Veteran Suicide Risk and Prevention
There is frequent attention in the media concerning suicide among veterans, and sadly, many veterans do die by suicide. Many factors increase a veteran’s risk of completing suicide, including substance abuse and post-traumatic stress disorder (PTSD).
Veteran Suicide Statistics
In 2017, approximately 6,100 veterans died by suicide. This number represents about 13% of all suicides in the United States that year.
The overall rate of suicide among veterans is 1.5x greater than that of the civilian population. In addition, over 900 members of the National Guard and military reserves who were never federally activated died by suicide in 2017. 1
The number of suicides among veterans has risen above 6,000 every year since 2008. Adult veterans aged 18-34 were the most likely group to commit suicide, and the rate of suicide among this age group has increased an alarming 76% between 2005 and 2017. 1
These statistics represent a grim reality among veterans. There is no one cause of veteran suicide, nor is there one single solution to preventing it.1 However, there is hope for veterans. Quality mental health and substance abuse treatment can significantly reduce a veteran’s suicide risk.
Veterans Suicide Risk Factors
Risk factors for suicide in veterans include: 2,3
- A prior suicide attempt.
- Having killed someone in combat.
- Mental health disorders.
- Access to lethal means, such as a firearm.
- A serious, negative life event, such as a divorce.
- Coping with injuries from military service.
- Leaving military service and entering civilian life.
Suicide Prevention Techniques
While there are certainly numerous risk factors for veteran suicide, there are also preventive factors that help reduce the risk of suicide for vets. These include:2
- Good coping skills.
- Being able to easily access mental health services.
- Having a sense of purpose in life.
- Strong positive connections with others.
- A sense of connection to one’s military unit.
Substance Abuse, Mental Health, and Suicide in Veterans
Substance use and mental health disorders are a risk factor for suicide in veterans. 1.5 Nearly 60% of veterans who died by suicide in 2017 and who had recently utilized the Veterans Health Administration had a diagnosed mental health disorder or substance use disorder. 1
Poor mental health is associated with both substance use and suicide. 5 Substance use may play a uniquely important role in the suicide risk of a veteran with a mental health issue. Research shows that, for veterans with PTSD, an additional diagnosis of depression did not increase suicide risk; however, an additional substance use disorder diagnosis did. 5
Opioids are particularly problematic for veterans. A recent study found that opioid use was associated with an increased risk of suicide in veterans. Veterans who took higher doses of opioids were twice as likely to die by suicide than veterans who took lower doses of opioids.4 Veterans diagnosed with opioid use disorder are among those with the highest suicide rates.1
PTSD and Suicide
PTSD has been strongly linked to suicide among both veterans and civilians, as one study showed that the rate of suicide is 13x higher in individuals who suffer from PTSD than in those who don’t. 6 PTSD was also associated with a 6 to 13 times greater risk of suicide among active duty service members. 6
PTSD is a mental health disorder that may result when a person experiences or witnesses a traumatic situation, such as a violent assault.9 The exposure of veterans to combat violence is linked to the development of PTSD, but other traumatic experiences in the military can lead to PTSD, such as seeing soldiers killed in combat or experiencing sexual violence in the course of military service.10
PTSD has been even more strongly linked to increased suicide risk in veterans when PTSD co-occurs with a substance abuse disorder.
The Veterans Affairs Administration (VA) offers an online tool, PTSD Coach, that can help you or a loved one cope with trauma and symptoms of PTSD.
When seeking help for a veteran, getting them into treatment quickly is crucial. The VA proposes the S.A.V.E. approach for helping someone you believe to be suicidal. SAVE stands for:8
- S-signs of suicide.
- A-ask (questions).
- V-validate. Acknowledge how they feel and offer help.
- E-encourage treatment and expedite getting help.
Starting with “S,” the signs to look for include the following:7
- Verbal statements, such as “I’d be better off dead,” or “No one cares if I die.”
- Evidence of searching the internet for such things as ways to commit suicide.
- Buying guns, obtaining medications, or obtaining other methods for suicide.
- Updating a will or asking others to take care of one’s children, pets, or parents.
- Telling people good-bye.
- Giving away possessions.
Indirect signs of potential suicidal actions may include the following: 7
- Substance abuse.
- Mood swings.
- Statements of feeling hopeless.
- Finding no purpose in life.
- Engaging in high-risk behaviors.
- Feelings of guilt and shame.
- Withdrawing from friends and family.
Moving on to “A,” you can ask direct questions of the person including: “Are you thinking of killing yourself?” Asking someone if they are suicidal will not put the idea in their head and increase their risk. Instead it can serve as a starting point for helping them.
The next step is “V”: validate. You can help to validate a person’s experiences and feelings by listening actively, accepting their situation and feelings, avoiding any judgement, letting them know their situation is serious and deserving of help and that you are here to assist them in getting that help.
The last letter, “E,” represents the active step of encouraging treatment and expediting help. Explain that there are options for them to get help, discuss those options, and try to assist them in accessing that help right away.
Veterans’ Substance Abuse and Mental Health Treatment
PTSD and veteran substance abuse are linked to an increased risk of suicide. Getting treatment for substance abuse and mental health disorders can be lifesaving.
The VA offers numerous treatment options, including VA rehab programs for mental health, which offer numerous services, including VA inpatient rehab. The VA also identifies numerous other resources for veterans or families who need help.
If you’re unsure whether you or someone you love needs professional help, the VA offers a confidential online assessment to evaluate anxiety, substance use, and PTSD.
If you do not live near a VA rehabilitation center, or the VA near you has a waiting list, you can also obtain treatment through a community care provider. Such providers have agreements in place with the VA to provide services to veterans when they cannot get timely treatment at their local VA rehab program.
If you or your loved one is a veteran in immediate crisis, you can call the crisis hotline 24/7 for immediate help at 1-800-273-8255 and press 1, text to 838255, or chat online at VeteransCrisisLine.net/Chat.
You can also call Sunrise House to discuss how to get into treatment for substance abuse and co-occurring mental house disorders immediately. Our parent company, American Addiction Centers, offers a veterans program, Salute to Recovery, at 2 authorized community care providers located in Las Vegas, Nevada and Hollywood, Florida.
- U.S. Department of Veteran Affairs. (2019). 2019 National veteran suicide prevention annual report.
- U.S. Department of Veteran Affairs. National strategy for preventing veteran suicide.
- Maguen S., Metzler T.J., Bosch, J., Marmar, C.R., Knight, S.J., Neylan, T.C., (2012) Killing in combat may be independently associated with suicidal ideation. Depression and Anxiety. 29(11), 918‐923.
- Ilgen, M. A., Bohnert, A. S., Ganoczy, D., Bair, M. J., McCarthy, J. F., & Blow, F. C. (2016). Opioid dose and risk of suicide. Pain,157(5), 1079.
- Chapman, S. L., & Wu, L. T. (2014). Suicide and substance use among female veterans: a need for research. Drug and Alcohol Dependence,136, 1–10.
- Gradus, J.L. (2017). PTSD and death from suicide. PTSD research quarterly.
- U.S. Department of Veteran Affairs. Suicide prevention. A guide for military and veteran families.
- U.S. Department of Veteran Affairs. Operation SAVE.
- National Institute of Mental Health, (2019). Post-Traumatic Stress Disorder.
- U.S. Department of Veterans Affairs. (n.d.). Types of Trauma.