Sui­cide among vets high­est in ru­ral ar­eas

Re­port also shows in­creases in western U.S.

Milwaukee Journal Sentinel - - MILWAUKEE WISCONSIN - HOPE YEN

WASH­ING­TON - Sui­cide among mil­i­tary veter­ans is es­pe­cially high in the western U.S. and ru­ral ar­eas, ac­cord­ing to new gov­ern­ment data that show wide state-by-state dis­par­i­ties and sug­gest so­cial iso­la­tion, gun own­er­ship and ac­cess to health care may be fac­tors.

The fig­ures re­leased Fri­day are the first-ever Depart­ment of Veter­ans Af­fairs data on sui­cide by state. They show Mon­tana, Utah, Ne­vada and New Mex­ico had the high­est rates of vet­eran sui­cide as of 2014, the most cur­rent VA data avail­able. Veter­ans in big chunks of those states must drive 70 miles or more to reach the near­est VA med­i­cal cen­ter.

The sui­cide rates in those four states stood at 60 per 100,000 in­di­vid­u­als or higher, far above the na­tional vet­eran sui­cide rate of 38.4.

The over­all rate in the West was 45.5. All other re­gions of the coun­try had rates be­low the na­tional rate.

Other states with high vet­eran sui­cide rates, in­clud­ing West Vir­ginia, Ok­la­homa and Kentucky, had greater lev­els of pre­scrip­tion drug use, in­clud­ing opi­oids. A VA study last year found veter­ans who re­ceived the high­est doses of opi­oid painkillers were more than twice as likely to die by sui­cide com­pared to those re­ceiv­ing the low­est doses.

The lat­est VA data also reaf­firmed sharp de­mo­graphic dif­fer­ences: Women veter­ans are at much greater risk, with their sui­cide rate 2.5 times higher than for fe­male civil­ians. Among men, the risk was 19 per­cent higher among veter­ans com­pared to civil­ians. As a whole, older veter­ans make up most mil­i­tary sui­cides — roughly 65 per­cent were age 50 or older.

Ra­jeev Ram­c­hand, an epi­demi­ol­o­gist who stud­ies sui­cide for the RAND Corp., noted that the sui­cide rate is higher for veter­ans than non-veter­ans in every sin­gle state by at least 1.5 times. “No state is im­mune.”

Ram­c­hand said it was hard to pin­point spe­cific causes be­hind vet­eran sui­cide but that it likely in­volved fac­tors more preva­lent in ru­ral ar­eas, such as so­cial iso­la­tion, lim­ited health care ac­cess, gun own­er­ship and opi­oid ad­dic­tion. Na­tion­ally, 70 per­cent of the veter­ans who take their lives had not pre­vi­ously been con­nected to VA care.

The data set of­fers more de­tailed break­downs on na­tional fig­ures re­leased last year, which found that 20 veter­ans a day com­mit­ted sui­cide. The numbers come from the largest study un­der­taken of veter­ans’ records by the VA, part of a gov­ern­ment ef­fort to un­cover fresh in­for­ma­tion about where to di­rect re­sources and iden­tify veter­ans most at risk.

The depart­ment has been ex­am­in­ing ways to boost sui­cide pre­ven­tion ef­forts.

“These find­ings are deeply con­cern­ing, which is why I made sui­cide pre­ven­tion my top clin­i­cal pri­or­ity,” said VA Sec­re­tary David Shulkin. “This is a na­tional pub­lic health is­sue.”

Shulkin, who has worked to pro­vide same­day men­tal health care at VA med­i­cal cen­ters, ex­panded emer­gency men­tal care to veter­ans with other than hon­or­able dis­charges. The depart­ment is also boost­ing its sui­cide hot­line and ex­pand­ing tele­health op­tions.

Ret. Army Sgt. Shawn Jones, ex­ec­u­tive di­rec­tor of Stop Sol­dier Sui­cide, said veter­ans sui­cide is an is­sue that needs greater aware­ness to pro­vide com­mu­nity sup­port. Tran­si­tion­ing back to civil­ian life can be dif­fi­cult for ac­tive-duty mem­bers who may re­turn home and feel un­able to open up to friends or fam­i­lies. As a re­sult, some veter­ans can feel over­whelmed by daily chal­lenges.

CHARLES DHARAPAK/AP

A study re­leased Fri­day finds sui­cide among mil­i­tary veter­ans is es­pe­cially high in the western U.S. and ru­ral ar­eas. The numbers show that women veter­ans are at much greater risk, with their sui­cide rate 2.5 times higher than for civil­ians.

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