Suicidality Among Veterans after Surgery

Jay Morse & Heidi Radunovich, PhD

Suicidal ideation and behavior is a critical topic for the U.S. military.  According to a recent Huffington Post article, 185 active-duty Army soldiers committed suicide? in 2013 – more than the number of Army soldiers killed in combat in Afghanistan in that year [1].    However, much still needs to be learned about what increases risk of suicide, and the role that ethnic status could play in suicide risk.

Copeland and colleagues researched suicidality in Hispanic and African American veterans [2] to determine if there was a relationship between suicidal behavior and ideation (SBI) in post-surgical patients who had a history of severe mental illness. This analysis included 89,995 veterans who had undergone surgeries such as bone or joint surgery, vascular surgery, or amputations.

Of the 89,995 VA patients (with an average age of 64) in this sample, 2,836 were found to have suicidal behavior and ideation in the 3 years following surgery.  Consistent with previous research (Prior suicide attempts, Oct 2014), the researchers concluded that veterans with a previous history of severe mental illness (schizophrenia, bipolar disorder, PTSD, or depression) experienced a significantly increased likelihood of SBI.

However, the results of the study were not as clear when examining different ethnicities – African Americans showed an increased likelihood of SBI while Hispanics did not, and it was not clear why this was the case. It was noted that both African-American and Hispanic surgical patients reported higher rates of severe pain after surgery, but received lower doses of medication than White, non-Hispanic pain patients.  More study will be required to determine the influence of ethnicity on   the risk of SBI following surgery.

While this study had a number of limitations, (the study used archival data and was limited to veterans, there were few women in the study) the importance of mental health care following surgery was clear.  Pre-operative and post-operative mental health monitoring is important to achieve a positive outcome for the patient.

When working with minority groups in the military, consideration should be given to the individual client’s environment – family, work, and community – and the influence of culture in these groups.

In an upcoming webinar Dr. Andrew Behnke will focus on current issues and implications for clinical and advocacy work with Latino military families.

References

[1] Wood, D. (2013, September 25).  Tragedy of military suicides will ‘go on for many years,’ army chief warns. The Huffington Post. Retrieved from: http://www.huffingtonpost.com/news/military-suicide-rate/

[2] Copeland, L. A., McIntyre, R. T., Stock, E. M., Zeber, J. E., MacCarthy, D. J., & Pugh, M. J. (2014). Prevalence of suicidality among hispanic and african american veterans following surgery. American Journal of Public Health, 104, S603-8.

 This post was written by Jay Morse & Heidi Radunovich, PhD, members of the MFLN Family Development (FD) team which aims to support the development of professionals working with military families. Find out more about the Military Families Learning Network FD concentration on our website, on Facebook, on Twitter, You Tube, and on LinkedIn.