(PS9-A21) Female Veterans: Understanding Treatment Seeking Behavior and Previous Suicide Risk Among Suicide Decedents

Background and aims: In 2020, 16.8 veterans died by suicide each day (VA, 2022). Among the general US populations, firearms are used in about 50% of suicide deaths and are the most lethal method, with an 85-95% fatality rate (Center for Disease Control and Prevention, 2022). Within the veteran population, firearms are used in 71% of all suicide deaths (VA, 2022), highlighting that firearm suicides are a major concern among US veterans. The present study seeks to examine how treatment seeking, previous suicidal thoughts, previous suicide attempts, and disclosure of suicidal thoughts differ among female veteran suicide decedents who used a firearm in their death and those who used another method. It is hypothesized that female service members who die by suicide with a firearm will be less likely to currently be in treatment, to have ever been in treatment, or to have previously attempted suicide. We further anticipate that the two groups will not differ in terms of history of suicidal ideation and disclosure of suicidal thoughts and plans.

Methods: Data for the present study were drawn from the National Violent Death Reporting dataset, which was provided to the research team by the CDC. The present study examined data from those who died by suicide with a firearm or another method. This study utilized a subsample of female civilians (n = 50,632) and female veterans (n = 1,440).

Results: Among females who have served in the military, firearms were the most used method for suicide (n = 610; 42.6% vs 30.7% among civilians), and females who served in the military were significantly more likely to use a firearm in their suicide death than civilian females (C² = 167.232; p < .001; φ_c = .057). Those who served in the military and died by firearm suicide were in mental health or substance use treatment at the time of their death at a significantly lower rate than those who used another method (33.4% vs. 45.8%; C² = 22.336; p < .001; φ_c = .125). Additionally, those who used a firearm had lower rates of lifetime mental health or substance use treatment (39.5% vs. 53.2%; C² = 26.41; p < .001; φ_c = .136). Those who used a firearm in their suicide death compared to those who died by another method had significantly lower rates of previous suicide attempts (23.0% vs. 36.0%; C² = 28.358; p < .001; φ_c = .140). The two groups had similar rates of suicidal ideation (23.3% vs. 24.1%; C² = .119; p = .389; φ_c = .009) and disclosure of thoughts (26.6% vs. 26.5%; C² = .001; p = .511; φ_c = .001).

Discussion: Firearm suicide deaths are a major concern among the veteran population. Female veterans are at a greater risk for utilizing a firearm in their suicide death than female civilians. Often, health care providers are tasked with discussing lethal means counseling and secure firearm storage; but female veterans who use a firearm in their death are less likely to seek mental health care services (compared to those who use another method), meaning that the message on secure firearm storage is not being provided to those who need to hear it most. Population level suicide prevention and means safety efforts are needed in order to increase secure firearm storage and reduce suicide rates.