More Comprehensive Data Shows Lower Average Veteran Suicide Rate

by U.S. Medicine

August 8, 2016

Serious Concerns Remain About 20, Not 22, Suicides A Day

By Sandra Basu

WASHINGTON—A recent veterans suicide analysis indicates that an average of 20 veterans died every day in 2014—slightly less than a 2010 estimate—but VA is not “declaring that this is progress,” according to David J. Shulkin, MD, the agency’s Under Secretary for Health.

“I will not say that anyone should feel good about 20 suicides a day,” Shulkin suggested.

Using 2010 data, VA previously estimated that an average of 22 veterans died a day. While that statistic has been widely cited by advocacy groups and the media in recent years, its accuracy has been questioned because it is derived from veteran records from only 20 states.

The new figure, on the other hand, was derived from 2014 data from every state. It is contained in a report planned for July release that analyzed approximately 55 million VA records from 1979 to 2014.

VA touted the analysis as the most comprehensive ever on veteran suicide.

“So rather than doing estimates, we actually have exact numbers,” Shulkin told reporters in a teleconference.

In explaining the statistic, he said that 7,403 veterans took their lives in 2014 and, divided by 365, amounts to an average of 20.2 suicides a day.

Shulkin further noted that, with data now on all 50 states, VA will need to go back and determine whether the 22-a-day veteran suicide estimate based on 2010 data was accurate for comparison purposes.

“Today we can say accurately it is 20,” he said about the suicide statistics, emphasizing that the VA is “not saying this is getting better.”

“This remains a critical issue for us, and we are intensifying our efforts because of our concerns about this,” he added.

Veteran Suicide

The data shows the suicide rate among nonveterans and veterans has increased since 2001 but is increasing at a greater rate than for nonveterans.

Since 2001, U.S. adult civilian suicides increased 23%, while veteran suicides increased 32% in the same time period. After controlling for age and gender, the risk of suicide is 21% greater for veterans, according to the VA information.

“The veteran rate of increase is still continuing, and that is really concerning to us and alarming to us,” Shulkin explained. “The U.S. civilian adult rate of suicide is increasing and that is alarming as well, but veterans are still at greater risk for suicide than the adult U.S. civilian population.”

Other key data from the research showed that 65% of all veterans who died from suicide that year were 50 years old or older in 2014.

Rep. Jeff Miller (R-FL), who chairs the House Committee on Veterans Affairs, called the suicide numbers “heartbreaking.” He also said that the passage last year of the Clay Hunt Suicide Prevention for American Veterans Act “is helping to increase the availability and efficacy of VA’s suicide prevention and mental health services.”

“The law is a step in the right direction,” Miller said, “but sustained progress will require a comprehensive approach to help ensure our most at-risk veterans have not only the care they need but also a job, a purpose and a system of support in place to help carry them through their struggles.”

Veteran Suicide Statistics, 2014

  • In 2014, an average of 20 veterans died from suicide each day. 6 of the 20 were users of VA services.
  • In 2014, veterans accounted for 18% of all deaths from suicide among S. adults, while veterans constituted 8.5% of the US population. In 2010, veterans accounted for 22% of all deaths from suicide and 9.7% of the population.
  • Approximately 66% of all veteran deaths from suicide were the result of firearm injuries.
  • There is continued evidence of high burden of suicide among middle-aged and older adult veterans. In 2014, approximately 65% of all veterans who died from suicide were aged 50 years or older.
  • After adjusting for differences in age and gender, risk for suicide was 21% higher among veterans when compared to U.S. civilian adults. (2014)
  • After adjusting for differences in age, risk for suicide was 18% higher among male veterans when compared to U.S. civilian adult males. (2014)
  • After adjusting for differences in age, risk for suicide was 2.4 times higher among female veterans when compared to U.S. civilian adult females. (2014)

Prevention Measures

The new data included some promising statistics about the relationship between providing VA care and veteran suicide rates: Since 2001, the rate of suicide among veterans who use VA services increased by 8.8%, while the rate of suicide among veterans who do not use VA services increased by 38.6%.

VA is being “extra aggressive” with new efforts to reduce suicide, including getting veterans in care, according to Shulkin.

“We have announced our commitment to doing same day urgent mental health evaluations at every VA medical center by the end of this calendar year,” he said. “We are well into that.”

In addition, a tool would be available for clinicians later this year using large database analytics to predict veterans at risk for suicide. That should allow clinicians to intervene earlier, Shulkin said.VA also is expanding telemental services to those parts of the country that have difficulty in attracting mental health professionals as employees. More than 60 new suicide intervention responders/counselors are being hired for the Veterans Crisis Line (VCL).

The hiring process continues to be challenging, however, according to Shulkin but that the VA does a lot of its recruiting from mental health trainees in VA and is “working extra hard to bring people in through both online and job fairs.”

He also said the agency is looking at salaries and trying to stay competitive in the marketplace.

“We are trying to go out there and tell our story about why this is a meaningful place to spend your career,” he added.

Applications for VA clinical positions are down 78% since the waitlist scandal that came to light in April of 2014, Shulkin noted, but said he did not know specifically how many were for mental health professionals.

Still, he pointed out that the damaged reputation was making it “extremely difficult” for VA to meet all of its clinical needs.

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