The Relationship Between Childhood Abuse and Suicidal Behaviours in a Treatment-seeking Sample of Canadian Military, Police, and Veterans
Abstract: The prevalence of suicide and related behaviours among members and Veterans of the Canadian Armed Forces (CAF) and Royal Canadian Mounted Police (RCMP) has received much empirical attention; however, data from clinical samples are less available than data from population-based studies. The present study examined potential relationships between suicidal behaviours and childhood abuse history in a treatment-seeking sample of CAF and RCMP members and Veterans. ata were obtained through chart reviews of 412 clients at an outpatient mental health clinic. Hierarchical logistic regressions were conducted to determine associations between childhood abuse and suicide-related behaviours.After controlling for demographics, individuals who reported a childhood abuse history were more than three times as likely as those reporting no abuse to have made a suicide attempt. Veterans and individuals reporting childhood sexual abuse were at the greatest risk of suicide attempt. The prevalence of suicidal behaviours was higher and the reporting of childhood sexual abuse was lower compared with rates found in population-level studies.Results correspond with population-based findings, that CAF and RCMP abused in childhood attempt suicide more than their non-abused peers, and Veterans of these forces are at greater risk than those serving. A higher prevalence of suicide-related behaviours and a lower prevalence of reported childhood abuse, compared with population-level samples, was found. Clinicians working with CAF and RCMP populations should be aware of increased suicide risk related to childhood abuse history and Veteran status and note that childhood abuse history may be under-reported among treatment seekers.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.