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Suicide Risk and Veterans Health Administration Utilization Among those With a Documented Suicide Attempt in the US
Mark A Reger1,2,3, Sybil W Morley4, Kevin D Masters4
1Office of Research & Development, US Department of Veterans Affairs, Washington DC.
The Journal of Clinical Psychiatry
|April 15, 2026
Summary
Veterans with a prior suicide attempt are more likely to use Veterans Health Administration (VHA) services post-separation, yet many high-risk individuals remain disengaged from care.
Area of Science:
- Military Health
- Suicidology
- Public Health
Background:
- Suicide attempts are a significant predictor of future suicidal behaviors.
- Veterans transitioning from military service represent a population at elevated risk for suicide.
- Understanding the impact of pre-separation suicide attempts on post-service outcomes is crucial.
Purpose of the Study:
- To investigate differences in Veterans Health Administration (VHA) utilization and suicide outcomes among service members with and without a history of suicide attempts before military separation.
- To assess the risk associated with pre-transition suicide attempts among U.S. Veterans.
Main Methods:
- A retrospective study analyzed 1,030,599 service members separating from the U.S. military between 2015 and 2020.
- VHA utilization, documented suicide behaviors, suicide mortality, and all-cause mortality were examined for two years post-separation.
- Comparison was made between individuals with and without a documented suicide attempt in the two years preceding military separation.
Main Results:
- Service members with a prior suicide attempt showed significantly higher initiation of VHA care (HR=1.91) and VHA mental health care (HR=2.20).
- Among those accessing VHA care, 90% with a recent suicide attempt utilized mental health services, but 39% with a prior attempt did not engage with VHA care.
- Individuals with a pre-separation suicide attempt had a substantially higher risk of a subsequent suicide attempt (RR=7.78) and suicide death (SMR=9.94) post-separation.
Conclusions:
- Most Veterans utilize VHA services post-separation, indicating successful engagement for many.
- A notable proportion of high-risk Veterans, specifically those with a history of suicide attempts, remain disengaged from VHA services.
- Targeted interventions are needed to improve VHA engagement among high-risk Veterans transitioning from military service.
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