Saturday, December 18, 2010
suicide veterans
Significant Mortality Ratios
The standardized mortality ratios (SMRs) showed that the risk of dying by suicide in the 18- to 34-year age range was 3 times higher for the veterans-only group vs nonveterans group (3.05; 95% confidence interval [CI], 2.31 – 3.96).
The SMRs were also significantly higher for the veterans only between the age of 35 and 44 years at 1.78 (95% CI, 1.37 – 2.29) and for those between 45 and 64 years old at 1.58 (95% CI, 1.27 – 1.95) compared with the nonveterans.
When using the broader definition of current and past military service, the women in the 18- to 34-year range had an SMR of 1.76 (95% CI, 1.32 – 2.27) and those in the 35- to 44-year range had an SMR of 1.30 (95% CI, 1.00 – 1.66) compared with the nonveterans.
"Very few women aged 45 to 64 were currently active in military service" at the time of their deaths," explain the investigators. So there was no SMR estimated that included that subpopulation.
"Overall, the broader definition brought the rate down a little bit, but it was still significantly higher than among nonveteran women," said Dr. Kaplan. "No matter how you define it, the numbers are still substantial."
Study limitations cited include "presumed undercounting of suicides [and] absence of data on military sexual trauma or combat exposure," the researchers write.
Dr. Kaplan noted that many past studies on suicide among the veteran population have focused almost exclusively on men.
"When we think about suicide we often think about suicide completion among men and suicide attempts among women. But I think this study shows that there is definitely a heightened risk among women with military experience," he said.
When asked to speculate as to why these rates were so high, he responded that the data were pulled from the years 2004 to 2007, which was at "the height of the war in Iraq."
He noted that past research has suggested that 15% of women who served in Iraq had experienced sexual assault or harassment. Other possible contributing factors include long periods of separation from families, alcohol or other substance abuse, and some women having problems fitting into the male-dominated military culture.
"Some women actually adopt some of the traits that men show, such as emotional inexpressiveness or being stoic and being unwilling to seek mental healthcare even when necessary. Women veterans also often feel stigmatized when they use the VA facilities, although I must say the VA has become far more responsive to their needs," he said.
Dr. Kaplan also noted that many of the women in the study committed suicide with a firearm. "So as clinicians, we need to be thinking about the heightened risk associated with easy access to firearms and be more aggressive in terms of doing assessments, probing for gun availability among both female and male veterans."
