The Silent Tragedy: Afghanistan Veteran Suicide Crisis

Since the September 11, 2001 terrorist attacks, over 30,000 veterans have died by suicide—four times more than the number of U.S. military personnel killed in combat in Iraq and Afghanistan. This equates to an average of 17 to 20 suicides per day. The suicide rate among veterans is 1.5 times that of the general population, with the rate for veterans aged 18-34 being almost three times higher than their non-veteran peers. The risk of suicide is even higher for female veterans, who are 1.85 times more likely to die by suicide than non-veteran women.

The reasons for the high rate of suicide among veterans are multifaceted. Research has shown a correlation between suicide and substance use disorders, untreated or under-treated mental health conditions, and stress from economic, legal, and relationship challenges. The difficulty of reintegrating into civilian life, the trauma of combat, and the constant fear of improvised explosive devices (IEDs) also play a role.

To address this issue, various legislative initiatives have been passed, and new programs have been established to provide mental health support and resources for veterans.

Afghanistan veterans are at a higher risk of suicide than non-veterans

Afghanistan Veterans at a Higher Risk of Suicide than Non-Veterans

Factors Contributing to the High Suicide Rate among Afghanistan Veterans

There are several factors that contribute to the high suicide rate among Afghanistan veterans. These include:

• Trauma of being in combat: Exposure to traumatic events during deployment, such as ambushes or killing civilians, can increase the risk of suicide.
• Mental health issues: Mental health conditions such as anxiety disorder, manic-depressive disorder, depression, post-traumatic stress disorder (PTSD), and traumatic brain injury (TBI) are commonly associated with suicide.
• Substance misuse: Veterans who misuse drugs or alcohol are more than twice as likely to die by suicide than other veterans.
• Access to firearms: The familiarity and access to firearms among veterans increase the risk of suicide, as firearms are the most common method of suicide.
• Difficulty reintegrating into civilian life: The challenge of adjusting to civilian life after military service can contribute to feelings of isolation and depression, increasing the risk of suicide.
• Military culture: The masculine culture in the military, which values toughness and self-sufficiency, can make it difficult for veterans to ask for help, leading to unaddressed mental health issues.

Initiatives to Address Veteran Suicide

Recognizing the high risk of suicide among Afghanistan veterans, various initiatives have been implemented to address this issue:

• Legislative initiatives: Legislative efforts, such as the "Commander John Scott Hannon Veterans Mental Health Care Improvement Act," aim to enhance suicide prevention strategies and increase access to mental health services for veterans.
• Community care providers: The MISSION Act of 2018 expands access to community care providers, including telehealth services, to provide support and treatment for veterans experiencing suicidal thoughts.
• Veteran-specific programs: States like Colorado have established pilot programs specifically aimed at suicide prevention among veterans, offering confidential and effective mental health treatment.
• Partnerships between organizations: Collaborations between medical care providers and legal aid professionals provide targeted assistance to veterans facing legal, housing, and financial challenges, which can contribute to suicidal ideation.

Military suicides have been outpacing the rate among the general US population

There are several factors that contribute to the rising suicide rate among military personnel. One factor is the exposure to mental, physical, moral, and sexual trauma during combat deployments and military service. The report by the Costs of War Project also highlighted the influence of the military's hegemonic masculine culture, which values machismo and toughness, making it difficult for service members to ask for help. In addition, the easy access to guns and the difficulty of reintegrating into civilian life after military service are also contributing factors.

The length of the wars in Afghanistan and Iraq, which have been ongoing for over two decades, has also played a role in the increasing suicide rate. The constant fear of improvised explosive devices (IEDs) and the high number of traumatic brain injuries (TBIs) among service members have taken a toll on their mental health. Moreover, advancements in healthcare have allowed troops to survive injuries and continue deploying, resulting in more physical and mental trauma. The combination of multiple traumatic exposures, chronic pain, and lasting physical wounds is linked to suicidal behaviors.

The issue of military suicides is a complex one, and there is no single solution. However, it is clear that more needs to be done to address this growing crisis. Providing better access to mental health services and promoting suicide prevention strategies are crucial steps in the right direction.

Post-9/11 veterans are at an increased risk of suicide compared to veterans of other wars

Several factors contribute to the elevated suicide risk among post-9/11 veterans. Firstly, they face challenges reintegrating into civilian life, often struggling to find a sense of belonging and self-worth upon their return. This difficulty in transitioning back to civilian life is exacerbated by the public's disinterest in and ignorance of the post-9/11 wars, with many Americans unaware that these conflicts were still ongoing. The length of the wars, including the war in Afghanistan, the longest in US history, has also taken a toll, with service members facing multiple deployments and prolonged exposure to combat stress and trauma.

Secondly, advancements in medical technology have allowed service members to survive serious injuries, including traumatic brain injuries (TBIs) from improvised explosive devices (IEDs), and return to the front lines. However, this has resulted in compounding traumas and an increased risk of suicide as service members redeploy with severe injuries. The rise of IEDs has been identified as a significant factor in post-9/11 conflicts, leading to a high incidence of TBIs, which, when combined with other traumatic exposures and chronic pain, increases the risk of suicidal behaviour.

Thirdly, the military's masculine culture, with its emphasis on machismo and toughness, discourages help-seeking behaviours among veterans. The stigma associated with mental health issues and the perception of seeking help as a sign of weakness can prevent veterans from accessing the support they need. This is further compounded by the easy access to firearms, which are the most common method of suicide in the United States.

Finally, unique factors such as military sexual trauma and moral injury have been identified as contributing to the increased suicide risk among post-9/11 veterans. Military sexual trauma, affecting a significant proportion of both men and women, can lead to complex trauma, especially when victims are required to continue working with their attackers. Moral injury, a sense of betrayal by higher-ups or a rupture in one's self-narrative as a good person, can also arise from the difficult ethical choices and experiences of war, further increasing the risk of suicide.

Veterans with combat experience are at a higher risk of suicide than those without

Veterans are at a significantly higher risk of suicide than non-veterans. A study by the Costs of War Project found that an estimated 30,177 active-duty military personnel and veterans who have served since the Sept 11, 2001, terrorist attacks have died by suicide, compared with 7,057 killed in military operations during the two-decade global war on terror. This means that suicides among post-9/11 veterans are about four times higher than combat deaths.

The overall suicide rate for veterans is 1.5 times that of civilians. Among post-Sept. 11 veterans between 18 and 35 years old, the rate is 2.5 times that of all civilians and double that of civilians of the same age. The suicide rate for veterans is 72% higher than for those who haven't served.

Among veterans who served during the wars in Iraq and Afghanistan, the suicide rate for those who were not deployed is 48% higher than for veterans who were deployed. This may be because those who have been deployed are more likely to seek help. A study of Iraq and Afghanistan veterans found three combat experiences most closely linked with suicidal behavior. These were ambushes and killing a civilian.

The risk of suicide among veterans is affected by a variety of factors, including exposure to trauma, stress and burnout, isolation and loneliness, easy access to and familiarity with guns, and difficulties reintegrating into civilian life.

Veterans with combat experience are more likely to suffer from post-traumatic stress disorder (PTSD). Depending on the branch, up to 31% of service members develop PTSD after returning from combat.

Veterans with legal problems are also nearly twice as likely to have serious thoughts of suicide and are one-and-a-half times more likely to attempt it than veterans without legal problems.

Substance misuse is another factor that increases the risk of suicide among veterans. Veterans who misuse drugs or alcohol are more than twice as likely to die by suicide than other veterans. More than 1 in 10 veterans are diagnosed with a substance use disorder.

Veterans with combat experience are also more likely to suffer from depression. Exposure to trauma or suffering a traumatic brain injury while in service can lead to an increased risk of both substance misuse and depression.

Veterans with combat experience are also more likely to have trouble paying their bills in their first few years after leaving the military. This financial stress can contribute to the risk of suicide.

Overall, veterans with combat experience face a range of challenges that increase their risk of suicide. It is important to recognize these risks and provide support and resources to help them transition back to civilian life.

Veterans' suicides are largely caused by firearms

Veterans Suicides Are Largely Caused by Firearms

The suicide rate among military veterans is alarmingly high and continues to rise. In 2019, the U.S. Department of Veterans Affairs reported 6,261 suicides among veterans. In close to 69% of those incidents, firearms were used. This is a stark contrast to the general population, where firearms are used in about 50% of suicides. This disparity is even more pronounced when comparing veteran men to non-veteran men, with firearms being used in 70% and 54% of suicides, respectively.

Firearms as a Lethal Means

Firearms are an extremely lethal means of suicide, with 85-90% of suicide attempts with a gun resulting in death. This is significantly higher than other methods such as drug overdose, which has a fatality rate of only 3%. Therefore, it is not surprising that firearms play a major role in veteran suicides, given their extensive training in the use of firearms and higher rates of gun ownership compared to the general population.

Risk Factors and Circumstances

Several risk factors and circumstances are associated with the high rates of firearm-related suicides among veterans. Firstly, there is a strong link between firearm access and suicide. Veterans who own firearms are more likely to die by suicide, and the presence of a gun in the home increases the risk for all household members. Additionally, physical health problems are a significant factor in veteran suicides, with many veterans suffering from service-related injuries and the associated mental health issues such as PTSD, depression, and anxiety.

Prevention Strategies

To address the high rate of firearm-related suicides among veterans, a multi-pronged approach is necessary:

• Public Awareness: Increase public awareness about the role of firearms in veteran suicides. Educate veterans and their families about the risk associated with firearm access and the importance of safe storage practices.
• Healthcare Services: Prioritize timely and accessible mental and physical health services for veterans. Encourage conversations between healthcare providers and veterans about firearm safety and suicide prevention.
• Disrupting Access: Facilitate voluntary and temporary relinquishment of firearms for veterans in crisis. Promote safe storage practices such as locking up firearms and storing ammunition separately.
• Legal Measures: Pass laws such as Extreme Risk Protection Orders (ERPOs) to allow for the temporary removal of firearms from individuals at risk of harming themselves or others. Implement waiting periods for gun purchases to create time and space between suicidal impulses and access to firearms.

Veteran suicides are a complex issue influenced by various factors, including firearm access, mental and physical health, and social and economic challenges. By implementing comprehensive strategies that address these factors, we can reduce the devastatingly high rate of firearm-related suicides among veterans and save lives.

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