New findings from the University of Manchester provide insight into the challenges and adversities experienced by Veterans before they take their lives
A new study by the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) based at the University of Manchester, shows the most common risk factors for suicide experienced by Veterans after leaving the UK Armed Forces mirror those reported in the general population. However, despite most Veterans seeking help from a range of support services prior to their death, few were receiving psychological intervention. This study, led by Dr Jodie Westhead, Dr Cathryn Rodway, and Professor Nav Kapur, is the second part of a wider study aimed at understanding the rates of and factors associated with suicide in personnel who have left the UK Armed Forces. By linking national databases of personnel discharged from the UK Armed Forces and data on suicide deaths, the new study identified all Veteran suicide deaths between 2007 and 2018. In this time, 1,230 (0.2%) Veterans sadly took their own lives. To better understand the pre-Service vulnerabilities, lifestyle factors and social adversities after discharge that may have influenced suicide risk in these Veterans, the researchers extracted information from coroners’ records for a sample of 145 of these Veterans.
The first part of the study, published by NCISH in 2023, showed Veterans of the UK Armed Forces were at no greater risk of suicide than the general population, but that there was 2-3 times higher risk in young (<25 years) ex-Service men and women when compared with the general population of the same age. Although there have been a number of studies of suicide in Veterans of the UK Armed Forces, there are few in-depth studies investigating the adversities and experiences Veterans face before they die, as well as their contact with support services that could be preventative.
This latest study found that among Veterans who had died by suicide:
- One in 10 had experienced childhood adversity. Relatively few (7%) had experienced trauma related to combat or had difficulty adjusting to civilian life (4%).
- Workplace, relationship, and/or housing problems were common, sometimes occurring shortly before death. Unemployment, alcohol and drug misuse, and self-harm were also common.
- Many experienced mental health problems, although rates of post-traumatic stress disorder (PTSD) were low. Despite this, only 5% had received psychological interventions. A quarter of Veterans had both a physical and mental health problem.
- Most (97%) had been in contact with support services, particularly with their GP. Rates of contact with alcohol and drug services were low, especially given the number of Veterans with drug and alcohol problems.
- When comparing younger (16-24 years) and older (25 years +) Veterans who died by suicide, younger Veterans were more likely to be single, have a history of suicidal ideation or intent, and drug misuse. There were no differences in support service contact between younger and older Veterans.
The findings suggest a number of research and policy implications to be considered:
- Common factors related to suicide in Veterans mirror those reported in the general population such as economic stress, substance misuse, and mental ill health. Few Veterans reported difficulties in adjusting to civilian life or traumatic events whilst Serving, indicating that perhaps the challenges of daily living had a greater impact.
- Despite other studies suggesting that Veterans are not help seeking, many in this study had been in contact with healthcare services prior to their death. However, only a minority of Veterans were receiving treatment, suggesting that treatment and not initial contact may be a more pressing issue. The barriers precluding Veterans from accessing treatment need to be better understood.
- A third of Veterans in this study had been in contact with their GP in the 3 months prior to their death. This presents a further opportunity for signposting to sources of support including those beyond mental health such as employment, and housing.
- Support services staffed by people who understand Armed Forces culture should be available and accessible. There should be a focus on increasing awareness amongst both Veterans and practitioners about the support services available to them.
As well as an academic paper, the team at the University have produced a short video about the study’s key messages and what these mean for prevention.
Thank you to Dr Cathryn Rodway and Dr Jodie Westhead for writing this Research Spotlight.
References:
Westhead, J., Ibrahim, S., Bojanić, L., Turnbull, P., Appleby, L., Bacon, A., ... & Rodway, C. (2025). Observational study of the pre-service vulnerabilities, in-service exposures and post-service antecedents of suicide in veterans of the UK Armed Forces, 2007–2018. BMJ Public Health, 3(1). https://doi.org/10.1136/bmjph-2024-001433
Rodway, C., Ibrahim, S., Westhead, J., Bojanić, L., Turnbull, P., Appleby, L., ... & Kapur, N. (2023). Suicide after leaving the UK Armed Forces 1996–2018: A cohort study. PLoS Medicine, 20(8), e1004273.
