Suicide Attempt Characteristics Among Veterans and Active-Duty Service Members Receiving Mental Health Services: A Pooled Data Analysis

Abstract

Past suicidal behaviors are among the strongest and most consistent predictors of eventual suicide and may be particularly salient in military suicide. The current study compared characteristics of suicide attempts in veterans (N = 746) and active-duty service members (N = 1,013) receiving treatment for acute suicide risk. Baseline data from six randomized controlled trials were pooled and analyzed using robust regression. Service members had greater odds of having attempted suicide relative to veterans, though there were no differences in number of attempts made. Service members also had higher rates of premilitary suicide attempts and nonsuicidal self-injury (NSSI). Veterans disproportionately attempted suicide by means of overdose. In veterans, combat deployment was associated with lower odds of lifetime suicide attempt, while history of NSSI was associated with greater attempt odds. Neither was significantly associated with lifetime suicide attempt in service members. Implications for suicide assessment and treatment are discussed.

The Military Suicide Research Consortium Common Data Elements: An Examination of Measurement Invariance Across Current Service Members and Veterans

“…Suicide rates within the U.S. military are elevated (Kuehn, 2009; Ramchand et al, 2011), and converging evidence indicates that suicide risk is not evenly distributed within the U.S. military, including across current service members and veterans (Villatte et al, 2015) and younger and older veterans (Kaplan et al, 2012). The assessment of suicide thoughts and behaviors, as well as suicide-related conditions, has been identified as a critical suicide prevention priority (Hoge & Castro, 2012; U.S.…”

“…An important consideration within the U.S. military is potential differences in suicide risk characteristics between current service members (i.e., active duty, Reserves, National Guard) and veterans (i.e., separated from service). One study of active duty service members ( n = 1,013) and veterans ( n = 746) receiving treatment for acute suicide risk found that active duty service members were 24% more likely to report a lifetime suicide attempt than veterans (Villatte et al, 2015). Active duty service members were also more likely than veterans to have a history of at least one premilitary suicide attempt (Villatte et al, 2015).…”

“…One study of active duty service members ( n = 1,013) and veterans ( n = 746) receiving treatment for acute suicide risk found that active duty service members were 24% more likely to report a lifetime suicide attempt than veterans (Villatte et al, 2015). Active duty service members were also more likely than veterans to have a history of at least one premilitary suicide attempt (Villatte et al, 2015). Furthermore, the suicide rates for the Reserves and National Guard may be accounting in part for the overall suicide rate increase observed within the military (Franklin, 2016).…”

“…Connection to the military (i.e., current vs. veteran) may also be an important distinction. Given potential differences in mental health characteristics between current service members and veterans (Villatte et al, 2015) and younger and older veterans (Kaplan et al, 2012), and given that the MSRC CDEs are administered across studies that are inclusive of both current service members and veterans, it is important to examine how the MSRC CDEs operate across these groups.…”

Expanded Roles and Recommendations for Stakeholders to Successfully Reintegrate Modern Warriors and Mitigate Suicide Risk

“…For example, these stressors are not only highly correlated with psychological problems (i.e., PTSD, depression and alcohol dependence), but lead to the 5.4 times higher odds of suicidal ideation found among MWs experiencing the highest number of reintegration stressors ( Kline et al, 2011 ). As may be expected, the increased suicide ideation/attempts are not limited to those with a prior suicide attempt history; most MWs who attempt suicide make their first attempt after military separation ( Villatte et al, 2015 ).…”