To Reduce Suicide Risk in Veterans, Efforts Must Include Functioning, Well-being

Instead of zeroing in on mental health and substance abuse problems, mental health services to reduce suicide risk among US veterans should also focus on maintaining or improving basic functioning (living, financial, and vocational) and well-being (social, psychological, and spiritual), suggests findings from a recent study in the Journal of Affective Disorders.

“While approaches focusing on reducing risk of suicide (eg, treating mental health symptoms, reducing access to lethal means, safety planning) have undeniable value, focusing on building and maintaining personal strengths helps individuals to build a life they feel is worth living,” researchers wrote. 

The study analyzed two waves of day collected 1 year apart for 1090 post-9/11 veterans from all 50 states and all military branches. Researchers were interested in identifying psychosocial factors associated with protection against subsequent suicidal ideation.

Eight psychosocial factors at wave 1 were significantly related to lower suicidal ideation at wave 2: employment, meeting basic needs, self-care, living stability, social support, spirituality, resilience, and self-determination. The more protective factors endorsed, the lower rates of suicidal ideation a year later, according to the study. 

“Further, reduction in suicidal ideation persisted in multivariate analyses even after controlling for robust risk factors,” researchers wrote. “In a model controlling for demographics factors, combat history, substance abuse, psychological distress, and history of suicidality (itself a strong predictor), the count of past-year cumulative protective factors continued to be significantly associated with reduced odds of subsequent suicidal ideation 1 year later.” 

Among the individual protective factors, sufficient money to cover basic needs and higher psychological resilience scores were significantly associated with lower odds of suicidal ideation the next year. 

“The results indicate that psychosocial rehabilitation and holistic approaches targeting financial well-being, homelessness, resilience, self-care, social support, spirituality, and work may offer a promising avenue in both veteran and nonveteran populations for treatment safety planning as well as suicide risk management and prevention,” researchers wrote. 

—Jolynn Tumolo

Reference:

Elbogen EB, Molloy K, Wagner HR, et al. Psychosocial protective factors and suicidal ideation: Results from a national longitudinal study of veterans. J Affect Disord. 2020;260:703-709. doi:10.1016/j.jad.2019.09.062