Nonfatal suicidal self-directed violence among US veterans (2022): the Assessing Social and Community Environments with National Data (ASCEND) for Veteran Suicide Prevention Study

Abstract

From 2001 to 2021, the age- and sex-adjusted veteran suicide rate in the United States increased 76.3%. Surveillance of suicidal ideation (SI) and nonfatal suicidal self-directed violence (NF-SSDV) is a critical component of public health-oriented suicide prevention efforts. To facilitate national NF-SSDV surveillance, a biennial, population-based survey was initiated: Assessing Social and Community Environments with National Data (ASCEND) for Veteran Suicide Prevention. A total of 17 396 veterans participated in the first large-scale ASCEND survey (2022). This article reports on SI and NF-SSDV prevalence among veterans residing in the continental United States, Hawaii, and Puerto Rico. Lifetime SI was reported by 31.98% (95% CI, 30.97-32.99), post-military SI by 25.88% (95% CI, 24.91-26.85), and past-year SI by 12.69% (95% CI, 11.90-13.47). The most commonly considered SI method among those with past-year SI was gunshot. Additionally, 36.87% (95% CI, 34.84-38.90) of veterans with lifetime SI reported lifetime preparatory behaviors. Moreover, 9.13% (95% CI, 8.43-9.82) of veterans reported lifetime interrupted attempts. Lifetime suicide attempts (SAs) were reported by 6.99% (95% CI, 6.41-7.56) of veterans, with 4.88% (95% CI, 4.39-5.36) reporting post-military SA. The most common method in prior attempts was medication overdose. ASCEND provides a novel opportunity to elucidate the prevalence of SI and different types of NF-SSDV in the veteran population. Recurring administration will elucidate changes in SI and NF-SSDV prevalence in the veteran population over time.

Keywords: suicidal ideation; suicide; suicide attempt; veterans.