Insufficient Mental Health Treatment for Veterans Contributes to High Suicide Rate

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Veterans are at increased risk of suicide. Image by ronmerk.

Veterans are at increased risk of suicide. Image by ronmerk.

Recent news stories have raised a storm of controversy about veterans’ medical treatment. Last week, in the aftermath of a scandal at the VA (Veterans’ Affairs) hospital in Phoenix, Arizona, three officials were placed on leave.

The U.S. Office of the Inspector General is investigating allegations about a cover-up, in which the facility hid names of the many patients who were waiting for medical appointments from inspectors’ view. Tragically, many of the U.S. veterans who were forced to wait months for medical appointments died before the date of their appointments.

This scandal mirrors a situation uncovered last year by the Atlanta Journal-Constitution. In August 2013, the newspaper revealed that 16 veterans had attempted suicide while waiting to receive mental health care at the overburdened Atlanta VA Medical Center, in Georgia.

The sad truth about the mental health treatment of veterans was confirmed by a March 2013 report by the National Academy of Sciences. The report concluded that the VA has been slow to treat the 44 percent of veterans who returned from Iraq or Afghanistan with a physical or mental health problem. Clearly, the VA’s care has been out of sync with the magnitude  of the needs of this population.

Veterans and Suicide: A Rising Problem

The January issue of Stars and Stripes, a news site geared toward members of the U.S. military, further sparked the ongoing controversy about the lack of medical care for veterans. The Stars and Stripes reported that according to new suicide data, about 22 veterans commit suicide every day. Over a three-year period, suicide rates of veterans generally remained unchanged, but young male veterans seemed more vulnerable to the risk – the suicide rates of male veterans younger than thirty increased by 44 percent! Female veterans, too, have been increasingly turning to suicide:  their suicide rates increased by 11 percent over a three year period.

The same report concluded that treatment, when attainable, is effective. Veterans who receive mental health treatment within the VA system have a noticeably reduced suicide rate.

Dr. Mark Kaplan of Portland State University has found similarly alarming research results. He and his colleagues scoured information gleaned from death certificates, coroners’ reports and police reports to examine rates of suicide among veterans and non-veterans.

They learned that veterans were far more likely than non-veterans to commit suicide. Furthermore, women who had served in the military had almost triple the rate of suicide of women who were not veterans. The suicide attempts often seemed related to mental health, substance abuse, relationship and financial problems.

Guns and Suicide

Veterans not only are at greater risk for committing suicide than the general population, they also use more violent means. Veterans who commit suicide, especially older ones, are more likely to die by means of firearms.

According to Dr. Kaplan, people who commit suicide by shooting themselves with guns are likely to have experienced a stressful life event within the previous two weeks. This can be interpreted to mean that veterans are more likely to commit suicide as a result of stressful events. In contrast, those in the general population who commit suicide are more likely to have an underlying mental illness that leads them to take their own lives.

These findings speak to the prevalence of PTSD, or Post-Traumatic Stress Disorder, in veterans. At least 15 percent of service members who have returned from the conflicts in Iraq and Afghanistan are estimated to have PTSD. Dr. Leo Sher, writing in the Cleveland Clinic Journal of Medicine in 2012, explains the links between PTSD, suicidal thoughts, and suicide attempts in veterans.

Dr. Sher notes that PTSD is potentially fatal, due to the risk of suicide. According to one study he cites, war veterans with PTSD might be more likely than civilians to attempt suicide. Undoubtedly, suicidal thoughts are considered more dangerous in war veterans, because of their knowledge about firearms. War veterans often own guns, meaning they often have access to a deadly instrument to act on their suicidal thoughts.

Reducing Suicide Rates: A Plausible Solution

At least one elected official is attempting to tackle this dire problem. Senator John Walsh of Montana, himself a veteran of the Iraq War, has introduced a bill that would directly affect veterans’ mental health treatment. Among other items, the bill seeks to raise salaries for mental health workers at the VA in order to close the care gap.

Currently, there are more than 1000 vacancies for mental health care positions at VA hospitals; better working conditions would help fill those positions with qualified workers. Additionally, the Veteran’s mental health bill calls for a yearly review of mental health programs at the VA hospitals, in order to ensure the streamlined use of resources.

Senator Walsh explained that although the costs of improving mental health treatment for veterans are high, the costs of ignoring the needs of those who serve would be far higher.

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