Suicidal ideation and attempts among US Veterans: Results from the 2011-2012 Behavioral Risk Factor Surveillance System

Purpose: Data about suicidal ideation (SI) and attempts (SA) among US Veterans are predominantly from clinical samples. This project documented SI and SA and their correlates among a nonclinical, representative sample of US Veterans.

Methods: Data are from the 2011 and 2012 Behavioral Risk Factor Surveillance System’s Veterans Health module (n=10,406). Items included service in a combat zone; lifetime diagnosis of depression, anxiety, PTSD, or a traumatic brain injury (TBI); mental health treatment at VA or non-VA facilities; and past-year SI and SA. Weighted analyses were adjusted for sex, age, race/ethnicity, employment, education and marital status. We also stratified models by gender.

Results: Almost half (42.8%) of the Veterans had served in a combat zone, and 15.5% had a mental health diagnosis. Approximately 5.0% (n=376) reported SI; of those who reported SI, 20.9% (n=42) reported SA. Serving in a combat zone was associated with lower odds of SI (aOR=0.58, 95%CI:0.35-0.96), but gender-stratified models revealed that association was salient for men but not women. After adjusting for mental health diagnoses, unemployment was associated with SI for male but not female Veterans. Formerly being married was associated with SI among female but not male Veterans.

Conclusion: Veteran suicide risk is a major national priority, and SI among this sample of Veterans was higher than the general US population. In addition to mental health treatment, systems providing care for Veterans should be attune to social environmental risk factors (e.g., unemployment, relationship dissolution) for suicidal ideation, and how those risk factors vary by gender.