Women's suicide risk rises sharply after military service
Young women who've served in the military face a suicide risk triple that of non-veterans. The Portland researchers who made this finding are urging medical and public health officials to find more effective ways to reverse the deadly epidemic.
"Most of the attention has focused on men -- that's why we call it a hidden epidemic," said co-author Mark Kaplan, a professor at Portland State University. "Clinicians need to be more aware of this problem. "
Kaplan's group analyzed records on every female suicide from 2004 to 2007 in Oregon and 15 other states. From 5,948 deaths, they calculated the risks faced by women who served in the military and those who did not.
Among veterans age 18 to 34, the suicide rate was 1 in 7,465, compared with 1 in 22,763 among non-veterans. Suicide rates were 78 percent higher among female veterans age 35 to 44, and 58 percent higher among those age 45 to 64. Dr. Bentson McFarland of Oregon Health & Science University, Nathalie Huguet of PSU, and Kaplan published the study Wednesday in the journal Psychiatric Services.
Reversing the epidemic won't be easy. Researches still don't know enough about what makes veterans more vulnerable. Most research on the problem has focused on men, Kaplan says.
"There needs to be more gender-specific treatment and prevention resources addressing the problems of female veterans," he says.
It's clear that the sustained psychological stress during deployment can make women and men vulnerable. Soldiers in Iraq and Afghanistan live under constant threat of attack and endure months away from spouses and children. Alcohol and drug abuse, used by some to cope with stress, increase suicide risk. However, not all military women in the study served overseas.
Many women in the military face the added threat of sexual violence. In a study of 21,800 women veterans who served in Iraq, 15 percent experienced sexual assault or harassment while in the service.
Unlike civilians, military women can be less likely than men to seek help for mental health problems, said Robert Tell, lead suicide prevention coordinator with the Portland VA Medical Center. The military culture motivates women to "prove" they are as strong as men, Tell says.
Women with military experience are more likely to use a gun when suicidal, Kaplan and colleagues found in a previous study. That makes suicide attempts far more lethal.
The military is attracting higher numbers of women and exposing them to more combat. A report in October by an Oregon legislative task force on women veterans' health notes that more than 250,000 women served in Iraq and Afghanistan, compared with 7,500 during the Vietnam War. Women are being exposed to more traumatic brain injuries, amputations, and other combat type injuries than before.
"There are women veterans who saw a lot of combat who look like the mom next door," says Tell. "I really hope studies like Kaplan's can get it into people's minds that women veterans served in harm's way."