Resilience, Cultural Beliefs, and Practices That Mitigate Suicide Risk Among African American Women Veterans

Abstract

Current Armed Forces members are more than twice as likely as members of the general population to die by suicide (Department of Defense [DoD] Task Force on the Prevention of Suicide by Members of the Armed Forces, 2010). Suicide is also the second leading cause of death among individuals in the U.S. Armed Forces (Bryan, Jennings, Jobes, & Bradley, 2012). Although efforts within the DoD and Department of Veterans Affairs (VA) have focused on understanding how to prevent suicide among Service Members and Veterans (including identifying drivers of suicidal self-directed violence [SDV]), the majority of research has centered on men, due to the fact that men generally are far more likely than women to die by suicide. However, a recent study conducted by the U.S. Department of VA found the suicide rate among women Veterans is approaching that of male Veterans. The 2015 report, which drew data from the VA's Suicide Repository as well as death information from 23 states, indicated that among those who have never served in the military, women (5.2 per 100,000 lives) kill themselves far less than men (20.9 per 100,000 lives; Hoffmire, Kemp, & Bossarte, 2015). However, there is less disparity in suicide rates between Veteran women (28.7 per 100,000 lives) and Veteran men (32.1 per 100,000 lives; Hoffmire et al., 2015).Though it is not clear what is driving the increase in suicide rates among women Veterans, recent findings suggest suicide rates may have more to do with who chooses to join the military than what happened during their service (e.g., deployment, military sexual trauma). The largest study of mental health and resilience ever conducted among military personnel found that men and women who join the military are more likely to have endured difficult childhoods, including emotional and sexual abuse (Kessler et al., 2014). In addition, this study revealed Army personnel had elevated rates of suicide ideation (Nock et al., 2014), suicide attempts (Nock et al., 2014), and various mental health problems (e.g., attention deficit hyperactivity disorder, intermittent explosive disorder, and substance use disorder) prior to enlistment (Kessler et al., 2014).The gender differential in suicide rates becomes even more complex when culture is considered, suggesting that there is far more diversity across cultures than there is between genders. This is potentially problematic considering the U.S. Armed Forces has become increasingly diverse in terms of race and gender composition (Kang et al., 2015). For example, African American men make up 30.7% of the Armed Forces

The experiences of faith and church community among Christian adults with mental illness: A qualitative metasynthesis.

“…This theme was evident across seven articles. By conceptualizing their experience of mental illness within a religious framework, participants described their faith as facilitating a sense of meaning, purpose, and ability to cope with the associated difficulties of mental illness; these feelings reportedly stemmed from a recognition of God’s plan for the participant (Holliman et al, 2018; Oxhandler et al, 2018; Starnino, 2016; Starnino & Canda, 2014; Tuffour, 2020). Participants who contextualized their mental illness and suffering in religious teaching and belief reported enhanced self-understanding (e.g., discovering oneself through adversity, developing one’s understanding of Christianity), spiritual renewal (e.g., feeling stronger in faith and closer to God), and religious practice (e.g., increased prayer and church attendance; De Castella & Simmonds, 2013; Sherman et al, 2018; Starnino, 2016).…”

“…These articles acknowledged that belief in a supportive God allowed for a positive means of coping with mental illness among Christians. A commonly reported belief was that God had a plan and purpose for each individual and would not subject them to difficulties that they could not overcome; this illustrates how participants used their relationship with God as a means to cope with the suffering associated with mental illness (Holliman et al, 2018; Lloyd & Hutchinson, 2022; Oxhandler et al, 2018; Sherman et al, 2018; Starnino, 2016; Starnino & Canda, 2014). Throughout the articles, the relationship with God was characterized as personal and comforting, where God is seen as an accessible and available social support and strength (De Castella & Simmonds, 2013; Lilja et al, 2016; Oxhandler et al, 2018).…”

Islam and suicide: An interdisciplinary scoping review.

“…Throughout our scoping review, we found that religion cultivated protective factors that in turn conferred resiliency to suicide. Some of which were cultivated intrinsically within the individual and others from belonging to a religious community (Dorsey Holliman et al, 2018). For example, intrinsic religiosity (IR; an orientation toward religion as a value in itself) is associated with lower levels of depression, greater resilience, better quality of life, and fewer suicide attempts (Al Eid et al, 2020; Mosqueiro et al, 2015).…”

Hidden Veterans: A Review of the Literature on Women Veterans in Contemporary Society

“…The literature which explores why women join the military predominately focuses on establishing an understanding of subsequent behaviours, such as resilience in adversity (Brooke, Holliman, Monteith, Spitzer, and Brenner, 2018), transitioning from the military (Burkhart and Hogan, 2015;Demers, 2013) and homelessness (Hamilton, Poza, Hines, and Washington, 2012). Whilst these explore reasons for joining, this is usually in the context of the wider studies research aims and is limited in its ability to establish reasons that are not focussed on subsequent difficulties, for instance, establishing why someone joined, in the context of exploring their narratives of premature discharge (Dichter and True, 2015).…”

“…While Gaines recognises the difficulties women can face, she also highlights that women who choose to work in such places are more likely to be confident, self-motivated, strong and fearless, which enables them to feel that they can be successful in the environment (2017). These characteristics are often associated with those who join the military and help them meet the challenges of service life (Brooke et al, 2018;Gutierrez et al, 2013). Burkhart and Hogan (2015) focus only on women's experiences, and establish a wide range of reasons for enlistment into the armed forces, such as: "To Seek Opportunities", "Pursuing Adventure" or "Seeking Safety" (p. 114).…”