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Veteran Suicides Increasing After Federal Election?
« on: September 25, 2015, 10:04:00 AM »
Susceptibility of Canadian Military Suicides Increasing Without Re-Instated Health Services

Literature Review

Natalie Gillis, MSc (Cand)
University of Liverpool Online, England
Mental Health Psychology


   There is considerable interest in the contributing factors that lead to military Veteran suicide. However, the majority of research appears to materialize from the United States on how service personnel may capitulate under the grip of suicide without health assistance. An advantage is the high number of recruits who were deployed to Afghanistan and Iraq since 2001 (Duhart, 2011), but it should be considered that not all studies will sync to leading global research or share other national values. Where there is very little investigative literature from Canada in comparison (Leenaars, 2013), this raises the question for how the country's soldiers may or may not function from services being stripped away. Literature available from the Canadian front expresses similar grief to their American counterparts on how to reduce these rates (Lee, n.d.), but a recurring gap with this topic everywhere is reliability and predictability because suicide is multi-determined (Leenaars, 2013) and inconclusive (Hoffmire, Piegari & Bossarte, 2013). As a result, irrefutable information could be lost (Hoffmire et al., 2013) because not everyone will be predictable, and not all studies show an association between Post Traumatic Stress Disorder (PTSD) and suicide (Kang, Bullman, Smolensk, Skopp, Gahm & Reger, 2015). Additionally, the mainstream recognizes the need to assist those who are coming back from deployments, but the bulk focuses on those returning from more recent theatres (war zones). The following literature review attempts to bring a clearer perspective of the difficulties when measuring a military populace.

Element and National Differentiations

   Kang et al. (2015) found that in 2008 those who served in the United States' Navy and Air Force had lower numbers of suicide than civilians, but those in the Army and Marine Corps had higher numbers than non-militants. One explanation for the Air Force and Navy having lower numbers of suicide in relation to the development and severity of PTSD could be the distance away from witnessing death (Grossman, 2009). Moreover, Duhart (2011) states that there was a 75% increase in mental health services by Army personnel who were deployed to Afghanistan between 2006-2009 alone, and more than 1.5 million soldiers from the United States went to Iraq and Afghanistan since 2001; more than 300,000 were diagnosed with PTSD from Operation Iraqi Freedom. These numbers are incomparable to the Canadian Armed Forces (CAF), and substantiates the claim that considerable research opportunities are less feasible with the CAF. In contrast, as one facet to increase literature, the Canadian Institute for Military and Veteran Health Research has partnered with a number of universities across the nation to focus on specific needs unique to Canada (Canadian Institute for Military and Veteran Health Research, 2015).

Issues with the Department of Veteran Affairs

   Veteran Affairs (VA) in both Canada and the United States have fragments, significant processing delays, and it is believed that the numbers of actual suicides are greater than what is reported (Duhart, 2014). A major note on the Canadian front is that with the upcoming Federal election many Veterans have not forgiven how pensions were completely taken away alongside unspent budgets for the CAF (Beaver & Clarke, 2015). The closing of more than half a dozen VA offices across the country in 2013 undermines the decrease of plausible suicides (Donnelly, 2014). It could, nonetheless, provide a platform and show how prospective veterans being set up for failure might need these support systems returned.
Difficulties in Collecting Data and the Utilization of Services

   Equally, this situation could be studied in opposition as to how other countries already function with either less than, equal to or more help. Unfortunately, there is also a shortage of consistent data from other countries on how soldiers function with, or make do without health services to treat psychiatric injuries. Work done by Basham, Denneson, Millet, Shen, Duckart & Dobscha (2011) expresses that the availability of mortality data has been challenging due to there being no set standard for reporting.

   The Department of Veterans Affairs in the US is presently collecting death certificates from 1999-2015 (Hoffmire et al., 2013), but it is crucial to mention that not every veteran accesses services from VA, so there will be missing prospects. Another factor to consider when collecting data is the potential for resistance because of their programmed "GI Joe" ways of thinking (Duhart, 2011). Consequently, these struggles to collect subsequent data works against being able to reflect a nation's vulnerability scale.

Themes of Military Veteran Suicide

   In light, Kang et al., (2015) were able to find that Veteran suicides in the US doubled in 2005-2009 for persons deployed to Afghanistan and Iraq. Their study also found that the highest rates were young, male, unmarried Veterans, and that being deployed to the war zone itself was not a constituent to the rise in suicides. Similarities in overall research suggest that prolonged poor health activities in relation to mental health conditions, adds to the risk of suicide albeit any treatment these individuals might receive (Lee, n.d.).

   Although mental health workers aim to provide the needs of individual cases, a pitfall is that they can also fail to consider the full scope of the Veteran community in how they try to seek help (Matthieu, Gardiner, Ziegemeier & Buxton, 2014). Matthieu et al., (2014) focused on agencies who may contact those Veterans in need of suicide prevention, methods used and the success rates of these recruitment processes. Their overall work highlighted the engagement of both private and public sectors to recognize and refer potential clients to services. A large limitation was the less than 50% response rate from agencies to take part in their sample study.

Rates of Military Veteran Suicide

   In addition, a study done in the US by Basham et al., (2011) reported that 22% of completed suicides between 2000 and 2005 (n=968) were individuals who received assistance from VA. The United States tells of there being roughly 18-22 suicides a day in their Veteran population (Duhart, 2011), but there is no consistent determination how many there are a day in Canada in comparison. The research available on US Veterans has crutched on samples of those who are at-risk of suicide because they were suffering from Depression (Basham et al., 2011).  After studying and observing several clients who visit the Emergency Departments in community settings, Knox (2012) and her colleagues noted that there is a need identify those Veterans at risk for suicide, provide intervention and follow-ups. 

Suggested Intervention Methods

   Social strategies, such as openness and self-awareness are key to prevention and risk of suicide. Being able to function and hold healthy relationships appear to be major constituents for improving health; Collaborative Assessment and Management of Suicidality, Cognitive Behaviour Therapy, and Dialectal Behaviour Therapy are encouraged as intervention methods (Knox, Stanley, Currier, Brenner, Ghahramanlou-Holloway & Brown (2012). Other avenues should be explored. Combined intervention strategies might be group retreats and talk-sites because they can be beneficial for creating bonds and sharing information. The possible dangers could be: mixing susceptible subjects with others who have instabilities, heated opinions and bullying tendencies. Management on scales that large could render as exhausting and difficult, especially with susceptibilities in a world of cyber bullying (Myers & Twenge, 2013).

Gaps in Research

   The largest gap is the unbalanced amount of data available between countries. Factors for this can be dependent on government and public interest, funding, cultural norms and the size of militaries around the World. Research does not always consider how men and women interpret trauma and their number of repeated deployments. There needs to be a trend of considering which element they served with (Air, Army, Sea), their exposure to certain events, and proximity to witnessing death on an individual basis; how many forces a country deploys and the individual's job would benefit a hollistic interpretation.

   Not all military veterans should be seen as being unsatisfied with health care they may actually receive. The data from service personnel who obtain benefits may indeed be satisfied with their services, yet in some cases this may be satisfaction of having something rather than nothing at all.  Another factor to consider that is missing is the need for being mindful of their potential for anger, rigid stubbornness and/or lowered tolerance levels; timeframe wise, this may acutely alter their impressions of healthcare and give different information.

   Mutual findings in research studies investigate long term health issues such as tobacco use, hypertension, digestive problems and heart disease, and co-morbid conditions (Lee, n.d.) that could be determinants for suicide which are not related to PTSD. Not all research is reflective of secondary or third party impacts for suicide on individual basis. Documentation of the numbers of Veterans who visit Emergency departments could give an idea of how many use this service. However, this may raise ethical and confidential issues.

   A specific set up with honest and reliable documentation of death by suicide could create legitimate rates for this populace. Medical records and death certificates need to match in order to obtain proper numbers, and it is important to further note that suicide may manifest years later for some people. Pooling every person together during a certain time when they went to war may not provide a hollistic scope of this phenomenon.


   There are several constituents that influence a person to take their own life. The listed gaps and overlooked features mentioned above, and similarly the at times exaggerated claims due to anger can negatively impact data. This report convolutes how difficult it may be to get a precise impression of how the Canadian military is actually suffering. Furthermore, it is still noteworthy to question the rates of suicide changing for Canadian military Veterans if programs are not re-instated after the 2015 Federal Election.


Basham, C., Denneson, L., Millet, L., Shen, X., Duckart, J., & Dobscha, S. (2011). Characteristics and VA health care utilization of U.S. Veterans who completed suicide in Oregon between 2000 and 2005. Suicide & Life-Threatening Behavior, 41(3), 287-296. doi:10.1111/j.1943-   278X.2011.00028.x

Beaver, T. & Clarke, R. (2015) Harper forgot about veterans. They haven't forgotten about him. Available at: (Accessed: 23/09/2015).

Canadian Institute for Military and Veteran Health Research (2015) CIMVHR Publications. Available at: (Accessed: 23/09/2015).

Donnelly, A. (2014) 'All we get is lip service': Thousands of furious veterans picket offices in battle with Julien Fantino. Available at:   today (Accessed:23/09/2015).


Grossman, D. (2009). On Killing: The psychological costs of learning to kill in war and society. New York: NY: Back Bay Books.

Hoffmire, C. A., Piegari, R. I., & Bossarte, R. M. (2013). Misclassification of veteran status on Washington state death certificates for suicides from 1999 to 2008. Annals Of Epidemiology, 23(5), 298-300. doi:10.1016/j.annepidem.2013.03.007

Kang, H., Bullman, T., Smolensk, D. , Skopp, N., Gahm, G., & Reger, M. (2015). Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Annals Of Epidemiology, 25(2), 96-100. doi:10.1016/j.annepidem.2014.11.020

Knox, K. L., Stanley, B., Currier, W., Brenner, L., Ghahramanlou-Holloway, M., & Brown, G. (2012). An Emergency Department-Based Brief Intervention for Veterans at Risk for Suicide (SAFE    VET). American Journal Of Public Health, 102(S1), S33-S37. doi:10.2105/AJPH.2011.300501

Lee, E. (n.d). Complex Contribution of Combat-Related Post-Traumatic Stress Disorder to Veteran Suicide: Facing an Increasing Challenge. Perspectives In Psychiatric Care, 48(2), 108-115.

Leenaars, A. A. (2013). Suicide among the Armed Forces: Understanding the cost of service. Amityville, NY,US: Baywood Publishing Co.

Matthieu, M. M., Gardiner, G., Ziegemeier, E., & Buxton, M. (2014). Using a Service Sector Segmented Approach to Identify Community Stakeholders Who Can Improve Access to Suicide Prevention Services for Veterans. Military Medicine, 179(4), 388-395. doi:10.7205/MILMED-D-13-00306

Myers, D.G., & Twenge, J.M. (2013). Social Psychology (11th ed). New York, NY: McGraw-Hill.
« Last Edit: November 02, 2015, 08:41:57 PM by Natalie_Gillis »