Association of Suicide Risk With Transition to Civilian Life Among US Military Service Members

Ravindran, Chandru; Morley, Sybil W; Stephens, Brady; Stanley, Ian H.; Reger, Mark A.

doi:10.1001/jamanetworkopen.2020.16261

Cited by 52 publications

(53 citation statements)

References 16 publications

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“…While the cause of this increase could be due to several possible reasons (e.g., mental health issues resulting in OTH/G discharge), the current study highlights how this is a population in distress around the time of transition. This finding is echoed in recent findings suggesting that service members with atypical separations (less than 2 years of service) are at increased risk of suicide following separation (Ravindran et al, 2020). The current results suggest that mental health intervention for service members at risk of receiving OTH/G discharge should begin while these personnel are still serving and that a warm hand‐off leading to continued mental health monitoring/treatment should continue following separation.…”

Section: Discussionmentioning

confidence: 86%

“…Transition assistance programs are largely aimed at improving economic and practical issues regarding transition (e.g., employment, housing), but veterans also experience increased psychological risks across this period. A recent study found that suicide rates increased over the initial period of separation and peaked in the second 6 months of this critical year following separation (Ravindran et al, 2020). However, suicide rates did not substantially decrease even after this critical period.…”

Section: Mental Health Surrounding Transitionmentioning

confidence: 99%

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A temporal analysis of mental health symptoms relative to separation from the military

Porter

Carey

Roenfeldt

et al. 2022

Depression and Anxiety

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Background: The transition from military to civilian life is a dramatic change that is often stressful for veterans. However, little is known regarding how mental health symptoms fluctuate in the period leading up to and following separation from the military.Methods: The current study examined posttraumatic stress disorder and depression symptoms reported on surveys completed within 1 year of military separation from 23,887 active duty Millennium Cohort Study participants. A series of general linear models and graphs stratified by demographic and military characteristics examined the association between time until/since separation and mental health symptoms.Results: Character of discharge had the most striking relationship between time until/since separation and mental health. Personnel with Honorable discharges did not differ in their level of mental health symptoms across the study period. In contrast, personnel with Other than Honorable/General discharges reported normal levels of mental health symptoms 1 year-prior to separation but reported progressively greater symptoms leading to separation which persisted through the remainder of study period.Conclusions: This study suggests that additional outreach is needed for personnel with Other than Honorable/General discharges. However, for most other personnel, increased mental health symptomatology around military separation is not a normative phenomenon and any instance should be treated promptly.

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Section: Discussionmentioning

confidence: 86%

Section: Mental Health Surrounding Transitionmentioning

confidence: 99%

A temporal analysis of mental health symptoms relative to separation from the military

Porter

Carey

Roenfeldt

et al. 2022

Depression and Anxiety

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“…Longitudinal studies are of course needed, but if true, structuring preventative efforts to address police contact in veteran populations at younger ages may be particularly important. It is important to note that postseparation, a subset of veterans have elevated risk of adverse outcomes such as suicide (Ravindran et al, 2020). The postseparation period may be a particularly vulnerable time for some veterans, which is consistent with our findings that younger age is associated with police contact.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with police contact in veterans with PTSD.

Camins¹,

Varela²,

Henderson³

et al. 2022

Traumatology

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A small number of veterans commit crimes and become involved in the criminal justice system. Emerging literature identifying empirically supported risk factors suggests that both general (i.e., sociodemographic and mental health) and veteran-specific (e.g., traumatic brain injury [TBI] and combat exposure) factors are associated with veteran aggression and criminal justice involvement. Yet, there is little exploration of risk factors for police contact in veterans with posttraumatic stress disorder (PTSD). Understanding how combat exposure, PTSD, and other factors common among veterans are or are not related to police contact is critical to inform preventative interventions. The current study examined the associations among sociodemographic, mental health, deployment-related factors, and recent police contact in a sample of veterans with PTSD (N = 100) recruited for a larger study on suicide risk. The impact of general (i.e., age, education, income level, substance use) and veteran-specific (i.e., PTSD symptoms, TBI, and combat exposure) factors on past 6-month police contact was examined using a logistic regression model. Only younger age was independently associated with police contact. However, a history of TBI had a trending association (p , .10). In contrast to the literature, combat exposure and PTSD symptom severity were not associated with police contact. The findings suggest initial prevention efforts should focus on younger veterans and those with a history of TBI.

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“…26 While women tend to attempt suicide more often than men, 27 men have a higher risk of suicide mortality. 28,29 Currently, there is a paucity of research assessing the role of sex in SA among veterans with chronic headache with or without TBI.…”

Section: Introductionmentioning

confidence: 99%

Suicide Attempts in US Veterans with Chronic Headache Disorders: A 10-Year Retrospective Cohort Study

Guo¹,

Zhang²,

Sico³

et al. 2021

JPR

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Objectives A large-scale retrospective analysis of veterans with chronic pain was conducted to examine (1) the annual incidence of suicide attempts (SA) in veterans with chronic headache and other chronic pain conditions, and (2) the risk of SA in men and women with chronic headache and chronic headache concurrent with traumatic brain injury (TBI) as compared to non-headache chronic pain. Methods This retrospective study (N=3,247,621) analyzed National Veterans Affair Health Administrative data of patients diagnosed with chronic head, neck, back and other chronic pain from 2000 to 2010. Multivariable Poisson regression was used to explore the relative risks of SA in veterans with chronic headache and chronic headache concurrent with TBI as stratified by sex. Results Veterans with chronic headaches had the highest annual incidence of SA (329 to 491 per 100,000) each year among all identified types of chronic pain conditions. Compared to other non-headache chronic pain, chronic headache is associated with increased risk of SA [men RR (1.48), CI (1.37,1.59); women RR (1.64), CI (1.28,2.09)], after adjusting for demographic factors, TBI, and psychiatric comorbidities. The risk increased further when chronic headache is comorbid with TBI [men RR (2.82), CI (2.60, 3.05); women RR (2.16, CI (1.67–2.78)]. Conclusion Veterans with chronic headache have a higher risk of SA than those with other chronic pain and women with chronic headache are at a higher risk than men with chronic headache. Chronic headache concurrent with TBI further heightened this risk, especially in men. Our data underscore the importance of identifying specific types of chronic pain in veterans with comorbid TBI and sex disparity associated with SA when targeting suicide prevention measures.

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Association of Suicide Risk With Transition to Civilian Life Among US Military Service Members

Abstract: This cohort study investigates the risk factors in suicides that occur after separation from active military service among US veterans.

Cited by 52 publications

References 16 publications

A temporal analysis of mental health symptoms relative to separation from the military

A temporal analysis of mental health symptoms relative to separation from the military

Factors associated with police contact in veterans with PTSD.

Suicide Attempts in US Veterans with Chronic Headache Disorders: A 10-Year Retrospective Cohort Study

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