Page 136 - 2022 Spring JSOM

An Ongoing Series

Veterans and Suicide

An Integrative Review of Risk Factors and Suicide Reduction Services

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Sherrionda Crawford, PhD *; John Duffey, PsyBA, MA ; Kanessa Miller Doss, PhD 3

ABSTRACT
Suicide has quickly risen to be among the top threats to hu- The prevalence of veteran suicide is significant, particularly for
manity the world over, which is most certainly the case for male Veteran Health Administration (VHA) patients, as well
American veterans. Literature has well documented that vet- as patients who have mental health/substance use disorders. In
erans are at increased suicide risk due to numerous factors as- 2017, there were 6,139 US Veterans and 919 National Guard
sociated with military culture. This article examines veterans’ and Reserve members to die by suicide. The highest veteran
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suicide reduction services by addressing the identification of suicide rate by age was between 18–34 (44.5 per 100,000),
veterans at elevated risk of suicide and assessing public- private and the lowest veteran suicide rate was between 55–74 (about
partnership models that promote effective collaborative out- 27 per 100,000). The suicide rate of female veterans was 16.8
reach and treatment. Essentially, this work appraises the de- per 100,000 compared to male veterans at 39.1 per 100,000
velopment and procedures of multi-organization systems (after adjusting for age in 2017). Self-inflicted firearm injury
collaborating to impart novel and effective processes to elim- accounted for 69.4% of veteran suicide deaths (70.7% of male
inate suicide as intended by Past-President Trump’s Executive suicide deaths, 43.2% of female suicide deaths) in comparison
Order No. 13,861. The essential risk factors associated with to 48.1% of non-veteran adult suicides. Consistent with prior
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the identification of veterans at elevated risk of suicide are re- statistics, veterans who recently used VHA services had higher
viewed. Public-private partnership models that encourage col- death rates (35.6 per 100,000) from suicide than veterans who
laborative and effective outreach and treatment are examined. had not recently used VHA services (28.9 per 100,000). The
The implications of this literature review will support mental suicide rate for VHA patients diagnosed with mental health or
health providers, researchers, and policymakers in innovative, substance use disorders was 56.9 per 100,000. 5
collaborative, and effective suicide prevention and interven-
tion practices for veterans. Directions for future research are In response to the suicide epidemic for US veterans, the Presi-
identified to further contribute to efforts to empower veterans dent’s Roadmap to Empower Veterans and End the National
and eliminate suicide. Tragedy of Suicide (PREVENTS) was authorized by an execu-
tive order endorsed by Past-President Trump on 9 May 2019.
Keywords: suicide; risk reduction; veterans; Servicemembers; A major goal of the national roadmap for suicide prevention
prevention; identification; intervention; partnerships is to develop a comprehensive proposal to empower veterans
and eliminate suicide. The executive order established the Vet-
eran Wellness, Empowerment, and Suicide Prevention Task
Force to construct this suicide prevention national roadmap.
Introduction
The plan emphasized coordinated suicide prevention endeav-
Annually, there are nearly 800,000 deaths by suicide world- ors, a national research approach, holistic collaboration with
wide. Suicide is among the top 20 leading causes of death all aspects of veterans’ lives, streamlined access to services and
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globally. In the United States, suicide is the 10 leading cause supports, and the promotion of social connectedness. 1
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of death, with approximately 48,000 deaths a year. There-
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fore, suicide is not only a national public health problem, but a The overarching aim of this article is to examine the trends
global public health crisis. According to the US Department and practices of collaborative multi-organization systems to
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of Veteran Affairs, more than 6,000 veterans died by suicide provide innovative and effective means to eradicate suicide

each year between 2008 and 2017. In an endeavor to reduce as envisioned by Past-President Trump’s Executive Order No.
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veteran suicide, Past-President Donald Trump issued Exec- 13,861. Two of the components to be included in the national
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utive Order No. 13,861 to empower veterans and cultivate roadmap to suicide prevention are addressed. First, the link
partnerships to provide veterans with their optimal needs for between essential risk factors and veterans’ identification of in-
suicide prevention. 1 creased risk of suicidality is examined. Second, public-private
*Correspondence to scrawford@troy.edu
1 Sherrionda Crawford is affiliated with the Division of Counseling, Rehabilitation, and Interpreter Training, Troy University, Troy, AL.
2 John Duffey is affiliated with the Alabama Institute for Behavioral Health and Research. Kanessa Miller Doss is affiliated with the Department
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of Psychology, Troy University, Troy, AL.
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