risk correlates; and assessed mental health treatment utilization among veterans with suicidal ideation, suicide plans or suicide attempts.
Results showed prevalence rates of 9%, 7.3% and 3.9% for current suicidal ideation, lifetime suicide plans and lifetime suicide attempts, respectively. Veterans aged 18 to 44 years were most likely to report suicidal behaviors, with 18.2%, 19.3% and 11.1%, respectively, endorsing suicidal ideation, suicide plans and suicide attempts.
The researchers noted the strongest correlates of suicidal ideation suicide plans were major depressive disorder, age, PTSD and adverse childhood experiences. The strongest correlates of suicide attempts were MDD, age, alcohol use disorder and adverse childhood experiences.
A total of 35.5% of veterans with current suicidal ideation reported being engaged in mental health treatment. A total of 54.7% of those who used the U.S. Veterans Administration as their primary source of health care engaged in mental health treatment compared with 23.8% of VA non-users.
“These findings underscore the importance for future research to better understand how to treat complex comorbidities, such as PTSD/MDD and PTSD/MDD/AUD to mitigate suicide risk, particularly among young veterans,” Nichter and colleagues wrote.
They also highlighted the importance of testing suicide-specific interventions.
“There is a dire need to test whether integrating brief suicide-specific interventions (ie, crisis-response planning) into existing trauma-focused treatments may enhance their effectiveness for reducing risk for suicidal behavior among military service members, veterans and other at-risk populations,” they added.