Suicidal thinking and US veterans
Something very personal about me, the thought of suicide is never too far behind. It is to the point that I need to qualify it to my counselor when I am asked if I have thoughts of suicide, I always do. A new study shows that I am far from alone Nearly 14 percent of military veterans reported suicidal thinking at one or both phases of a two-year Veterans Affairs (VA) study.
More than 2,000 U.S. veterans were surveyed twice as part of the National Health and Resilience in Veterans Study, ask around we are a tough bunch and sometimes even tougher to know. The survey was first conducted in 2011 and again in 2013. Each time, the veterans were asked whether they had experienced suicidal thoughts in the past two weeks.
They also answered a host of other questions, which was important to determine the factors associated with suicidal thinking. About 86 percent of the veterans denied having any such thoughts, both times they were asked. I will be first to call BS, we are a tough bunch, but it is sometimes to the point that we refuse to admit we need help. If you need more proof than my word, look at veteran suicide statistics.
Like myself, about 5 percent had “chronic” suicidal thinking, this is defined a little differently than you might think though. These veterans reported suicidal thoughts in the past two weeks both times they were surveyed, two years apart. Nearly 4 percent had “remitted” suicidal thinking: They reported suicidal thoughts in the first questionnaire but not the second. Conversely, about 5 percent reported such thoughts only during the second survey.
Combined, 13.7 percent of the total sample reported suicidal thinking at either or both time points. While this is probably low, it at least, gives some sort of baseline and more importantly, a window into the lives of veterans in general.
It’s difficult to compare this prevalence rate to that of U.S. adults in general. Studies on suicide vary widely in their methods–for example, how questions are worded, and the time frames they cover and studies often focus on particular age brackets or other subgroups.
For a general reference point, a study by the Centers for Disease Control and Prevention, published in 2011, in which 3.7 percent of U.S. adults reported having suicidal thoughts in the past year might be a good place to start. However, even by that yardstick, the rates in the new study are high.
“Our results … highlight the dynamic nature of [suicidal ideation],” write the researchers, “as evidenced by the meaningful proportion of U.S. veterans reporting changes in suicidal ideation over time.”
Thankfully, the study underscores the need for ongoing periodic monitoring–not just a one-time screening. Also, among those veterans who reported suicidal thinking only at wave 2, 65 percent had never engaged in any mental health treatment. While I can say this is not shocking, the researchers say this is another finding that points to the need for more outreach.
Not surprisingly, higher levels of psychiatric distress, physical health problems, and substance use history predicted chronic suicidal thinking and again this is a duh moment for anyone who is a veteran.
Social connectedness–widely seen as a major buffer against suicide risk–emerged in the study as a factor associated with the remission of suicidal thinking. By the same token, veterans who reported less social support at wave 1 were also more likely to report the onset of suicidal thinking at wave 2.
However, for many of the veterans reporting chronic suicidal thinking, social support did not appear to help that much. Speaking for myself, it is hard to connect to other people that have no idea what it is like to fight in a war, what are you going to talk about and how the hell do you explain your issues? How is social support going to help when no one can relate? The researchers say that for these veterans, addressing psychiatric and physical health, and substance use problems, may be more critical.
The study has several different limitations, as does any study really. Because so many people dropped from the first survey to the second, it would not be surprising to think that they were worse off and this has a likelihood of increasing the rate of suicidal thinking in the second survey.
Smith, N., Mota, N., Tsai, J., Monteith, L., Harpaz-Rotem, I., Southwick, S., & Pietrzak, R. (2016). Nature and determinants of suicidal ideation among U.S. veterans: Results from the national health and resilience in veterans study Journal of Affective Disorders, 197, 66-73 DOI: 10.1016/j.jad.2016.02.069
This entry was posted on April 5, 2016 by Dr. Jekyll. It was filed under Politics, Psychology and was tagged with anxiety, behavioral science, depression, lifestyle, Mental Health Stuff, military, post traumatic stress, social science, veterans.