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For many female veterans, post-war life can be more deadly than being on the battlefield. A recent research study out of Portland State University (PSU) and Oregon Health & Science University (OHSU) suggests young female veterans are nearly 3 times as likely as civilian women to commit suicide. The paper "Self-Inflicted Deaths Among Women With U.S. Military Service: A Hidden Epidemic?" appears in the December 2010 journal Psychiatric Services, published by the American Psychiatric Association. This work is the first general population study of current suicide risk among women with U.S. military service.
A Sad Trend for Women
While it is known many women veterans experience posttraumatic stress syndrome (PTSD), hypertension and depression, until this study, there was not a clear sense of whether these and other symptoms were leading to acts of suicide.
Mark Kaplan, DPh, professor of community health at PSU, said that, tragically, when we think of suicide mortality in the military and among veterans we think first and foremost about men, not women.
"The new data sadly shows that women veterans have picked up a trend that has plagued male veterans for years: attempting suicide by using guns," explained Kaplan, who co-authored the paper with Bentson McFarland, MD, PhD, professor of psychiatry, OHSU School of Medicine and Nathalie Huguet, PhD, of PSU. "Both genders are more likely to succeed in suicide if they use guns other than other methods."
Younger Women at Higher Risk
The research, funded by the American Foundation for Suicide Prevention, was conducted by tracking suicide data in the 16 states that constitute the National Violent Death Reporting System, a program within the CDC.
 According to the study, female veterans between the ages of 18 and 34 are at highest risk. The rate was lower in the next oldest age group studied (35-44 years of age) and the rate was lower still among those ages 45-64. However, even within this age group, the rate was higher than civilian women's suicide rates. The study examined data on 5,948 female suicides committed between the years 2004 and 2007. In the 18-34 age group alone, there were 56 suicides among 418,132 female veterans (1 in 7,465) and 1,461 suicides among 33,257,362 non-veterans (1 in 22,763).
"This study shows that young women veterans have nearly triple the suicide rate of young women who never served in the military," said Kaplan. "The elevated rates of suicide among women veterans should be a call-to-action, especially for clinicians and caregivers to be aware of warning signs and helpful prevention resources."
Nurses Can Help
Robert Tell, LCSW, lead suicide prevention coordinator, Portland VA Medical Center, believes nurses are a tremendous help to preventing suicide.
"The most important clinical factor in preventing suicides is a positive clinical relationship. Nurses excel at connecting with clients and assuring that they are taken care of, which saves lives," he commented. "I believe the reason women vets have higher suicide rates than their civilian counterparts is because they are more hesitant to seek treatment and more comfortable with guns."
Kaplan adds that nurses should make sure to ask their female patients about their military history. "They also need to be more alert to the signs that female patients who are veterans might be contemplating suicide and to assess their access to firearms," he explained. "In an earlier study, we found that female veterans were 56 percent more likely to use a firearm to end their lives than their nonveteran counterparts."
Kaplan suggests the Veterans Administration create a hotline for women. "Women veterans often feel stigmatized and will not use their services. If they can call in and speak with someone anonymously, they may do it, and it could save lives."
Read the full text of the study here.
Leslie Feldman is a contributor to ADVANCE.
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