Younger Vets at High Suicide Risk

The authors hypothesize that veterans with service-connected disability may have reduced suicide risks as a result of their greater access to VA health services and regular compensation payments that stabilize their income. Depressed veterans with PTSD, they point out, more often receive therapy or medication based treatment than veterans without PTSD because VA funding is allocated specifically for treatment of the condition.

"Those veterans with PTSD and depression are probably getting more mental health care, and may also be getting antidepressants, both of which help to reduce the risk of suicide," Koenig said.

The Fight Doesn't End at Home

However, even though access to care could lower the chances of suicide among veterans, many are often hesitant to seek medical attention for fear of stigma.

Dr. Bruce Spring, assistant professor of clinical psychiatry at the University of Southern California in Los Angeles, fears this stigma could be deadly.

"[We must] have a culture where seeking psychological and psychiatric care is promoted," he said.

Some experts feel that therapy and medication are only a part of the solution and instead encourage a multidisciplinary approach.

"Of course, we need greater availability and encouragement of psychiatric care," said Koenig. But, he added, "some veterans don't want to see mental health professionals."

Koenig feels that many veterans would feel less stigmatized if they were able to see a chaplain to talk to about their emotional distress; he favors increasing the availability of chaplains in the military.

"One of the most powerful deterrents to suicide is religious belief," Koenig said. "Any of the stresses that veterans face has a spiritual component that is typically ignored by mental health professionals."

Others in the field are concerned that even if veterans choose to seek out treatment, the nation may not be able to provide the infrastructure -- and access to that infrastructure in terms of policy and insurance -- to meet the needs of those who will need it.

"It will only get worse with returning veterans," said Ragan. "Do we need to link increased funding for wars with increased funding for the resources to take care of these individuals when they return home from war?

"We must decide, as a nation, if we should fund the resources to take care of these individuals."

Regardless of the method, other experts agree that the psychiatric needs of veterans must be targeted in an effort to curtail the rising suicide rates.

Valenstein and her colleagues hope that the findings presented in their study will assist policy makers and clinicians in targeting and monitoring specific veterans for signs and symptoms of potential suicidal behavior. It is her goal to better address the psychiatric needs of depressed veterans in an effort to stymie suicide rates.

After all, she said, "the mission is to improve the quality of care."

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