An annual review of suicide among veterans found that rates increased in 2021 during COVID-19 lockdowns, with the largest jumps among young women with some military service, according to a report released Thursday the Department of Veterans Affairs.
Among young women, when compared to their civilian counterparts who never joined the military, female veterans between 18 to 34 years old were nearly three and a half times more likely to take their own lives in 2021. And among women of all ages who died by suicide in 2021, veteran women were nearly three times as likely to use a firearm than a civilian.
Overall, the rate of female veterans of any age dying by suicide jumped by 23.7% from 2020, versus a jump 3.5% among men.
The VA report covered suicide data from the Center for Disease Control for 2021, the latest year for which full data was available.
“A lot of the other issues might just be issues that women in the country face that are compounded for veterans,” said Rajeev Ramchand, co-director of the RAND Epstein Family Veterans Policy Research Institute. said, like lack of childcare due to availability or cost, waning support systems and work-related struggles.
Jenna Carlton, a veteran in that demographic, agrees. Carlton, 29, spent four years in the Navy and wrote the The Veteran Workbook aimed at young military members leaving the military. She also speaks and writes on veterans issues.
“It’s alarming but not surprising,” said Carlton, who posts on social media as the Millennial Veteran. “Most of the women that reach out to me have been, I don’t want to say victims, but survivors of [military sexual trauma]. They’ve had not the best experience in the military and a lot of mothers have reached out to me, saying, how they’ve been separated from the their children or have been the primary caretaker as a woman in the military and then becoming a veteran and trying to find that same income. There’s a lot of stressors.”
As young women veterans saw a spike, so did the rest of the veteran community, the VA found, after two years of decreasing rates. In 2021, 6,392 Veterans died by suicide, an increase of 114 suicides from the previous year. Overall, suicide was the 2nd leading cause of death for veterans between 18 and 34 years old, the VA found, trailing only accidents. Suicide was the fifth leading cause of death for veterans ages 45 to 54.
Though suicide among women vets jumped the most, the VA found, the overwhelming majority of veterans who die by suicide are men, particularly young men. And veterans of all ages and genders face higher risk of suicide than non-veterans. Among all veterans, the 2021 suicide rate was nearly 34 deaths out of every 100,000 veterans. Among the general U.S. population of non-veterans, that figure was just under 17.
The numbers were even more stark among young vets between the ages of 18 and 34. For every 100,000 vets in that age group, nearly 50 died by suicide in 2021. Among the next-oldest group of veterans, between 35 and 54, almost 36 died of suicide for every 100,000.
The heightened suicide rates among veterans matched trends across the broader U.S. population as Americans faced financial strain, housing instability, increased anxiety and difficulty accessing health care in the first full year of the COVID-19 pandemic.
“Those who may have been more vulnerable going into COVID were also impacted at different and perhaps more significant levels,” said Matthew Miller, executive director for Suicide Prevention at the VA. “There’s some common themes there that match with what we saw on our nation as a whole during COVID.”
He said that the impacts of the pandemic hit particularly hard among veterans who are women, homeless veterans, those who are not usually connected to health care and those with lower incomes.
Easier availability of firearms also contributed to increased suicide rates nationally, and hit veteran women particularly hard, the VA found. Between 2001 and 2021, there was also a 14.7% increase in veteran women firearm suicides.The VA suicide report for 2021 data, released Thursday, found that firearm suicide rate among veteran women was 281.1% higher than non-veteran women.
A report that evaluated women’s firearm behaviors during the COVID-19 pandemic was cited in the VA’s annual study. As firearm sales substantially increased overall during the pandemic, with women representing half of new gun owners between 2019 and 2021.
“Women Veterans described newly or increasingly believing that firearms were necessary and important for protection of oneself, one’s family, and one’s property against others,” researchers said. Women told researchers they bought guns for reasons including pandemic uncertainties; pandemic-related threats necessitating self-defense, preparedness, and self-sufficiency; and political and social unrest, and racial justice demonstrations.
“The need to prepare for the worst should someone want to seize one’s limited resources” was a common theme among women, researchers found. Women living alone felt these concerns as well as the need to protect themselves and their children. “The fear that individuals lack empathy in times of turmoil was expressed by women (especially single women), who noted their children as a reason for increasing their firearm accessibility,” researchers said.
Evidence shows that veterans who report military sexual trauma have increased suicide mortality and women in the military are disproportionately affected by sexual assault, according to RAND’s Ramchand. “Preventing and really addressing military sexual trauma is suicide prevention,” he said.
In addition to sexual trauma women faced during military service and their firearm familiarity, broader issues that young women in the U.S. faced during the pandemic might also play a role, according to Ramchand.
The young female veteran suicide data is indicative of two trends, according to Miller. First, women veterans bought more firearms in 2021 compared to previous years. Second, some groups of women sought care through the Veterans Health Administration, VHA, more during the pandemic “while the individuals who died by suicide, decreased their engagement during that time,” Miller said.
“Would that decrease of engagement be secondary to the fact that they had a lot to manage in life that it was difficult maybe to coordinate care and engage in however their job had changed, however parenting had changed?” he said.
In light of the alarming statistics, the VA officials sat down with lead personnel for women’s mental health and suicide prevention at the VHA. From those conversations, they discovered less engagement between VHA providers and women veterans regarding firearm lethal means safety.
“There may be a bit of a bias where we think that firearms are for discussion with male veterans, maybe that’s not a discussion point that’s necessary with female veterans,” Miller said.
To get at this, the VA wants to have a significant push across its clinics to increase firearm lethal means safety discussion with women veterans in 2023 and 2024. It was not immediately clear what that would look like in practice.
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As the VA considers the effects of the pandemic on veteran suicide rates, officials are taking into account how to reach populations who don’t interact with the veteran healthcare system. According to the report, 8.7% of all 6,392 Veterans who died by suicide in 2021 received either VHA or Veterans Benefits Administration services in 2020 or 2021, while 51.3% received neither services.
“A lot of veterans who died by suicide have never interacted with our mental health system, or a mental health provider overall, which is why we have to think more expansively than just access to health care on this very important mission,” said Dr. Shereef Elnahal, Under Secretary for Health at the Department of Veterans Affairs.
Since 2021, the VA has implemented a number of new programs and resources to combat suicide among veterans of all ages and demographics. One example is the VA’s targeted campaigns with commercials focused on women and young veterans and secure firearm storage.
“Are you sick of hollow gestures and meaningless nods of understanding? Are you tired of being repeatedly thanked and told you’re a hero? While you feel like a liability,” the narrator says. “Crisis can happen unexpectedly to anyone and though it might seem like a small barrier, a simple lock puts space between the thought and the trigger.”
Another VA effort is the 988 Veteran Crisis Line, VCL – an extension of the National Suicide Prevention Lifeline, which launched on July 16, 2022. The crisis line fielded nearly 1 million contacts which includes over 750,000 calls, according to the report.
However, one Senator is asking for an audit of the VCL after a VA inspector general report uncovered a failed intervention with a suicidal veteran by one of the center’s responders.
“Veterans have their calls the answer 98% of the time, the only other is less than 2% where an abandonment occurs and the phone is hung up,” Miller said. “Within those calls that we’re able to answer, we answered 96% within 20 seconds or less, which is the 911 general standard.”
The VA is now betting on amalgamation of policies aimed at firearm safety storage, increased behavioral health access and programs aimed at combatting suicide among specific populations.
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