Castro and Kintzle (2014) asserted that the interpersonal-psychology theory states that three critical factors can be used to determine the risk of suicidality in an individual. They include failed belongingness, burdensomeness, and acquired ability. Failed belongingness is the feeling of failure that one gets with regards to maintaining connections and social relationships. Burdensomeness includes the feeling of giving the family, friends, and the society at large an unbearable burden. Thirdly, the acquired ability relates to an individual inclination towards engaging in painful behavior such as suicide. One of the critical health concerns facing the United States is suicide among returning combat military personnel including the young veterans. In 2014 alone, a research conducted by the Veteran Affairs (VA) postulated that more than 74,000 veterans committed suicides which accounted for 18% of all the self-inflicting deaths experienced in the country. With the psychology theory in mind, it would be important to assess and recognize suicide risk in returning combat veterans.
Veterans and Suicidality
Before assessing the risk factors that can increase suicidality in veterans, it is critical to understand the vulnerability factors that might lead them to the ending of their own lives. Researchers have postulated that the risk of suicide in the veterans is approximately 21% more than the rate among civilian adults. Kaplan et al . (2012) illustrated that between 2001 and 2014, the rates of suicide among the veterans have risen by 32%. Women have a particularly worrying trend given that in the same period, research has shown that their rates have increased up by about 85%. Another critical data that should be noted is that in 2014, 65% of the suicides caused by the veterans included individuals who were 50 years and above, most of who had little engagement in the most recent wars ( Kaplan et al . 2012). A study conducted by the Veterans Integrated Service Network (VISN) revealed that most veterans have difficulty in reintegrating to the life of civilians. Most of them reported a loss of hope, status, self, and purpose in life.
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Because they experience financial constraints, they are unable to provide their family members adequately hence intensifying the sense of burdensomeness. Most of the returning veterans empathize that it was easy to coexist in the military community because of their shared experiences and values. However, Patricia et al . (2009) illustrated that the study showed that these individuals have a feeling of general disconnect from the civilian world which plays a critical role in their tendency to remain isolated. They, therefore, develop a lack of belongingness which is closely associated with the emergence of suicidal ideation ( Patricia et al . 2009). The study also revealed that veteran’s exposure to pain is another important factor that can be considered in assessing their tendency to commit suicide. Their increased tolerance for pain characterized by their ability to cope with main could lead to suicidality ( Castro & Kintzle, 2014).
Recognizing the Risk Factors
According to Patricia et al . (2009), “Suicide Risk in Returning Combat Veterans,'' the three factors that can lead a returning veteran to commit suicide include burdensomeness, failed belongingness, and acquired ability. Some of the critical questions to ask a veteran that would help in assessing their risk include matters relating to their relationships, finances, and loss of purpose or status. In each of the three factors suggested by Patricia et al . (2009), some factors can increase the chances of a veteran committing suicide.
Burdensomeness
Burdensomeness includes the feeling of giving the family, friends, and the society at large an unbearable burden. One of the critical factors that can lead to a feeling of burdensomeness on a returning veteran is mental health whereby the veteran feels that their ailment causes an unbearable burden on the family members.
Mental Health
As stated earlier, veterans commit suicides at a higher rate compared to the general population. The Veteran Affairs estimated that approximately 5000 veterans commit suicide every single year. The deaths are inevitable despite some prevention mechanism carried out by the VA. One of the primary risk factors usually assessed in determining suicidality among the veterans is their mental health condition. One of the mental conditions closely associated with suicidality among the veterans is the Post-traumatic Stress Disorder (PTSD). PTSD is a mental disorder that comes about after experiencing a traumatic event and is characterized by nightmares, recurring images of the traumatic event, and difficulty in forming social relationships. Pompili et al. (2013) asserted that there is strong evidence that suggests there is a high suicide risk among veterans who experienced combat trauma in the form of PTSD. Moreover, the intensity of the combat trauma and the frequency with which it occurred can also influence suicidality among the veterans. The rationale behind PTSD and suicidality among the veterans stems from the fact that many of these ex-soldiers experience multiple intrusive thoughts of guilt with regards to certain decisions that they took in the course of the war.
Failed Belongingness
Failed belongingness is the feeling of failure that one gets with regards to maintaining connections and social relationships. Some of the factors that can cause a feeling of failed belongingness include an increased disconnect to the rest of the world. Risky behavior that these people could engage in includes abuse of drugs, alcoholism, and stigmatization, all which could lead to suicidal ideation.
Drug and Alcoholism
Veterans using alcohol and other drugs are almost twice as likely to commit suicide as those who do not. Veteran women are even at a higher risk of committing suicide when using alcohol and drugs with a prevalence of approximately five times that of their peers in the general population. The highest risks have been reported in veterans who misuse prescriptions including the sedative medicines. Women abusing the opioid drugs are also reported to have an increased risk of killing themselves. Findings from a study conducted by a journal referred to as ‘’Addiction’’ postulated that suicide preventing techniques should be directed to veterans who suffer from substance abuse disorder especially if they have one of the following mental disorder including schizophrenia, anxiety or PTSD among others.
Stigma
As stated earlier, the VA postulates that approximately 22 veterans commit suicide in each day. Such a high rate can be associated with barriers to receiving mental care chief of them being the stigma. Whereas physical injuries sustained during military operations are quickly treated, the veterans remain with untreated emotional and psychological wounds that occurred in the course of their operations. Kaplan et al . (2012) pointed out that once they reconnect back to the society, such wounds cause them to isolate themselves from the general population. The receipt of mental treatment is also highly stigmatized in the military community. Some view it as a factor that goes against the military ideals of endurance, self-sufficiency, strength, and mental fortitude. Therefore, those seeking mental treatment are regarded as weak, dependent, and deficient. Such stigmatization will have a toll on an individual because it will subsequently act as a barrier to health increases the likelihood of suicide once the person is no longer able to sustain the increased pressure.
Acquired Ability
Thirdly, the acquired ability relates to an individual inclination towards engaging in painful behavior such as self-harm. Due to their torrid experiences in the combat, they have a higher likelihood of engaging in irrational behavior which aims at inflicting pain or even leading to suicide. One of the common risk factors for suicide among veterans is due to access to firearms.
Access to Firearms
It has come to the attention of many authorities of the rise in suicide rates in America and how the numbers in the veteran population seem to be topping the charts. Most the suicides reported have been completed using firearms. Research has also found out that reducing the rate of suicides among these people would require separating them from their guns. The decision to terminate life is always spontaneous and therefore the most tenable way of preventing such an unlikely scenario among the veterans is to reduce their accessibility to firearms. The use of guns is the deadliest method one can use in committing suicide. Other methods such as pills are prone to abortion and therefore do not kill as often. The firearms can also be used to explain the surprisingly high rate of suicidality among female veterans in comparison to the female counterparts in the population. In this regard, the VA reported that female veterans are33% more prone to use a gun to commit suicide than the women in the general population.
In summary, understanding suicide among the returning combat veterans require an appreciation of the interpersonal-psychology theory that attempts to explain the position of the veterans in the society. The key risk factors for suicide among these people include mental illness such as PTSD, drug and alcohol abuse, access to firearms, stigma, and the difficulties in readjusting to the society. Important strategies that the veterans can use in preventing suicidality include camaraderie, treatment for PTSD, restricting their access to firearms and other weapons, and engaging in community support.
References
Castro, C. A., & Kintzle, S. (2014). Suicides in the military: the post-modern combat veteran and the Hemingway effect. Current psychiatry reports , 16 (8), 460.
Kaplan, M. S., McFarland, B. H., Huguet, N., & Valenstein, M. (2012). Suicide risk and precipitating circumstances among young, middle-aged, and older male veterans. American journal of public health , 102 (S1), S131-S137.
Patricia A, Alexander, Lisa, & Brenner, (2009). Recognizing Suicide Risk in Returning Combat Veterans. Military OneSource Affiliate Update.
Pompili, M., Sher, L., Serafini, G., Forte, A., Innamorati, M., Dominici, G., ... & Girardi, P. (2013). Posttraumatic stress disorder and suicide risk among veterans: a literature review. The Journal of nervous and mental disease , 201 (9), 802-812.
