Chris, Sue, Amir, and Hector are US veterans, and they are experiencing significant problems. No, not because they chose to spend years in the military for relatively low pay, or because they are having challenges trying to determine the kind of work to which they are best suited in the civilian world. Decidedly, those are tough issues, but they are not the primary concerns that these, and many veterans like them, are experiencing. Chris, Sue, Amir, and Hector are wrestling with whether life as they experience it today is worth living anymore, and they don’t seem to have any good answers to that question. Indeed, each of them could well be tomorrow’s heart-rending story in our local newspapers.
Army Col. Carl Castro, PhD, who researches suicide prevention and treatment, has said that “The core of the issue is that it’s not that people who attempt suicide … want to harm themselves as much as they want the pain they’re currently in to stop, and they don’t see any other way out”.1 Recent research by the Military Suicide Research Consortium shows that when asked why they tried to kill themselves, military individuals indicated that out of 33 answer choices one particularly resonated: the desire to end intense emotional distress.2 Something is indeed pushing veterans in particular to end their lives, with their rate of suicide currently 1.5 times that of their age contemporaries in the greater society.3
Additional studies suggest that other significant issues also contribute to the rise in severe mental health crises facing veterans today: multiple side effects of both prescribed and illicit drugs, lack of family and intimate relationships, the COVID-19 pandemic and its overall implications, underlying psychological challenges, and, unsurprisingly, post-traumatic stress disorder (PTSD).4 PTSD is particularly experienced by a subset of those who are engaged in or who witness traumatic events, such as in combat. Importantly, the incidence of PTSD is over twice as high among women veterans as men,5 suggesting that the well-documented sexual abuse and violence in military life adds significantly to mental health issues.
New or lesser-known factors contributing to mental health crises include the negative impact of cyberbullying and social media (for which the military says it is now creating new policies), as well as the high rate of divorce and separation affecting service members and veterans.6 Recent research shows the divorce rate among members of the US military is almost twice the average national divorce rate.7
Regardless of the cause, there are clear trends evident in the data: veterans today face a 57% higher risk of suicide than individuals who haven’t served in the armed forces.8 Over 125,000 veterans have taken their own lives since 2001, making suicide the second leading cause of death among veterans under 45.8 In addition to a complex set of factors like inadequate affordable housing, poverty, job or income loss, substance abuse, and health problems, many veterans, especially those dealing with homelessness, have lingering effects of PTSD and show a high rate of inadequate family and social support networks.9
The US Department of Veterans Affairs (VA) was created to understand and serve the unique challenges facing veterans and to harness the capacity of the largest integrated health care system in the United States, which currently serves more than 9 million (of 12 million) veterans in the country.10
The Department of Defense and the VA are both placing greater attention and resources on studying and providing solutions to the concerns facing their constituents. Within the past decade, the Military Suicide Research Consortium has grown to include over 150 researchers across a wide array of governmental and academic sectors and is building a broad body of understanding about mental health issues leading to suicide within these populations.
What is still needed is an incisive response by the VA to increase its focus on new mental health challenges affecting former service members, despite the many laws, regulations, and rules that regulate eligibility for these services. The VA should leverage innovative ways of making mental health a greater priority, especially for veterans who have not previously applied for care—like Chris, Sue, Amir, and Hector, who are facing life-limiting challenges for the first time.
David Sevier co-managing director, The Generations Study Group, North Carolina
Disclosure of interests
The author reports no potential conflicts.