A new study conducted by researchers with the Department of Veterans Affairs suggests that, when it comes to male and female veterans, mental health support is far from a one-size-fits-all affair.
The study, published in September in the journal Social Science & Medicine, found that, of a pool of 25 male and 25 female veterans who had made a recent suicide attempt, different gender-specific thought patterns emerged. According to the veterans' own recollections of their thinking in the periods immediately preceding their suicide attempts, women tended to recall feeling "shameful," "tainted" and "worthless," while men said they felt "it just wasn't worth it," "I've had enough," and "screw this."
That's according to a summary of the study published by the VA on its blog in September.
"The researchers also found that experiences related to self-concept, power, relationships, coping and stress were key contributors to the Veterans' suicide attempts," adds the post, authored by VA staffer Mike Richmans. "These experiences often differed by gender."
The veterans who participated in the study, according to the VA summary, had an average age of 45 and represented service from the Vietnam War to the post-9/11 conflicts. More than half were white.
According to a study abstract, the participants were recruited from Veterans Health Administration facilities across the country and participated in hour-long interviews that covered topics including their military experience, the content of their suicidal thoughts, and accounts of suicide attempts and the health care they received following the attempt.
While the study's eight authors acknowledged there's not enough information to tailor gender-specific approaches to veteran suicide prevention, the research does suggest some specific ways to sustain and promote mental health.
"Women veterans may benefit from methods to increase self-worth through positive social relationships, while men veterans may benefit from methods that increase their sense of purpose in life and help them achieve their ideal selves through successful experiences," the abstract states.
"Our findings suggest that women and men have very different precipitating thoughts when they decide to take their own lives," Dr. Lauren Denneson, the study's lead author and a specialist in social psychology and public health at the VA Portland Health Care System, said in a statement published by the VA. "Women feel personally like they are not worth anything, and men feel like the world has sort of let them down."
Some of the interviewed veterans' responses, as reported by the VA, are wrenching.
"I felt like such a failure. No relationship worked. I wasn't productive. I wasn't doing anything that was good. I was just nonexistent in an existing world. My self-esteem was so low," one woman told researchers.
Another said her mind was telling her, "You don't deserve to be here, you don't deserve to be anything.'"
For Kayla Williams, director of the Military, Veterans, and Society Program at the Center for a New American Security, the research into the specific needs of female veterans represents a heartening trend.
"VA continues to do research on this so their providers can do a better job," she said. "A lot of research people can have gut feelings on this and be wrong."
The research has been motivated, at least in part, by significant growth in the population of female veterans as barriers to service come down and the military takes more meaningful steps to recruit and retain women. A VA report on female veterans published in 2017 projected that women will make up nearly 16% of all veterans by 2040 -- a nearly threefold increase from the 6% they represented in 2000.
The suicide rate among female veterans is also rising -- by 61% between 2005 and 2017, compared with a 43% increase among male vets, according to the VA study. While male veterans are still more likely than female veterans to attempt suicide, female vets have a suicide rate 2.2 times higher than their female civilian counterparts.
A survey of available literature and research on the health of female veterans found the number of papers increased from fewer than 30 in 2010 to 100 in 2015. Of the 440 papers on the topic published from 2008 to 2015, 302 were VA-funded.
Williams said the new survey does provide important insights on how to support male and female veterans, well before a crisis emerges.
"When I read about issues about feeling that they're not worth anything, almost insecurity, as opposed to how often I feel like men are angry -- the feeling that the world has let them down," she said. "Women are really different; it's more internally focused. That's why it's so important that, when we're thinking about how to tackle the suicide prpblem in the military community, we have to get further, to use a military term, left of boom."
That means helping female vets stay engaged with their communities and peers, she said, noting that new fellowship programs and organizations geared toward female veterans, such as the Women Veterans Network and Purdue University's Focus Forward Fellowship, serve this end.
"All these initiatives were started by researchers seeing the data of women's outcomes and trying to help them more upstream," she said.
According to the VA blog post, a national long-term survey of veterans who have recently attempted suicide is now underway, led by Denneson and her co-authors.
"The survey is designed to help us better understand the factors we previously identified that contributed to the Veterans' suicide attempts," she said. "This should help in informing treatment recommendations."
If you or someone you know needs help, the Veterans Crisis Line is staffed 24 hours a day, seven days a week, at 800-273-8255, press 1. Services also are available online at www.veteranscrisisline.net or by text, 838255.
-- Hope Hodge Seck can be reached at email@example.com. Follow her on Twitter at @HopeSeck.