Contribution of veterans' initial post‐separation vocational, financial, and social experiences to their suicidal ideation trajectories following military service

Abstract

Background Veterans' success with navigating the challenges of transition from military service may contribute to their risk for suicidal outcomes. The concept of well‐being can help to conceptualize and assess successful navigation of reintegration challenges and may serve as an optimal target for public health‐oriented suicide prevention. Methods The relationship between US veterans' psychosocial well‐being and experiences of suicidal ideation (SI) during the first 3 years following military separation was evaluated using multinomial logistic regression predicting SI trajectories over time in a population‐based, longitudinal, post‐9/11 veteran cohort. At 3‐months post‐separation, veterans reported on their socio‐material conditions, functioning, and satisfaction with respect to vocational, financial, and social domains. SI frequency was assessed at 3‐, 9‐, 15‐, 21‐, and 27‐months post‐separation using the Patient Health Questionnaire‐9. Results Veterans' vocational, financial, and social well‐being were associated with their SI trajectories, even after accounting for mental health. Socio‐material conditions, functioning, and satisfaction all emerged as important predictors of SI trajectories, although results varied across domains. Effects were largest for social well‐being. Conclusions Suicide prevention efforts may benefit from a holistic approach that considers veterans' needs for support across their vocational, financial, and social well‐being, inclusive of their socio‐material conditions, functioning, and satisfaction within each domain.

Situational stress and suicide attempt behavior in Army soldiers and veterans: Insights from the Army Study to Assess Risk and Resilience in Servicemembers‐Longitudinal Study

“…Using a large sample of Army soldiers and veterans and longitudinal study design, the current study addresses this gap in the literature. Findings contribute to a growing body of literature attesting to the vulnerability of transitioning veterans to situational stress and suicide-related outcomes (Kline et al, 2011;Ravindran et al, 2020;Shen et al, 2016;Sokol et al, 2021) and to the likely role of situational stress in driving suicide-related outcomes within this subgroup of military personnel (Chu et al, 2022;Haller et al, 2016;Hoffmire et al, 2023;Interian et al, 2012;Kline et al, 2011;Sayer et al, 2010).…”

“…Those experiencing the greatest levels of situational stress during transition tend to perceive overall greater difficulties readjusting to civilian life, have greater struggles with mental health and/or substance use disorders, be more likely to seek mental health services, and be at greater risk for suicidal ideation than those experiencing lesser levels of stress (Haller et al, 2016;Interian et al, 2012;Kline et al, 2011;Sayer et al, 2010). Relatedly, in a study of nearly 10,000 recently discharged veterans, vocational, financial, and social well-being throughout the transition period were significantly associated with trajectories of postdischarge suicidal ideation such that high well-being was associated with low or remitting suicidal ideation, and low well-being was associated with greater persistence of suicidal ideation (Hoffmire et al, 2023). A recent investigation into newly discharged veterans also suggested recent exposure to situational stressors may be key to improving prediction models of suicide attempt behavior following discharge.…”

The Well-Being of Student Veterans: A Feasibility Study Using the Well-Being Inventory in the Academic Setting

“…SV are at a higher risk of mental health disruptions due to the complex health needs associated with their time in the service, often because of traumatic injuries (Hinkson et al, 2021;Hoffmire et al, 2023). According to Dyar (2019), complex health needs in veterans can be defined as a combination of physical and psychological conditions such as PTSD, anxiety, depression, insomnia, alcohol or substance misuse, and suicidal thoughts or attempts.…”

The impact of stress and well‐being during the COVID‐19 pandemic on mental health in U.S. veterans

“…Past research suggests that well-being is lower among veterans with diagnosed MH conditions (Blakey et al, 2022) and more severe MH symptoms (Mitchell et al, 2023;Vogt et al, 2021). There also is evidence to suggest that veterans' initial post-separation well-being predicts their subsequent trajectories of suicidal ideation (Hoffmire et al, 2023). The COVID-19 pandemic had a negative impact on veteran well-being (Kelly et al, 2022;Reilly et al, 2022); however, previous research has not typically investigated multiple domains of well-being or considered the associations between well-being and MH outcomes.…”