Suicidal ideation and mental health indicators among u.s. adults with military service history

Mental health and suicide risk are urgent topics among populations with military service histories. Epidemiologic studies about these topics are limited in that: (1) most research about suicide risk comes from mortality studies and much less is known about suicidal ideation or attempt; and (2) information about veteran mental health and suicide risk comes mostly from clinical populations (i.e., Veterans Health Administration (VHA) utilizers), limiting knowledge about veterans in general. To address these gaps, we examined 2010 Behavioral Risk Factor Surveillance System (BRFSS) data from 5 states that assessed past 12-months suicidal ideation (n=26,736). State-level data were matched with the national BRFSS dataset to facilitate weighted analyses that were stratified by sex and examined differences in four mental health indicators (suicidal ideation, mental distress, poor sleep, life dissatisfaction) by military service history (i.e., active duty, veteran, National Guard/Reserves). Among this sample, military service history was associated with slightly increased odds of frequent mental distress (aOR=1.34, 95%CI:1.02-1.76) and poor sleep (aOR=1.36, 95%CI:1.10-1.69) among men; it was not associated with mental health outcomes among women. Results suggest that military service history, itself, is not independently associated with suicidal ideation. To be clear, mental health and suicide risk are public mental health imperatives for all populations, not just those with military service histories. Suicide is the tenth leading cause of death and enhancing population-based surveys, like the BRFSS, to include information about suicide risk can lead to more accurate national surveillance.