Veterans in College at Risk for Suicide: Report

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G.I.s who come home from war and go on the college appear to be harboring high rates of suicidal thoughts, according to a new survey.

Almost half of veterans at colleges and universities in the U.S. reported thinking about suicide, M. David Rudd of the University of Utah and colleagues reported at the American Psychological Association meeting in Washington.

More than a third reported severe anxiety, and about a quarter reported severe depression, they found.

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"Current results would appear to indicate that large numbers of student veterans are experiencing significant psychiatric symptoms, with a considerable number at heightened risk for suicide," they said.

Many veterans returning from deployment will likely make use of higher education benefits granted to them, the researchers wrote, but it's questionable whether campuses will be ready for them, given that many face psychiatric diagnoses such as posttraumatic stress disorder (PTSD).

Rudd and colleagues conducted the first national survey to assess student veterans' emotional adjustment, psychological symptoms and suicide risk.

They distributed an electronic survey via chapters of the Student Veterans of America that included 34 questions spanning multiple psychological assessment scales.

Overall, the researchers found that the severity of symptoms was "surprisingly high," with most mean scores -- those for anxiety, depression, suicidality, combat exposure, and PTSD -- falling in clinically elevated ranges.

"In short, the 'average' student veteran reported experiencing moderate anxiety, moderately severe depression, significant symptoms of PTSD, and evidencing at least some noticeable suicide risk," they wrote.

Of 545 student veterans surveyed, 415 of whom were male, 34.6 percent had severe anxiety, 23.7 percent had severe depression and 45.6 percent had significant symptoms of PTSD.

As well, almost half of the sample (46 percent) reported thinking about suicide, and 20 percent had a plan for committing the act. About 10 percent thought about suicide often or very often; 7.7 percent had made an attempt; and 3.8 percent believed that a suicide attempt was "likely" or "very likely."

Rudd and colleagues called the findings "alarming," not only in comparison to other college or university students, but also in contrast to veterans seeking mental health services from Veterans Affairs clinics.

When assessing suicide risk, they found a strong relationship with PTSD, as 82 percent of those who had tried to take their lives reported significant symptoms of the disorder.

As well, 60 percent of attempters reported severe depression which was statistically significant.

Veteran Students at Risk for Suicide: Report

The severity of PTSD symptoms moderated the relationship between suicidality and depression, "something for all clinicians to be mindful of in day-to-day practice," the researchers wrote, as PTSD symptoms "can often times be overlooked when comorbid with significant depression, hopelessness, and suicidality."

"Sometimes, clinicians query about the most prominent symptoms, and that can be depression," Rudd said in an email to MedPage Today. "Also, it's important to recognize that some of those struggling with PTSD have not had 'direct' combat exposure."

For instance, Rudd said, even those in support positions "are exposed to the threat of violence in a combat zone, even if indirectly, so it's sometimes overlooked."

He and colleagues concluded that it's important to consider whether colleges and universities are adequately prepared to treat student veterans when needed, since treating combat-related trauma and suicide risk requires special training.

They noted that they're "not aware" of any data on the preparedness of campus counseling centers to meet demand for these services, although some have responded by setting up Student Veteran Service Centers.

Broad-based screening for student veterans may also be worth considering, the researchers said.

The study was limited by self-reported data and its cross-sectional nature. Also, it has a limited ability to evaluate psychiatric conditions because it relied on brief screening measures, particularly in terms of assessing PTSD, which also requires clinical examination to diagnose.