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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
Westhead, Jodie Ibrahim, Saied Bojanić, Lana Turnbull, Pauline Appleby, Louis Bacon, Andrew Dale, Harriet Harrison, Kate Kapur, Nav Rodway, Cathryn
Westhead, Jodie
Ibrahim, Saied
Bojanić, Lana
Turnbull, Pauline
Appleby, Louis
Bacon, Andrew
Dale, Harriet
Harrison, Kate
Kapur, Nav
Rodway, Cathryn
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2025-03-25
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Abstract
INTRODUCTION: Although there have been a number of epidemiological studies of suicide in veterans, there have been few in-depth studies of those who have died. Studies have not explored the relative contribution of pre-service, in-service and post-service factors. We aimed to investigate the adversities veterans face before they take their lives, their contact with support services that could be preventative and whether these differ in younger and older veterans.
METHODS: Using national databases of discharged personnel and suicide deaths, we identified deaths by suicide in personnel who left the UK Armed Forces (UKAF) between 2007 and 2018. We extracted information on the antecedents of suicide in a random sample of these deaths from official investigations, mostly coroners’ records.
RESULTS: In total, we obtained data for 145 individuals; 134 (92%) were male and 11 (8%) were female. Seven (5%) were from a minority ethnic group. The median age at death was 36 years (21–65 years). 18 (12%) veterans had experienced childhood adversity. Relatively few (10, 7%) experienced trauma relating to deployment on combat operations or had difficulty adjusting to civilian life (6, 4%). Most (140, 97%) veterans had been in contact with support services, particularly primary care (130, 90%), but undertreatment was common with only 10 (5%) veterans having received psychological intervention. Unemployment, alcohol and drug misuse, mental and physical ill health, workplace, housing and relationship problems were common antecedents.
CONCLUSIONS: Veterans experience a range of challenges after leaving the UKAF. Common antecedents to suicide, such as self-harm, suicidal ideation and drug misuse, are open to intervention. However, despite most veterans seeking help from a range of support services, few were receiving psychological intervention. Prevention should also focus on addressing the needs of veterans beyond mental ill health, like employment and housing.
Citation
Westhead, J., Ibrahim, S., Bojanić, L., Turnbull, P., Appleby, L., Bacon, A., Dale, H., Harrison, K., Kapur, N., & 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), article-number e001433. https://doi.org/10.1136/bmjph-2024-001433
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BMJ Publishing Group
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BMJ Public Health
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© Author(s) (or their employer(s)) 2025. Re- use permitted under CC BY- NC. Published by BMJ Group.
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2753-4294
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This work was jointly funded by the UK Ministry of Defence (MoD) (Grant/ Award Number: Not Applicable) and NHS England (Grant/Award Number: Not Applicable).