(PS6-C72) US Military Service Buffers Suicide Risk Among Individuals with Disabling Limitations

Importance: People with disabilities are at heightened risk for suicide ideation, planning, and attempt, with risk growing as the number of disabling limitations increases. Military veterans have increased rates of suicide deaths and disability relative to civilians, yet it is unclear whether veteran status confers higher risk for suicide in those with disability.

Objective:  To determine whether the association of disability status with suicide ideation, suicide planning, and suicide attempt differed as a function of veteran status.

Design, Setting, and Participants: This secondary data analysis utilized a nationally representative, cross-sectional study using 2015–2020 National Survey on Drug Use and Health data (N=231,099, representing 236,551,727 U.S. adults). Disability status included problems with hearing, vision, mobility, cognitive function, or executing complex activity, and counts ranged from 1, 2, or ≥3 disabling limitations. Multivariable logistic regression examined suicide ideation, planning, and attempt as a function of veteran status and disability variables.

Results: Suicide risk was reported by 4.39% of the sample (weighted n=10,401,065). Veterans represented 10.71% of the sample (weighted n=25,334,073). Among those with no disability, veteran status was associated with higher risk of suicide planning (AOR:1.71, 95%CI:1.17-2.49). Among those with 1 or 2 disabling limitations, being a veteran was associated with a lower risk of suicide planning (AOR:0.57, 95%CI:0.34-0.95) and history of attempt (AOR:0.46, 95%CI:0.24-.88), respectively. No significant differences in suicide ideation were observed by veteran status among those reporting 3+ disabling limitations.

Conclusions and Relevance: Veterans with no disability had a greater risk for suicide relative to civilians with no disability. However, veteran status among those with disabilities was generally associated with lower suicide risk. Veteran status may mitigate suicide risk given increased receipt of more disability-related care through the Department of Veterans Affairs. Further research would extend this line of inquiry by examining the cause and type of disability as well as perceptions of disability on self-worth. It is possible that physical wounds of war are protective because of the meaning and value of service to one’s country.