Suicidal ideation among young Afghanistan/Iraq War Veterans and civilians: Individual, social, and environmental risk factors and perception of unmet mental healthcare needs, United States, 2013

Abstract

Suicidal Ideation among Afghanistan/Iraq War Veterans remains a health concern. As young Veterans adjust to civilian life, new risk factors might emerge and manifest differently in this group versus those in the general population. We explored these differences. With 2013 National Survey on Drug Use and Health data, we examined differences in risk of past-year suicidal ideation between Veterans of the Afghanistan/Iraq War periods aged 18–34 years (N=328) and age-comparable civilians (N=23,222). We compared groups based on individual and socio-environmental risk factors as well as perceptions of unmet mental healthcare needs. We report adjusted rate ratios (aRRs); interaction terms tested for between-group differences. PY suicidal ideation rates for Veterans and civilians did not differ (52 versus 59 per 1,000, p=0.60) and both groups shared many risk factors. However, drug problems and perceived unmet mental health care needs were vastly stronger risk factors among Veterans versus civilians (interaction terms indicated that the aRRs were 3.8–8.0 times higher for Veterans versus civilians). Other differences were discovered as well. Past-year suicidal ideation rates did not differ by Veteran status among young adults. However, different risk factors per group were detected, which can inform Veteran suicide prevention efforts.

Association of Cardiovascular Disease and Military Veteran Status With Impairments in Physical and Psychological Functioning: Retrospective Cross-Sectional Analysis of US National Survey Data

“…58 The present study finding of elevated high-risk substance use among younger adults aligns with previous research on age-related substance use patterns in both veterans and nonveterans, and with evidence of high rates of substance misuse among recent-era veterans. 15,59,60 The present study finding of reduced rates of high-risk substance use in those with heart disease/risk is consistent with AHA/ACCF guidance that providers should encourage patients to moderate alcohol consumption 58 and with known risks of illicit drugs, especially for persons with chronic illnesses. 61 The age-related differences in high-risk substance use and serious distress also suggest a potentially important outreach opportunity to use new technologies, such as mobile applications and telehealth, in helping patients self-manage cardiovascular event risk and psychological symptoms.…”

“…The present study finding of elevated high-risk substance use among younger adults aligns with previous research on age-related substance use patterns in both veterans and nonveterans, and with evidence of high rates of substance misuse among recent-era veterans. 15,59,60 The present study finding of reduced rates of high-risk substance use in those with heart disease/risk is consistent with AHA/ACCF guidance that providers should encourage patients to moderate alcohol consumption 58 and with known risks of illicit drugs, especially for persons with chronic illnesses. 61…”

Unemployment, homelessness, and other societal outcomes in patients with schizophrenia: a real-world retrospective cohort study of the United States Veterans Health Administration database

“…The significant burden of mental illnesses that young veterans with schizophrenia carry was clear, with half having substance use disorder, nearly onethird experiencing PTSD, and more than 10% experiencing suicidal ideation. The frequencies of these conditions were numerically lower in young veterans without schizophrenia, with approximately one-quarter having substance use disorder, approximately one-fifth having PTSD, and less than 1% experiencing suicidal ideation; nonetheless, the prevalence of these conditions remains high, similar to reports from other studies on the younger VHA population (substance misuse in 14-32% of veterans aged 18-34 years [41], PTSD in 20-30% of veterans aged 18-29 years [42,43], and suicidal ideation in 0.6% of veterans aged 18-25 years) [44]. The majority of young veterans were unemployed, with a greater frequency of unemployment among young veterans with schizophrenia compared to those without schizophrenia (71.4% vs. 54.3%), likely reflecting the findings from previous studies reporting an association between younger age and poorer social functioning [20,29,[45][46][47].…”

Stress, resilience, and reintegration among post-9/11 us veterans : a holistic investigation

“…Human costs are equally as, if not more, important to consider. Suicide rates among post-9/11 veterans are 21% higher than their civilian counterparts (Logan, Bohnert, Spies, & Jannausch, 2016 The purpose of this state of the science review was to: 1) describe veteran reintegration, 2) synthesize recent literature, and 3) provide management strategies and recommendations.…”