Study Examines Suicidal Ideation among Post-9/11 Veterans Recently Separated from Military Service
The transition from military service to civilian life may result in Veterans experiencing a loss of sense of self and purpose, as well as stress associated with re-establishing or redefining occupational, social, and recreational roles. Men and women Veterans are at 13% and 15% increased odds of experiencing lifetime suicidal ideation (SI), respectively, compared to their non-Veteran peers. While most who experience SI do not die by suicide, it has been identified as one of the strongest risk factors for suicide and is an important sign that help is needed even when it does not lead to suicide. This study sought to empirically identify unique trajectories of change in SI frequency among a sample of post-9/11 Veterans (7,823 men and 1,743 women) during the first three years after their separation from military service. Study participants were asked to complete an online survey at six timepoints: baseline (within 90 days of separation) and at about 9, 15, 21, 27, and 33 months post-separation. A total of 3,733 Veterans completed all surveys. Measures included frequency of suicidal ideation, demographics, and military service characteristics.
- The majority of Veterans do not experience substantial SI in the first three years after service (90%), demonstrating that most Veterans are resilient to this experience and suggesting that suicide-focused interventions should be targeted for the minority of Veterans with symptomatic trajectories (10%).
- Three symptomatic SI trajectories, that were similar across genders, were identified: delayed onset (low initial SI that increased with time; 5%), remitting (moderate-to-high initial SI that decreased with time; 3%) and chronic (moderate-to-high SI throughout the study time period; 2%).
- Key correlates of symptomatic SI trajectories included: younger age, racial/ethnic minority groups, other than honorable or medical separation, enlisted rank, and early connection with VA healthcare.
- Continued service in the National Guard/Reserves and officer rank were associated with lower odds of assignment to a symptomatic trajectory.
- Understanding trends and drivers of SI during the military transition period can inform: 1) treatment of SI itself, to reduce Veterans’ distress and improve health and functioning during this challenging time; and 2) upstream suicide prevention services for reintegrating Veterans.
- While not including mental health and trauma history predictors in this analysis may be viewed as a limitation, this decision was guided by the current state of knowledge about Veterans’ experiences of suicidal ideation as they separate from service.
This study was funded by HSR&D (IIR 19-374). Dr. Hoffmire is part of the VISN 19 Rocky Mountain MIRECC. Drs. Vogt and Borowski are part of the National Center for PTSD. Dr. Vogt is also with HSR&D’s Center for Healthcare Organization & Implementation Research. Dr. Maguen is with VA San Francisco Health Care. Dr. Griffin is with HSR&D’s Center for Mental Healthcare and Outcomes Research.
Hoffmire C, Borowski S, Griffin B, Maguen S, and Vogt D. Trajectories of Suicidal Ideation Following Separation from Military Service: Overall Trends and Group Differences. Suicide & Life-Threatening Behavior. January 23, 2022; online ahead of print.