By: John M. Duffey, MAC, NCC, ALC
The 2019 Veterans Affairs Suicide and Prevention Report indicates that between 17 and 22 veterans commit suicide in the United States every day. Veteran Suicide comprises 18.1% of the total suicides committed throughout the United States each year and the number appears to be increasing annually. The causes or factors leading up to suicide behavior among veterans are broad and there is no singular causation factor that can be used to predict suicidal ideation or intent. The greater majority of veterans who attempted and those who completed suicide were all previously diagnosed and had, at some point, received treatment for, mental illness. Suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and helplessness.
Physical Health problems, especially chronic disabling or life disrupting, increase the risk of suicide. Serious chronic physical pain, disability, immobility, and traumatic brain injury are factors that increase the risk of suicide. This is especially so if the person sees him/herself as a burden on loved ones or friends.
Mental health issues, as listed earlier also increase the risk of suicide attempt or completion. Conditions such as PTSD, MDD, GAD, PD, Bi-Polar One Disorder, Conduct Disorders, and Schizophrenia present factors that increase the risk for suicide. When combined with substance abuse disorder the risks are exacerbated. Abusing alcohol, cannabis, and opioids (all depressants) significantly increase the risk of suicide over other drugs.
Environmental conditions can also serve to increase a person’s risk of suicide. Prolonged stress such as harassment, bullying, relationship problems, or unemployment contribute to depressive and anxiety symptoms and heighten a person’s sense of hopelessness and helplessness. Significantly stressful or traumatic life events like near death incidents, combat, rejections, divorce, financial crisis, or life changing events also contribute to an elevated risk of suicide.
Historical factors also play a considerable role in a person’s predisposition for the development of suicidal ideation and behavior. Of course, a person who has previously attempted suicide is immediately at increased risk of competing suicide in the future. If a person has a family history that includes suicide attempts or completed behaviors there is also an increased risk for the individual under certain conditions of health, mental health, and environment.
Just as there are factors that increase the risk of suicide there are also factors that strengthen a person’s resistance to it. These are often referred to as, “Protective Factors,” because they serve to protect the individual from thinking in and acting in that direction. These include Family and community connection and support, effective problem-solving and coping skills, and limited or restricted access to the means of committing suicide. Chief among the protective factors is ACCESS TO MENTAL HEALTH CARE. Not just care but quality mental health care.
A person with strong cultural and religious beliefs that discourage suicide is also strengthened and less likely to choose suicide when confronted with overwhelming environmental, conditional, and mental challenges and stressors. Church membership and participation also affords the individual a means of receiving support and assistance in dealing with conditional and environmental challenges through community togetherness and mutual helpfulness.
Something to look for when concerned that a person may be suicidal is a change in behavior or the presence of new behaviors:
1. Talk. If a person talks about Killing themselves, feeling hopeless, having no reason to live, being a burden to others, feeling trapped, or unbearable pain.
2. Behavior. Behaviors that signal a risk are increased use of alcohol or drugs, researching a way to end their life such as looking on the internet for ways to commit suicide, withdrawing from activities, isolating from family and friends, sleeping too much or too little, visiting or calling people to say goodbye, giving away prized possessions, Aggression, and fatigue.
3. Mood. People who are considering suicide often display one or more of the following moods: Depression, Anxiety, Loss of Interest, Irritability, Shame, Agitation/anger, Relief or sudden improvement in symptoms.