Why Are So Many Older Veterans Committing Suicide?

The Fort Hood shooting shines a spotlight on an overall epidemic, but suicide rates are higher for older generations.

National Journal
April 13, 2014, 8:31 a.m.

The Fort Hood shoot­ing re­ignited the na­tion­al de­bate over the surge of sui­cides among those who served in Ir­aq and Afgh­anistan. But older vet­er­ans have been largely over­looked in the con­ver­sa­tion.

Nearly 70 per­cent of all vet­er­ans who com­mit sui­cide are age 50 or older, ac­cord­ing to the Vet­er­ans Af­fairs De­part­ment. This is double the sui­cide rate for the same age group in the non­vet­er­an com­munity.

Al­though na­tion­al track­ing of vet­er­an sui­cide rates is un­re­li­able at best, the VA es­tim­ates that 22 vet­er­ans com­mit sui­cide each day. This means ap­prox­im­ately 8,030 vet­er­ans kill them­selves every year, more than 5,540 of whom are 50 or older.

Some vet­er­ans’ ad­voc­ates say it’s easi­er for older vet­er­ans to feel Amer­ica has for­got­ten their sac­ri­fices.

“You know, ‘We’re just old guys, and we’re go­ing to die, so why pay much at­ten­tion to them?’ …That’s kind of the feel­ing that some of our mem­bers have,” said Tom Ber­ger, ex­ec­ut­ive dir­ect­or of the Vi­et­nam Vet­er­ans of Amer­ica na­tion­al health coun­cil.

But on Cap­it­ol Hill, ef­forts to com­bat vet­er­an sui­cides — spe­cific­ally among older vet­er­ans — are largely miss­ing in the flurry of men­tal-health and VA le­gis­la­tion. Two om­ni­bus vet­er­ans bills in the Sen­ate in­clude a pro­vi­sion to ex­tend en­roll­ment eli­gib­il­ity for VA health care from five years after the end of ser­vice to 15 years, which would ac­count for pos­sible delayed ef­fects of war. Sen. John Walsh, D-Mont., who in­tro­duced one of the om­ni­bus bills, is the first Ir­aq War com­bat vet­er­an to serve in the Sen­ate.

But only vet­er­ans of the Ir­aq and Afgh­anistan wars would be eli­gible for the 15-year dead­line.

Ber­ger, who served in the Navy in Vi­et­nam, la­ments that ex­pand­ing the en­roll­ment eli­gib­il­ity does noth­ing for Vi­et­nam vet­er­ans. But he ad­ded that the ex­ten­sion “would have made a world of dif­fer­ence” for vet­er­ans dir­ectly after the war, when sui­cide rates first tend to spike.

Ber­ger cred­ited the re­cent shoot­ings on mil­it­ary bases for be­ing “one of the things that has pro­pelled the men­tal-health is­sue “¦ to the fore­front,” but he ad­ded that the Vi­et­nam Vet­er­ans of Amer­ica has been “deal­ing with men­tal-health is­sues for a long time.”

The VA es­tim­ates that 30 per­cent of Vi­et­nam vet­er­ans suf­fer from posttrau­mat­ic-stress dis­order, com­pared with 11 to 20 per­cent of Ir­aq and Afgh­anistan vet­er­ans.

Many Vi­et­nam vet­er­ans suffered an es­pe­cially dif­fi­cult trans­ition back in­to ci­vil­ian life due to the wide­spread protests against the war. Even now, when search­ing “Why are Vi­et­nam Vet­er­ans “¦ ” in Google, the first few words that pop up to com­plete the sen­tence are “home­less,” “crazy,” and “hated.”

The stigma at­tached to Vi­et­nam may have made some vet­er­ans re­luct­ant to im­me­di­ately seek the help they needed when they first re­turned from ser­vice, Ber­ger said. “It’s taken a long time for us to over­come that neg­at­ive im­age,” he said.

A study re­leased last year by the VA re­com­mends that the de­part­ment in­crease its sui­cide-pre­ven­tion meas­ures for those who served in Vi­et­nam. VA of­fi­cials es­tim­ate that only one in five vet­er­ans who com­mit sui­cide were en­rolled in VA health care. The VA’s up­dated sui­cide in­form­a­tion earli­er this year showed a de­crease in the sui­cide rate for middle-aged male vet­er­ans who use VA health care, com­pared with an in­crease for the same age group of vet­er­ans who don’t.

Robert Boss­arte, who coau­thored the VA study, said that des­pite ini­tial wor­ries that older vet­er­ans wouldn’t use the Vet­er­ans Crisis Line, the op­pos­ite has proven true.

“The greatest pro­por­tion of callers is in fact middle-aged adults,” he said.

Many aging vet­er­ans face the same is­sues as the gen­er­al pop­u­la­tion in grow­ing older, such as de­clin­ing health and mo­bil­ity, which can fuel feel­ings of loneli­ness and isol­a­tion. Older people also tend to suf­fer from more chron­ic pain, es­pe­cially if they have en­dured a war wound.

But for vet­er­ans, men­tal health — in­clud­ing PTSD — is also a key factor.

“We know that psy­chi­at­ric dis­orders play a very large role,” Boss­arte said.

Walsh’s bill does try to tackle PTSD with a pro­vi­sion that would force the Pentagon to reex­am­ine troops who were dis­charged for PTSD-re­lated be­ha­vi­ors, which can in­clude night­mares, flash­backs, changes in per­son­al­ity, sleep­ing dis­orders, and sui­cid­al thoughts.

For now, Ber­ger is re­serving his opin­ion on the le­gis­la­tion, but he stressed that “the dev­il is in the de­tails.”

“Or­der­ing the VA to do something doesn’t mean it’s go­ing to get done the prop­er way,” he said. “Just say­ing ‘They should do this’ and ‘They should do that’ doesn’t mean they’re go­ing to do it.”

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