22 a Day: Is there a suicide pandemic within the ranks?

Two cadets, among 1,000 seniors isolated at the Air Force Academy, committed suicide within days from each other amid the COVID-19 pandemic. This has rattled the service from the senior leadership to its trainees. Unlike other branches, the Air Force has kept cadets on campus. The cadets have been socially distancing in single rooms, away from their roommates since the start of March.

Air Force Lt. Gen. Jay Silveria wrote to cadets, their families, staff, and alumni: “I am heartbroken to confirm that since Thursday we have mourned the loss of two of our First-Class cadets here on our campus, and our entire Academy community is understandably shaken.”

The Air Force on Friday said that 137 airmen had committed suicide in 2019. That is roughly a 33 percent increase over the previous year. That means that 59 airmen and civilians have killed themselves since the Air Force sounded the alarm on August 1st regarding the spike in suicide deaths and declared a one-day stand-down to focus on resiliency and suicide prevention.

The previous year was the most devastating in suicide numbers in well over a decade. The Air Force did not further break out the 137 number, but leaked Air Force slides posted on the unofficial Facebook page Air Force amn/nco/snco, which listed the 2019 tally as 136, said that 84 active-duty airmen, 24 civilians, 14 reservists, and 14 Air Guardsmen had killed themselves last year.

But the suicide problem is even grimmer in the veteran community.

There are 18 million veterans living in the U.S. today — 8 percent of the population. They are predominantly male (92 percent), though the number of female veterans is on the rise.

We have all seen the campaign to stop the veteran suicides (22 a day). But are they just 22? And has this rate risen over the years? The water gets very muddy, depending on the source. To me, this should be easy to track with the VA. However, not all vets are in the VA system, and this wouldn’t include active duty, guard, or reserve personnel that commits suicide.

The veteran population has experienced an increase in the number of suicides, according to the VA. The number of veteran suicide deaths per year increased from 5,787 in 2005 to 6,139 in 2017. The annual number of veteran suicide deaths has stayed above 6,000 since 2008. The yearly number of veteran suicide deaths increased by 129 from 2016 to 2017. With 330 million people in the U.S., this doesn’t even hit anyone’s radar. (The number of veteran suicides per year was the lowest in 2006 and the highest in 2014.)

So again, 22 a day? Maybe. With roughly 775,000 Vietnam Vets still alive today and our Iraq, Afghanistan veterans (nearly three million) ever-increasing, it would seem as though we have stalled or slowed veteran suicides.

In 2005, an average of 87 American adults, a number which included veterans, died by suicide each day. In 2017, an average of 124 Americans died by suicide each day. The average number of veteran suicide deaths per day has equaled or exceeded 16.0 since 2007. On average, the number of civilians who died by suicide each day has steadily increased each year since 2001.

When compared with suicide mortality among the civilian population, a more significant increase in the relative risk for suicide among veterans was observed for those not using the veterans Health Administration (VHA) services. Read that again: This suggests that VHA services are working in somehow reducing the risk of suicide.

Mental health disorders, including major depression and other mood disorders, have been associated with increased risk for suicide. Since 2001, the proportion of VHA users with mental health conditions or substance use disorders (SUD) has increased from approximately 27 percent to more than 40 percent in 2014. I don’t give this a ton of credit because I believe that more soldiers are coming forward and seeking help. Twenty years ago, it was far less acceptable to raise your hand and say you needed to talk to someone.

Veterans aged 18–34 had the highest suicide rate in 2017 (44.5 per 100,000). Their rate increased by 76 percent from 2005 to 2017. This category would be mainly from your Iraq and Afghanistan wars. Veterans ages 55–74 had the lowest suicide rate per 100,000 in 2017. These vets would most likely have served during Vietnam or post-Vietnam.

Breaking it down by gender, in 2017 the rate of suicide among female veterans was 17 per 100,000, compared with 39 per 100,000 among male veterans. Suicide among female veterans was 2.2 times the rate among non-veteran women, while the 2017 rate of suicide among male veterans was 1.3 times higher than the rate among non-veteran males. In 2017, 70 percent of male veteran suicide deaths and 43 percent of female veteran suicide deaths resulted from a firearm injury. The three leading methods, in order, are by firearm, drowning, and suffocation.

The big issue with all of this is tracking: There is not a single state that asks on a death certificate if the person was a veteran. Every state should be required to do so. By adding this piece of information to each birth certificate, we would have much more accurate numbers regarding veteran suicides.