Suicide risk and prevention in veteran populations.

Rates of suicide among veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) rose significantly from 2005 to 2007, adding to existing concerns about veteran suicide risk by the Department of Veterans Affairs. This paper summarizes the available data about risk and rates of suicide in veterans, including the choice of appropriate comparison groups and the identification of risk factors. The data suggest that taking into account the selection bias of who enters the military (known as the healthy soldier effect), rates of suicide in veterans are higher than expected, especially among activity duty OEF/OIF veterans and even more so among those who experienced injuries and trauma. Thus, the experiences of war and the downstream sequelae, in particular the individuals' psychological reactions and societal responses, lead to suicide risk. This paper describes the VA's response to these data in developing and implementing suicide prevention interventions.