Study: Military service lowers suicide risk in people with disability

Key takeaways:

• Veterans with disabilities showed lower suicide risks than nonveterans with disabilities.
• VA disability care or the pride of sacrifice for one’s country could contribute to the “buffering effect.”

Military service could be a protective factor against suicide risk among people with functional disabilities, according to a study.

The cross-sectional study found that while veterans without disability had higher suicide risk than nonveterans, that dynamic was reversed among individuals with disabilities. Veteran status appeared to have a “buffering effect” against suicide risk in individuals with disabilities, Rebecca K. Blais, PhD, and colleagues wrote in JAMA Network Open.

Blais and colleagues used self-reported data of 231,099 U.S. adults from the National Survey on Drug Use and Health from 2015 to 2020. Participants were 8.92% veterans (16% aged 35 to 49 years; 91% men; 78.4% non-Hispanic white) and 91.08% nonveterans (25.4% aged 35 to 49 years; 44% male; 63.3% non-Hispanic white).

Researchers assessed disability status and risk for suicide using a series of yes-or-no questions. They asked whether any physical or emotional condition was leading to difficulty seeing, hearing, concentrating, climbing stairs and other disabilities, as well as whether participants had planned or tried to kill themselves in the past 12 months.

Among participants with no disabilities, veterans were 71% more likely to report planning suicide compared with nonveterans (adjusted OR = 1.71; 95% CI, 1.17-2.49). However, among participants with one disability, veterans had 43% lower odds of planning suicide vs. nonveterans (aOR = 0.57; 95% CI, 0.34-0.95).

Veterans with two disabilities were 54% less likely to have attempted suicide (aOR = 0.46; 95% CI, 0.24-0.88) than nonveterans.

A possible “protective factor” helping veterans could be disability-related care through the Department of Veterans Affairs, which also states its “top clinical priority” is suicide prevention, according to the study.

The researchers noted that a physical disability stemming from military service could serve as “evidence of a sacrifice to one’s country” that is less stigmatized, and more protective against suicide, than “invisible wounds of war” like PTSD. But they urged “caution” with this interpretation, as the study did not compare mental and physical disabilities.

The study called for further research into the reasons behind these associations, particularly interpersonal factors that have been correlated with suicide risk.

Limitations to the study included a lack of data on disability severity and no consideration of how specific types of disability affect suicide risk. Psychiatric comorbidities, aside from depression, also were not considered.