Expert reporting
Jeremy Schwartz has covered military and veterans issues for the American-Statesman since 2009 and reported from Iraq in early 2011 and from Afghanistan in April 2012. He was part of the Statesman investigative team that determined causes of death for nearly 300 Texas Iraq and Afghanistan veterans in September 2012. Read more at statesman.com/uncountedcasualties.
Suicides among veterans increased more than 20 percent between 2007 and 2010, when an average of 22 veterans per day killed themselves, according to a long-awaited Department of Veterans Affairs study released Friday.
The study, the most comprehensive yet conducted by the VA on veteran suicide, found that about 8,000 veterans committed suicide in 2010, or 22 a day, up from the estimated 18 per day in 2007.
The study concluded that suicide is particularly a problem among older veterans, with just under 60 being the average age of the veterans who killed themselves. About 70 percent of the suicides occurred in veterans over 50. The VA study didn’t analyze suicides specifically among Iraq and Afghanistan veterans, who typically are much younger and represent just a small portion of the overall veteran population. But other analyses have shown that younger veterans are also killing themselves at alarming rates.
A 2012 American-Statesman investigation into deaths of Texas veterans of Iraq and Afghanistan found that the percentage under 34 committing suicide was 1.7 times higher than the overall Texas population of similar age.
VA officials said that because suicide among the overall U.S. population has risen at a faster rate than that of veterans in recent years, the situation among veterans isn’t as dire as many experts and veteran advocates contend. Robert Petzel, undersecretary of health for the VA, said the study “provides preliminary evidence that the programs initiated by VA are improving outcomes.”
And Robert Bossarte, the VA epidemiologist who conducted the study, told The Washington Post that veteran suicides are part of a national trend. “There is a perception that we have a veterans’ suicide epidemic on our hands,” he said. “I don’t think that’s true.”
Veterans advocates viewed the results through a different prism.
“Any way a human being looks at this disaster, an increase from 18 to 22 suicides a day is a crisis that requires the immediate attention of top VA officials,” said Paul Sullivan, veterans outreach director for the Bergmann and Moore law firm in Maryland and former head of Veterans for Common Sense, which sued the VA over its suicide response in 2008. That lawsuit helped expose the high numbers of veterans killing themselves: While the VA had vigorously denied a 2008 CBS News report citing the estimate of 18 veteran suicides a day, documents obtained during the lawsuit showed the VA not only agreed with the CBS News estimate, but was trying to hide the extent of the suicide problem from public view.
Sullivan said he hoped the current VA study would be reviewed by independent researchers. “The next step is a peer review … because the VA has a history of downplaying the suicide crisis,” he said.
The latest study is the result of a two-year effort to obtain better suicide numbers from individual states, which report death certificate information to a federal database called the National Death Index. In all, 34 states have provided information to the VA and eight more have agreed to do so, but data from just 21 states was used in the study. A follow-up study in May is expected to contain additional data (That could include statistics from Texas, which wasn’t included in Friday’s study and has only provided partial numbers, according to the VA). Numbers from 2012 are also expected over the next year.
The study, using VA health administration data, also found that veterans at risk for suicide should get intensive monitoring and case management in the first four weeks after receiving VA health services, when most suicide attempts occur.
“Outreach remains critically important,” the report stated, adding that the Veterans Crisis Line, a toll-free number for veterans and active duty service members, has proven to be an effective strategy in getting veterans help. VA officials said they have met an executive order from President Barack Obama to hire new staff to increase the line’s capacity by 50 percent and are in the midst of an “aggressive” hiring campaign to find 1,600 new counselors and 800 peer-to-peer specialists.
While the study didn’t analyze suicide methods, it did reveal the prevalence of drug overdoses in suicide attempts: More than half of nonfatal suicide attempts were the result of drug overdoses or intentional poisonings.
The 2012 American-Statesman investigation showed that drug overdoses among Iraq and Afghanistan veterans represent a largely hidden epidemic: Of the 266 Texas veterans whose cause of death was determined, 44 died of a drug overdose that wasn’t considered a suicide, largely from prescription drugs dispensed for pain and psychological distress. That was just one less than the number of Texas Iraq and Afghanistan veterans whose deaths were classified as suicide, suggesting the VA’s prescription drug overdose problem could be at least on par with its suicide crisis.
Yet compared with suicides, drug overdose deaths have received relatively scant attention from the VA, and the agency has yet to publicly release a comprehensive breakdown of causes of death of Iraq and Afghanistan veterans. The agency has told the American-Statesman it soon plans to release an “all-cause” mortality study of combat veterans that could provide that information, though officials have declined to say how they plan to use or present the results.
