Recent age and sex trends of suicides in veterans require in-depth investigations

On February 1st, the United States Department of Veterans Affairs released the most recent statistics on suicides in veterans. The report is based on data from 21 states from 1999 to 2010. The report presented suicide trends in veterans in two different ways. First it showed that in 1999 one in four persons committing suicide was a veteran, a proportion that decreased to one in five in 2010. Secondly, as per estimates from suicide numbers, the suicide rate per day in veterans increased from approximately 20 in 1999 to 22 in 2010. The report explained these apparently contrasting trends by pointing to the overall increase in suicides in the general US population, an 11% increase from 2007 to 2010. The report concluded that suicide in veterans remains a significant problem in 2010.

The statistics that attracted my attention were the age-wise comparisons in 21 states of the percentage of veterans in the population and the percentages of veterans in those committing suicide. The comparisons were performed separately in males and females (figures 4 and 5, pp. 20). Overall, veterans of both sexes accounted for more suicides than their percentage in the population. In male veterans, the percentage differences, i.e., difference between their percentage in suicides and their percentage in population were wider in young veterans than among older veterans; and in males, the percentage differences decreased with increasing age. For instance, young male veterans were 5% of the general population, but they accounted for more than 11% of suicides. Among those aged 75 years or over there were no percentage differences between male veterans and male non-veterans. However, age-wise suicide trends in female veterans were different from males. Relative to the percentage of female veterans in the population (1-2% in different age groups), female veterans accounted for 3-7% of suicides in all age groups. The percentage differences somewhat increased with age and in contrast to males the highest percentage difference (6%) was noted for female veterans aged 75 years or over. There were no explanations available for these trends in the report.

Editor Suicide in the military has received attention recently, and preventive measures have been put in place including a dedicated helpline and simplifying veterans’ access to health services. Nevertheless, there is still room for improvement e.g., by prioritizing interventions in high-risk sub-groups. This report provides useful information for prioritizing these ongoing interventions. What has also been learnt from the experience in civilian settings is that the suicidal mechanisms differ significantly with respect to age. States like Oregon and Maine, therefore, have separate programs of suicide prevention in older adults. Perhaps there are different underlying pathways to suicidal risk in male and female veterans as suggested by observed age and sex trends. I think that an in-depth investigation of suicidal mechanisms by age and sex in veterans can be useful in improving the effectiveness of prevention efforts.

Report is available at: http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf

More details on the suicide prevention in the US are available at: http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full-report.pdf

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