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National Veteran Suicide Database Analysis

Cejamil S. Calderon

Hahn School of Nursing and Health Sciences, University of San Diego

HCIN 540: Introduction to Health Care Information Management

Dr. Kathy Klimpel

5 December 2020
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Abstract

A large data set from the 2019 National Veteran Suicide Prevention Annual Report suggests that

veteran suicides is a national problem. The contributing factors of suicide would include the

following: economic disparities, homelessness, unemployment, level of military service-

connected disability status, community connection, and personal health and well-being. This

paper presents the critical results of veteran suicides from 2005-2017.Every day the United

States is currently grieving with each suicide; 45,390 American adults died by suicide in 2017

and out of the 45,390 suicide deaths in 2017, 6,139 account for veterans (U.S. Department of

Veteran Affairs, 2019). This paper argues that suicide is a serious a public health concern and

there should be a relentless pursuit of evidence-based clinical interventions and preventions is

needed. The paper concludes by presenting the three levels of strategic focus to help veterans

deal with suicide or suicidal ideations. The national strategic plan has hopes of completely

eradicating future veteran suicides.

Keywords: suicide, economic disparities, homelessness, unemployment, level of military

service-connected disability status, community connection, and personal health and well-being,

strategic focus,
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National Veteran Suicide Database Analysis

Suicide is a national problem amongst all age groups, genders, and ethnicities. Especially,

during these current times amongst the coronavirus pandemic. During these times social

distancing and sometimes home isolation is required; it would be expected to have increased

feelings of loneliness, sadness, and anxiety (U.S. Department of Veteran Affairs,2020). Suicide

is a critical public health problem because it does not just affect the individual that committed

suicide, but it affects the people around that person. One suicide will notably affect an estimated

135 surviving individuals (Cerel et al., 2018).

Literature Review

The Department of Veteran Affairs has examined the critical issue of veteran suicide by

identifying veteran suicide through an annual report. The Centers of Disease Control (CDC) and

Preventions National Death Index PNDI gathered the findings from this report. According to the

Department of Veteran Affairs, it was indicated that there was an average of 20 suicide deaths

per day in 2014 when combining veteran, active duty, and National Guard/Reserve statuses (U.S.

Department of Veteran Affairs, 2019). The report would reflect the most current national veteran

suicide data available from 2005 through 2017. The data includes the cultural context of suicide

in the United States, the total number of veteran suicides from 2005 to 2017, the average number

of veteran suicides per day 2005 to 2017, and age and sex-adjusted suicide rates.

The critical factors that are involved within the culture of veteran suicide would be The

critical, dynamic, and individual interactions involved within the culture of veteran suicide,

including economic disparities, homelessness, unemployment, level of military service-

connected disability status, community connection, and personal health and well-being (U.S.
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Department of Veteran Affairs, 2019). One economic disparity is veteran enrollment in

healthcare through the Veteran Health Administration (VHA) that lowered the likelihood of

employment and reduced income levels compared to veterans without VHA care (Eibner et al.,

2016). Veterans reported that their specific military skills were not transferable in the civilian

sector, resulting in unemployment and, eventually, homelessness. In January 2017, the U.S.

Department of Housing and Urban Development Point-in-Time Count estimated that 40,000

veterans were homeless and just over 15,300 were living on the street or unsheltered (Mccarthy

et al., 2015). Homelessness reduces the quality of life for the veteran and thus can contribute to

suicidal ideations. Furthermore, social connection for the veteran plays a vital role on the veteran

support systems. Social isolation is a risk factor for veteran suicide; among veterans, suicide

rates are higher for those divorced, widowed, or never married and lowest among those who are

married (U.S. Department of Veteran Affairs, 2019). Lastly, the overall health and well-being of

veterans is a factor for suicidal ideations. Specifically, veterans with mental health diagnoses,

sleep disorders, traumatic brain injuries, or pain diagnoses are more likely to die by suicide (U.S.

Department of Veteran Affairs, 2019). The contextual culture of suicide has many unpredictive

and complex factors. The number of suicides is still rising year by year and the nation needs to

address this issue (U.S. Department of Veteran Affairs, 2019).

Critical Results of Veteran Suicide

Every day the United States grieves with each suicide. In 2017, 45,390 American adults

died by suicide, as presented in Figure 1, a statistic that has gradually increased every year since

2005 (Office of Mental Health and Suicide Prevention,2018). Among U.S. adults, the average

number of daily suicides rose from 86.6 American adults in 2005 to 124.4 American adults in

2017 (U.S. Department of Veterans Affairs, 2019). Out of the 45,390 suicide deaths in 2017,
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veterans accounted for 6,139 of those deaths. A visualization of these findings is presented in

Figure 2. Key results showed that the number of veteran suicides dramatically exceeded 6,000

each year from 2008 to 2017. These numbers included an average of 15.9 veterans died a day by

suicide in 2005 and an average of 16.8 veterans died a day in 2017 (U.S. Department of Veterans

Affairs, 2019). The number of annual veteran suicides was lowest in 2006, with 5,688 deaths,

and highest in 2014, with 6,272 deaths. The VHA needs to endorse more initiatives and outreach

for all veterans nationwide. The data is devastating and needs to be addressed. Additionally,

veteran suicides by gender is presented in Figure 3. The data suggests that between 2009 and

2017; annual suicide deaths among women remained between 150 and 300 but exceeded 6,000

for men by the year 2017. In support of these findings, that veteran men are 20 times more likely

to die from suicide compared to women. Regardless of sex, the numbers are not significantly

dropping, and more individualized treatments and initiatives should be offered, such as care

related to specific military sexual trauma or post-traumatic stress disorder. The key to reducing

veteran suicide may be to implement veteran-specific plans regardless of gender identification.

Lastly, Figure 4 represents a comparison between nonveteran and veteran suicidal deaths. Data

suggests that while the percentage of nonveteran suicidal deaths have steadily increased, the

number of veteran deaths have steadily decreased.

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Figure 1

U.S Adult Population of Suicide Deaths from 2005-2017

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Figure 2

Veteran Suicide Deaths from 2005-2017

Figure 3
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Male and Female Veteran Suicide from 2005-2017

Figure 4
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Comparison on Non-Veteran and Veteran Suicide Deaths from 2005-2017

Discussion and Future Actions on Suicide Preventions

Suicide is truly a public health concern and requiring relentless pursuit of evidence-based

clinical interventions and preventions. As a nation that needs to desperately downward bend the

curve for the coronavirus pandemic, the nation simultaneously needs to start downward bending

the curve for suicide deaths. One way to address the issue is for the VHA to focus on improving

suicide prevention programs and creating a more systematic/therapeutic approach to defeat

suicide. Currently there are three levels of strategic focus to help veterans deal with suicide or

suicidal ideations. First, universal strategies aim to positively impact all veterans. The strategies

include public awareness and education campaigns on the availability of suicide prevention
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resources for veterans and the promotion of responsible media coverage (U.S. Department of

Veterans Affairs, 2019); selective strategies designated for veteran subgroups that may be at

increased risk for suicidal behaviors; (e.g., specific outreach towards women veterans, veterans

with substance abuse challenges, and veterans that have been recently separated from active

military service; U.S. Department of Veterans Affairs, 2019); and a strategy designed for

veterans identified as a high risk for suicide. Veterans at high risk for suicide may be referred to

the Veterans Crisis Line, the Recovery Engagement and Coordination for Health – Veterans

Enhanced Treatment (REACH VET) program (U.S. Department of Veterans Affairs, 2019), or

recommended for clinical review. Lastly, a more aggressive approach for veteran suicide

prevention is the launch of the President’s Roadmap to Empower Veterans and End the National

Tragedy of Suicide (PREVENTS; U.S. Department of Veterans Affairs, 2019). The executive

order was signed by President Trump in March 2019. A cabinet-level task force has launched to

develop this national roadmap for suicide prevention, which will include proposals and plans

addressing cross-sector integration and collaboration, a national research strategy, and a cohesive

implementation strategy (U.S. Department of Veterans Affairs, 2019). The national strategies

developed and implemented will serve as a catapult to eradicating suicide among the veteran

population.

References
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Cerel, J., Brown, M. M., Maple, M., Singleton, M., Venne, J., Moore, M., & Flaherty, C. (2018).

How Many People Are Exposed to Suicide? Not Six. Suicide and Life-Threatening

Behavior, 49(2), 529–534. https://doi.org/10.1111/sltb.12450

Eibner C., Krull H., Brown KM., Cefalu M., Mulcahy AW., Pollard M., Shetty K., Adamson

DM., Amaral EF., Armour P., Beleche T., Bogdan O., Hastings J., Kapinos K., Kress A.,

Mendelsohn J., Ross R., Rutter CM., Weinick RM.,... Farmer CM,. (2016). Current and

Projected Characteristics and Unique Health Care Needs of the Patient Population

Served by the Department of Veterans Affairs. Rand Health Quarterly.

https://pubmed.ncbi.nlm.nih.gov/28083423/

Mccarthy, J. F., Bossarte, R. M., Katz, I. R., Thompson, C., Kemp, J., Hannemann, C. M., …

Schoenbaum, M. (2015). Predictive Modeling and Concentration of the Risk of Suicide:

Implications for Preventive Interventions in the US Department of Veterans Affairs.

American Journal of Public Health, 105(9), 1935–1942

https://doi.org/10.2105/ajph.2015.302737

Office of Mental Health and Suicide Prevention, (2018) 2005-2017 National Suicide Data

Appendix (2019). Washington, DC; U.S. Department of Veterans Affairs.

https://www.mentalhealth.va.gov/suicide_prevention/index.asp

U.S. Department of Veterans Affairs. (2019). 2019 National Veteran Suicide Prevention Annual

Report. Retrieved from

https://www.mentalhealth.va.gov/docs/data-sheets/2019/2019_National_Veteran_Suicide

_Prevention_Annual_Report_508.pdf

U.S Department of Veteran Affairs. (2020, October 26). Suicide and the COVID-19 pandemic.

Suicide Prevention. https://www.mentalhealth.va.gov/suicide_prevention/