Suicidal ideation, suicide attempt, and non-suicidal self-injury among female veterans: Prevalence, timing, and onset

J Affect Disord. 2020 Aug 1:273:350-357. doi: 10.1016/j.jad.2020.04.017. Epub 2020 May 12.

Abstract

Background: Suicide rates among female veterans have continued to increase, particularly among those not using Veterans Health Administration (VHA) care. Nonetheless, suicide research has rarely focused on female veterans, particularly non-VHA users. The present study examined the prevalence and onset of suicidal ideation (SI), suicide attempt (SA), and non-suicidal self-injury (NSSI) in relation to military service among female veterans. Additionally, current, past, and never VHA users were compared in regard to SI, SA, and NSSI prevalence.

Methods: Female veterans (n = 439) participated in a national, cross-sectional survey.

Results: Lifetime prevalence of SI (47.9%), SA (17.7%), and NSSI (13.2%) were high. Participants were more likely to report experiencing SI and SA following separation, compared to preceding (SI, SA) or during (SI only) military service, controlling for time at risk. However, onset was more likely to occur prior to military service, compared to after separation, for SI, SA, and NSSI. In age-adjusted analyses, current and past users of VHA care were more likely to report experiencing lifetime SI, compared to those who never used VHA care. However, when adjusting for service era, past and never VHA users did not significantly differ.

Limitations: Cross-sectional design, retrospective recall, and convenience sample.

Conclusions: For female veterans, onset of SI, SA, and NSSI appears to most commonly occur before military service. However, SI and SA prevalence are highest following separation, suggesting a period warranting additional support and intervention. Results underscore the need for continued suicide surveillance, prevention, and intervention efforts for female veterans, especially current VHA users.

Keywords: Female; Non-suicidal self-injury; Onset; Suicidal ideation; Suicide attempt; Veteran.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Self-Injurious Behavior* / epidemiology
  • Suicidal Ideation
  • Suicide, Attempted
  • Veterans*