Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability

Abstract

ImportancePeople with disability are at heightened risk for suicide ideation, planning, and attempt, with risk growing as the number of disabling limitations increases. Military veterans have higher rates of suicide deaths and disability relative to nonveterans.ObjectiveTo evaluate whether veteran status is associated with greater risk for suicide in those with disability.Design, Setting, and ParticipantsThis survey study used cross-sectional self-reported data from US adults who participated in the 2015-2020 National Survey on Drug Use and Health. Data were weighted to represent the population. Data analysis was conducted from July to August 2022.Main Outcomes and MeasuresSuicide ideation, planning, and attempt served as primary outcomes. Disability status (present or absent) and number of disabling limitations (1, 2, or ≥3) served as factors. Veteran status was determined based on self-report (veteran or nonveteran). Multivariable logistic regression examined suicide ideation, planning, and attempt as a function of veteran status and disability variables.ResultsParticipants included 231 099 US veterans and nonveterans, representing 236 551 727 US adults, of whom 20.03% (weighted n = 47 397 876) reported a disabling limitation, 8.92% were veterans (weighted n = 21 111 727; 16.0% aged 35-49 years; 91.0% men; 6.7% Hispanic; 10.9% non-Hispanic Black; and 78.4% non-Hispanic White) and 91.08% were nonveterans (weighted n = 215 440 000; 25.4% aged 35-49 years; 44.0% male; 16.5% Hispanic; 11.7% non-Hispanic Black; and 63.3% non-Hispanic White). Overall, 4.39% reported suicide ideation, planning, or attempt (weighted n = 10 401 065). Among those with no disability, veteran status was associated with higher risk of suicide planning (adjusted odds ratio [AOR], 1.71; 95% CI, 1.17-2.49). Among those with 1 or 2 disabling limitations, being a veteran was associated with a lower risk of suicide planning (AOR, 0.57; 95% CI, 0.34-0.95) and history of attempt (AOR, 0.46; 95% CI, 0.24-0.88).Conclusions and RelevanceIn this study of how suicide risk differs as a function of disability and veteran status, risk for death by suicide was lower among veterans with disability relative to nonveterans with disability. Veteran status may mitigate risk for suicide given increased receipt of more disability-related care through the Department of Veterans Affairs. Further research would extend this line of inquiry by examining the cause and type of disability as well as perceptions of disability on self-worth. It is possible that physical wounds of war are protective because of the meaning and value of service to one’s country.

Suicide risk in U.S. adults: Alcohol misuse, veteran status, and urbanization comparison.

“…More research is needed to identify more prominent risk factors for rural veterans and identify relevant protective factors among these groups. Relevant protective factors against alcohol misuse or suicide risk could include access to psychosocial support services (e.g., Straus et al, 2019), living and housing stability, employment (Elbogen et al, 2020), and disability status (Blais et al, 2023). This latter factor may be protective because of its association with support resources and greater stability associated with the support of said resources.…”

Harbingers of hope: Scientists and the pursuit of world peace

“…International wars, civil wars, proxy battles, conflicts, invasions, and insurgencies all end badly. They are all accompanied and followed by disruptions in the delivery of basic social services, especially access to healthcare, which has led to epidemics and spikes in infection and diseases, critical battle-related injuries, and chronic disability ( Blais et al, 2023 ), acute malnutrition, acute and chronic mental health conditions, and horrific deaths ( Sher, 2023 ). Wars always result in widespread suffering, enduring stress, trauma, loss, and population displacement, which can reverberate and scar the well-being of future generations.…”

“…Living in war-torn countries has been associated with physical handicaps, and mental and psychological anguish (due to exposure to death). Complaints such as post-traumatic stress disorder (PTSD), anxiety, depression, sleeplessness, nightmares ( Birhan et al, 2023 ; Pavlova et al, 2023 ; Rogowska & Pavlova, 2023 ), alcohol and substance abuse ( Dissanayake et al, 2023 ), suicidal thoughts, tendencies, and attempted suicides ( Blais et al, 2023 ; Sher, 2023 ) sexual and non-sexual violence ( Hladik et al, 2023 ), and psychosomatic disorders all have been reported. These will have long-lasting effects on affected individuals.…”