Suicide
Behind the Epidemic of Military Suicide
Here's what our society can do to improve the mental health of our veterans.
Updated June 12, 2024 Reviewed by Tyler Woods
Key points
- Veterans are at a higher risk of suicide than the general public.
- Practicing resilience models within the military is essential for protecting our soldiers.
- TBI increases the risk of suicide and often goes undiagnosed with current procedures.
- Seeking community is especially important when transitioning back to civilian life.
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There is perhaps no group at greater risk of suicide than our armed forces. In a recent article published in USA Today, suicide has been confirmed to be the leading cause of death among active-duty soldiers from 2014 to 2019. It is so common that the #22ADAY Movement was created as a call to action, shedding light on the average of 22 veterans who die by suicide each day. According to the U.S. Department of Veteran Affairs, rates of veteran suicide continue to climb and are currently at an all-time high of 1.66 times greater in the veteran population versus the civilian population. It is more important than ever that we, as a nation, devise a plan to intervene, support, and save the people who have sacrificed so much for our country.
Difficulty Understanding the Problem
In a recent article, writer Dave Phillips recounted stories from a collection of soldiers who returned from deployment with mysterious and “life-shattering” mental health issues leading to psychosis, hallucinations, and suicidal and homicidal ideation—despite many of them being miles from the front lines. Not directly witnessing trauma or combat meant that when these soldiers took the PTSD and traumatic brain injury (TBI) screeners required to receive services upon their return, the scales often did not capture the underlying issues they were returning home with—leaving many of them without the necessary treatment. This is problematic as growing evidence shows that those with TBI are at an increased risk for death by suicide.
The origins of the brain injuries being incurred by the soldiers in the more recent wars have been deemed a mystery until recent findings uncovered the impact that the strategic approach the United States had taken to fight the Islamic State had on health outcomes for those deployed on the ground. According to Phillips' article, the strategy was to dramatically reduce soldiers deployed, intended to save lives by employing air strikes as well as having smaller groups on the ground firing tens of thousands of high-explosive shells—far more than any American artillery battery has fired since the Vietnam War.
While soldiers' lives were, in fact, saved, the death and devastation came when they returned home with mental and physical health problems connected to traumatic brain injuries they had suffered. Research shows a 1.9 ratio increase in suicides in those with TBI versus those without, due to an increased level of impulsivity and reduced ability to perceive long-term perspectives and consequences, as well as increased instances of depression, leading to isolation and perceived helplessness.
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Removing the Fear to Seek Help
Many of the PTSD screeners previously mentioned also did not account for the chronic, yet normalized, stress experienced by these soldiers, which can begin as early as basic training. When discussing this issue with veterans in my therapy practice, the resounding message is that they are not receiving the mental health support they need and are desperately seeking. Many share the fear of losing rank, or worse, being thrown out of the military altogether, if they were to admit their struggle or suicidal thoughts.
In speaking with an officer in the Army who supports active-duty soldiers, he explained that the military does promote mental health services and acting on issues before they become worse, however there are caveats to the system. Once mental (or physical) health services are sought out, the individual may find themselves being omitted from certain jobs or duties to reduce risk to themselves or their fellow soldiers. While this does not technically count as a strike against them, it can get in the way of certain merits being earned, as well as opportunities to engage in promotion-worthy initiatives.
To save the lives of our veterans and improve outcomes for their mental health, the Army specifically has adopted a Master Resilience Training Course focusing on self-awareness, self-regulation, optimism, mental agility, strength of character, and connection. There is still, however, frustration reported by veterans around not being given the time and space to grieve or process what they experienced both while deployed and during the rigors of enlistment. Resmaa Manakem explores this phenomenon in his book My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, how a similar culture exists in law enforcement, where officers who encounter trauma on the job are not provided time and space to process what their bodies and minds experience.
There are, of course, reasons for this mentality in spaces like the military and law enforcement. As Richard Doss put it in his TedTalk, Trained Not to Cry: The Challenge of Being a Soldier, his drill sergeant once said, “I cannot teach you two things at the same time. Either I am teaching you to be hard, or I am teaching you to be soft.” When it comes to standing up to life-or-death scenarios, there is validity to this statement, but what about aftercare? Those in charge can help support the messaging of resilience models by modeling that strength comes from being vulnerable and willing to talk, support one another, and not minimize or placate emotions, which also promotes emotional healing and rest. Universally promoting these resilience models in the military would also make it more likely that discharged veterans would seek out resources provided by the VA to smooth the transition back to civilian life.
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Coming Home
When considering reintegration to society, research shows that the most vulnerable time for veterans occurs after discharge, when they struggle to readjust to civilian life and attain the social support they need. Increasing connection to other veterans, finding a purpose or mission, such as going back to school or finding employment, connecting with other civilian communities, or finding a religious or spiritual practice that supports the transition are all helpful protective factors.
The most salient point is that we must advocate for our veterans as if their lives depend on it. What they experience is beyond what many of us can comprehend, and having support networks available is imperative.
One such resource is the Veterans Crisis Line at 1-800-273-8255. You can chat online or send a text message to 838255 to receive confidential support 24 hours a day, seven days a week, 365 days a year. There are also resources readily available at all local VA hospitals. Taking the time to support our armed forces and validate their experiences translates to a societal effort in keeping these people, alive, and an important part of the country they sacrificed so much for.
To find a therapist near you, visit the Psychology Today Therapy Directory.
Portions of this article were taken from my co-authored book, Surviving Suicidal Ideation: From Therapy to Spirituality and The Lived Experience.
References
Bahraini, Nazanin H., et al. "Suicidal ideation and behaviours after traumatic brain injury: a systematic review." Brain Impairment 14.1 (2013): 92-112.
Ravindran C, Morley SW, Stephens BM, Stanley IH, Reger MA. Association of Suicide Risk With Transition to Civilian Life Among US Military Service Members. JAMA Netw Open. 2020 Sep 1;3(9):e2016261.
Rossom RC, Peterson EL, Chawa MS, Prabhakar D, Hu Y, Yeh HH, Owen-Smith AA, Simon GE, Williams LK, Hubley S, Lynch F, Beck A, Daida YG, Lu CY, Ahmedani BK. Understanding TBI as a Risk Factor Versus a Means of Suicide Death Using Electronic Health Record Data. Arch Suicide Res. 2023 Apr-Jun;27(2):599-612.