Suicides among young veterans climbed sharply in a recent three-year period, according to a new government analysis focused on Veterans Health Administration clients.
The number of suicides among 18- to 29-year-old men increased from 88 in 2009 to 152 in 2011. That translates into a 44% rise in the suicide rate, which jumped to 57.9 suicides per 100,000 veterans.
Experts were at a loss to explain the increase. It occurred as the Department of Veterans Affairs was bolstering its suicide prevention efforts in response to a sharp rise in military suicides during a decade of war in Afghanistan and Iraq.
One possibility is that those efforts have been successful in drawing more suicidal young veterans to the VA for care, but that many still wind up killing themselves.
"If you have more people at risk, the rates are going to change," said Dr. Timothy Lineberry, a suicide expert at the Mayo Clinic in Rochester, Minn., who was not involved in the analysis.
The authors called the trend alarming but pointed to a decline in the suicide rate among male VA patients ages 35 to 64 — a much larger population — as a sign that aggressive outreach and mental health treatment are working.
In 2010, that age group had 972 suicides, or 39 per 100,000 — a rate 16% lower than in 1999.
The improvement came as the suicide rate in the general population of men ages 35 to 64 rose 27%, to 27.3 suicides per 100,000. Government researchers have blamed the increase largely on the economy.
Janet Kemp, director of the VA's suicide prevention program and coauthor of the analysis, attributed the decline among middle-aged male veterans to the "concentrated effort we've made to target these people known to be at risk."
But she said younger veterans — even those who enroll in the VA for healthcare — are often reluctant to seek mental health treatment. "They're not fully engaged in services yet," she said.
Craig Bryan, research director at the University of Utah's National Center for Veterans Studies, said the contrasting trends illustrate the difficulty of providing treatment to patients across many generations. What works for older veterans, whose problems are often unrelated to their military careers, is not necessarily effective for younger veterans, many of whom are trying to rejoin society after being at war.
"The message is always 'go and get help,'" said Bryan, who was not involved in the study. "But just because you go to treatment doesn't mean that it works."
Just over a third of the nation's 22 million veterans — and about half of the 2 million who served in the recent wars — are enrolled to receive VA healthcare.
While the new analysis focuses on veterans enrolled in the VA, it suggests that the situation is more dire for those who are not. The researchers used death records from 23 states to look at suicides of male veterans of all ages not using the VA.
Their suicide rates increased by a third between 2001 and 2010 and were significantly higher than the rates for veterans in those states enrolled in the VA.
Both groups had much higher rates than civilians.
The new analysis is part of an expanding effort to track veteran suicides and determine how to prevent them.
The same VA researchers published a study last year that used state death records to estimate that 22 veterans committed suicide each day in 2010.
Though that statistic is cited most frequently in relation to the recent wars, the numbers represent a small fraction of veteran suicides overall.
Because military service has become relatively rare since the days of the draft, 86% of veterans are at least 40 years old, and most completed their service well before Sept. 11, 2001.
They account for about 85% of veteran suicides.
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