Exposure to Suicide in Veterans and the Impact on Increased Suicide Risk

Background and Purpose: Suicide remains an enduring challenge within the U.S. veteran population despite significant efforts aimed at reducing risk. The Veterans Affairs (VA) 2023 National Veterans Suicide Prevention Annual Report has found a continued rise in the rate of veteran suicides over the past ten years. While the CDC reported an increase in suicide rates in the civilian population of 4.5% from 2020-2021 (Welder & Stone, 2023), the most recent VA report found that the veteran suicide rate increased by 11.6% for the same year (Department of Veterans Affairs, 2023). Research is needed to further understand the factors that may play a role in identifying and reducing risk of suicide. It is well known that exposure to suicide creates vulnerability to self-harm behaviors. Given the rates of suicide in the veteran population, it is likely veterans are exposed to suicide at high rates. The purpose of this study was to explore rates of suicide exposure in veterans and its impact on suicide risk.

Methods: Data were collected from 3,188 Southern California Veterans. An online survey approach was utilized for data collection. Potential participants received an invitation to participate in the study and were provided with a link to complete the survey online. The survey took approximately 30 to 60 minutes to complete. All participants received a $25 gift card. Participants were asked to indicate whether they had known anyone who had died by suicide, how many people they knew whose cause of death was suicide and how many had prior service. Suicide was measured using the Suicide Behaviors Questionnaire Revised. Odds ratios were calculated to determine whether knowing someone who died by suicide increased odds of meeting the diagnostic criteria for suicide risk.

Results: Sixty percent of veterans had exposure to suicide, knowing at least one person who died by suicide. Of those, 27% indicated knowing one individual whose cause of death was suicide while 29%, 19%, 9% reported knowing two, three and four people who died by suicide, respectively. Seventeen percent of the sample indicated knowing more than five individuals who took their own life. Over 70% reported at least one of these individuals was someone who had served. Individuals who knew at least one person who died by suicide had two times the odds of meeting the diagnostic criteria for suicide risk.

Conclusion and Implications: While most suicide prevention focuses on mental health issues and crisis management, both important elements of prevention, more work is needed to look holistically at the complex factors that create risk. Findings here demonstrate suicide exposure to highly prevalent in the veteran population and causes increased risk for suicide. Screening for suicide exposure may be an important element to identifying risk. Interventions focusing on reducing risk after suicide exposure may also be a way to expand suicide prevention. Research should continue to explore the role suicide exposure may play in creating susceptibility to suicide risk.