Publication year
2015
Citation Title
Military veterans' experiences with suicidal ideation: Implications for intervention and prevention
Journal Name
Suicide and Life-Threatening Behavior
Journal Volume
45
Issue Number
4
Page Numbers
399-414
DOI
10.1111/sltb.12136
Summary
An in-depth analysis of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veteran’s experiences with suicidal ideation was conducted. The study included 34 semi-structured interviews with OEF/OIF Veterans on what lead up to disclosure of suicidal ideation during clinical assessments. Overall there were found to be three overarching domains relevant to Veterans’ experiences around suicidal ideation: military culture, difficult deployment experiences, and post-deployment adjustment challenges.
Key Findings
Veterans made implicit and explicit references to military culture throughout the interviews, yet each noted individual experiences within this culture.
Within the post-deployment domain, four primary themes emerged: adjusting to civilian culture, changes to sense of self, feeling overwhelmed by stressors, and lacking purpose or meaning in life.
Secondary themes present across the main themes were: struggles for control, discomfort with ambiguity, functional limitations, mental health issues, employment concerns, inadequate contributions to society, disrupted relationships, and devaluation of life.
Implications for Program Leaders
Offer Service members post-deployment reintegration workshops on adjusting to civilian culture, coping with life stressors, rebuilding a sense of self, and developing a life purpose and meaning
Provide post-deployment support groups for deployed Service members to process difficult deployment experiences (e.g., difficult duties, unit cohesion and leadership, and combat experiences)
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals can find help
Implications for Policy Makers
Continue support for suicide prevention efforts that are responsive and flexible in meeting Service members’ unique experiences
Build awareness across military branches around the importance of supporting and promoting mental health among returning Service members
Encourage collaboration among DoD programs, the Veterans Affairs (VA), and community-based organizations to support Service members’ reintegration needs
Methods
Veterans who screened positive for depression or PTSD and endorsed suicidal ideation during brief risk assessments were recruited at three geographically diverse VA medical centers.
Thirty-four Veterans were asked in semi-structured interviews about events or circumstances that led up to their disclosing suicidal ideation, prior suicide attempts, and prior experience with suicidal ideation and mental health care.
Analysis included the research team independently reading each transcript, creating preliminary codes, discussing divergent coding, and establishing consensus on common themes.
Participants
Thirty-one participants were male and three were female.
Most participants identified as White (74%), while 15% identified as Black, 6% as Latino, and 6% as other.
The average length of time that participants were in the military ranged from 3-30 years, with the average being 14 years.
Limitations
Participants in this study had already accessed VA health care and endorsed suicidal ideation prior to participating in the interviews; which could have biased the findings.
Veterans self-selected to participate in the study; therefore, findings could have biased towards those who were more comfortable discussing thoughts of suicide.
The proportion of racial/ethnic minority and women veterans in the study was lower than the proportion of racial/ethnic minority and women veterans from OEF/OIF who received assessments during the same study period; therefore, the results should be interpreted with caution to these groups.
Avenues for Future Research
Further this study with a more diverse group (e.g., gender, race and ethnicity, rank) of Service members and their experiences with suicidal ideation
Investigate in greater depth the themes of adjustment to civilian culture, coping with unexpected stressors, developing a sense of self, and life purpose and meaning
Explore upstream prevention efforts, prior to a crisis or presentation of suicidal ideation
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
We sought to understand Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans’ experiences with suicidal ideation. Semi-structured interviews with 34 OEF/OIF veterans addressed circumstances leading up to disclosure of suicidal ideation during brief clinical assessments. We used an iterative, inductive and deductive thematic analysis approach. Results
revealed three pervasive, persistent domains that reinforce the uniqueness of veteran suicidal thoughts: military culture, difficult deployment experiences, and postdeployment adjustment challenges. Within postdeployment, we identified four themes that serve as intervention targets: adjusting to civilian culture, changes to sense of self, feeling overwhelmed by stressors, and lacking life purpose or meaning.
revealed three pervasive, persistent domains that reinforce the uniqueness of veteran suicidal thoughts: military culture, difficult deployment experiences, and postdeployment adjustment challenges. Within postdeployment, we identified four themes that serve as intervention targets: adjusting to civilian culture, changes to sense of self, feeling overwhelmed by stressors, and lacking life purpose or meaning.
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