Those Who Serve - Addressing Firearm Suicide among Military Veterans
In 2021, 72% of veteran suicides were by gun — the highest proportion in 20 years.
By: Paige Tetens
Beginning in 2020, the destabilizing impact of the COVID-19 pandemic led to social isolation, economic struggles, and worsening mental health for people across the country. Though suicide rates across the nation had declined from 2019 to 2020, they began to increase in 2021. And veterans were not immune to this trend.
More veterans died by suicide in 2021 than in 2020, and studies show that veterans saw a higher incidence of mental health concerns during than before the pandemic. By 2021, 72 percent of veteran suicides involved firearms — the highest proportion in over 20 years. With an average of 18 veterans dying by suicide in the United States each day, 13 of them by firearm, we cannot address veteran suicide without talking about guns.
Veterans confront unique challenges during their service and face new ones when they return to civilian life, but veteran firearm suicide is an outsized part of a larger emergency.
In the United States, firearm suicide is a devastating public health crisis, claiming nearly 25,000 lives every year. Veterans account for approximately one in five adult firearm suicides — about 4,600 deaths every year. Over the past 20 years, the veteran firearm suicide rate has increased by 51 percent. The firearm suicide rate among non-veteran adults increased 32 percent over this same period.
Source: Everytown Research analysis of U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, “2001–2021 National Data Appendix,” November 2023, https://bit.ly/2Qblicx. Veteran and non-veteran firearm suicide rates exclude suicides among people age 17 years old and under.
Gun ownership increases the likelihood of firearm suicide, and suicide attempts with firearms are nearly always lethal.
The dynamics of suicide are complex. However, research has confirmed that a combination of risk factors are often present before a suicide attempt: (1) current life stressors, such as relationship problems, unemployment or financial problems, bullying, alcohol and substance use disorders, or mental health conditions; (2) historical risk factors such as childhood abuse or trauma, a previous suicide attempt, or a family history of suicide; and (3) access to lethal means of harm such as firearms. Suicide risk dramatically increases when these factors coincide to create a sense of hopelessness and despair.
Easy access to firearms during a moment of crisis can mean the difference between life and death.
Firearms are a particularly lethal means of self-harm, and most people who survive a suicide attempt do not go on to die by suicide. Limiting gun access in these moments can ensure veterans live on as valued and valuable community members.
Veterans are more likely to own guns than non-veterans and are more likely to die by firearm suicide.
Across all suicide methods used veterans suffer a higher suicide rate compared to non-veterans, but firearms are the prevailing method among veterans who die by suicide.
Half of veterans report owning guns, compared to 20 percent of non-veterans; and veterans are nearly three times more likely than non-veterans to die by gun suicide.
In fact, the use of guns in veteran suicide is becoming more frequent. In 2021, 72 percent of veteran suicides were by gun — the highest proportion in 20 years. The prevalence of firearm use in veteran suicide means an already urgent crisis is that much more lethal.
Source: Everytown Research analysis of U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, “2001–2021 State Data Appendix,” November 2023. The proportion of suicides by gun was developed using the most recent year of available data: 2021.
Firearms are increasingly used in suicides among female veterans.
Firearm suicide makes up a smaller proportion of all suicide deaths among female veterans than among male veterans, but that is changing. From 2001 to 2021, the proportion of suicide deaths by firearm increased faster among female veterans than among male veterans (42 percent compared to 9 percent). This trend is consequential because women are the fastest-growing veteran group.
Veteran suicide is rising among all races and ethnicities.
By sheer numbers, the vast majority of veterans who die by suicide are white, as is also the case in the general U.S. population. However, the highest suicide rates per 100,000 veterans in 2021 were seen in American Indian and Alaska Native veterans, followed by white veterans and Asian, Native Hawaiian, or Pacific Islander veterans.
When looking at change in overall suicide over the past two decades, the data clearly shows that rates are rising among veterans of all races and ethnicities, although the burden is not felt equally.
This has been especially sharp among two groups: American Indian and Alaska Native veterans, who have had a 145 percent increase in their suicide rate; and Asian, Native Hawaiian, and Pacific Islander veterans, who have had a 259 percent increase.
Source: Everytown Research analysis of U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention, “2001–2021 State Data Appendix,” November 2023, https://bit.ly/2Qblicx.
How do these increases compare to racial and ethnic increases in suicide in the general public?
For both veterans and the general population, the suicide rate has increased for all racial and ethnic groups. But these increases are especially stark for veterans.
Only Black veterans saw the same suicide increase as in the general population (58 percent). In all other groups, the veteran rate increase outpaced that of the general population.
This is especially so for Asian, Native Hawaiian, or Pacific Islander veterans, who saw one of the lowest increases in the general population (30 percent), but the highest among veterans (259 percent).
The veteran suicide rate is highest among 18- to 34-year-olds.
In 2002, the highest suicide rate was seen among veterans aged 35 to 54, an age group made up of veterans who served at the same time as conflicts in Vietnam (1962–1973), the Persian Gulf (1991), and the intervening years.
Twenty years later, the suicide rate has increased among the youngest veterans, and veterans aged 18 to 34 now have the highest rate of suicide.
In fact, in 2021, the rate of suicide among this age group was 37 percent higher than the rate of suicide among veterans overall. Among both men and women, the youngest veterans are facing the highest burden. This younger cohort of veterans began service in the post-9/11 era, and some of the youngest veterans hadn’t even been born when the conflict began.
Veteran suicide is not always the result of combat trauma.
It is commonly assumed that suicide risk in veterans is due in large part to exposure to traumatic incidents while deployed to combat.
But among veterans who served during the Iraq and Afghanistan wars, those who were not deployed to those war zones were actually at higher risk for suicide than those who were.
Combat trauma has a complex relationship with suicide risk among veterans, and while research shows that certain conditions like post-traumatic stress disorder (PTSD) can contribute to suicide risk, there is no clear association between combat exposure generally and the risk of dying by suicide.
Some evidence suggests this noteworthy difference is due to the “healthy warrior effect,” where soldiers are screened for their psychological resilience early in their careers. Recruits are trained in an intense environment that may reveal traits or disorders ill-suited for a war zone.
One study of Marines deployed in Iraq and Afghanistan found that all psychiatric conditions except PTSD occurred at higher rates in non-deployed soldiers, suggesting that resilience is observed before deployment. Since veterans with mental health diagnoses have a higher suicide rate, such resilience may be an important protective factor.
Additionally, aspects of being in the military separate from combat exposure can contribute to a veteran’s suicide risk. Military service can provide soldiers with positive experiences and skills, such as leadership, decision-making, teamwork, and commitment. But the culture that leads to success in the military — prizing discipline, group needs, and close bonds with other soldiers — may be lacking in U.S. society when a soldier transitions to become a veteran.
Physical conditions that may result from military service can prove challenging as well. Chronic pain, sleeplessness, increased health problems, and decreased physical ability are all risk factors for suicide. Research shows that without support veterans risk feeling disoriented and without identity or meaning when they transition to civilian life.
Solutions
While more research is urgently needed to determine the effectiveness of veteran-specific suicide prevention and intervention efforts, policies that address firearm suicide generally can also be used to address the rising rates of suicide among veterans.
First, it is important to promote practices that put time and distance between those contemplating suicide and their guns. Veterans are more likely to own firearms than non-veterans, and the average firearms-owning veteran owns six guns.
Also, a 2022 survey found that while half of veterans own guns, the majority do not store all their guns securely. Secure storage at home, storing guns out of the home with trusted friends, family members, or community members, and utilizing Extreme Risk Protection laws — that allow immediate family members and/or law enforcement to petition a civil court for an order to temporarily remove guns during times of crisis — are all important intervention tools that can help prevent veteran suicide.
Second, increased awareness about the risks of firearm ownership among veterans can mitigate suicide risk. Many Americans are unaware of the threat firearms in the home can pose with respect to suicide, but access to a firearm increases the suicide risk three-fold for all household members. Veterans are far more likely to own firearms than non-veterans, but only 6 percent of veterans agree that having a gun in the home is a suicide risk factor.
Lastly, the lack of timely information about even the most basic aspects of veteran suicide makes it difficult to design effective interventions. Data from 2021, the most recent year available, shows that veteran suicide was exacerbated by the effects of the COVID-19 pandemic. Now, years later, it is important to see how these trends and impacts have changed. Yet public access to that data is likely two to three years away.
Knowing what challenges are facing today’s veterans is crucial to alleviating them and ultimately preventing suicide.
Paige Tetens is a Senior Associate with the Research Team at Everytown for Gun Safety. She has been with Everytown since 2018 where her work focuses on veteran suicide, hate-motivated violence, and tracking gun violence incidents.
Lead image courtesy of the author.