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- Introduction: A low level of social connectedness is a risk factor and a warning sign for suicide, and it is particularly relevant to understanding suicide in veteran populations. Data from psychological autopsies may provide insights into changes in social behaviors among former US military service members and veterans (MSMVs) who have died by suicide.
Methods: 41 individuals who were in the social network of former MSMVs who died by suicide were recruited through publicity through veteran non-profit organizations and snowball sampling. Each participant completed an in-person or Zoom interview with a mix of close- and open-ended questions about the former MSMV in 20 sub-sections. Descriptive statistics were derived from quantitative variables of interest to characterize the veteran population represented by the proxy respondents. Qualitative data from transcripts of three selected sub-sections of the interview protocol underwent systematic text condensation to create an organized, hierarchical codebook of relevant themes.
Results: The proxy respondents represented a total of 26 former MSMVs with high prevalence of multiple known suicide risk factors, including mental illness (85%), substance use disorders (92%), prior suicide attempts (58%), and firearm access (77%). Common themes identified through qualitative analysis included changes in social engagement in the last year, six months, and 30 days of the former MSMV’s life, importance of social influences, and perceived facilitators and limitations of social connections for the MSMVs. These proxy interviews demonstrate a high rate of behavioral changes related to social connectedness preceding suicide and reveal high levels of heterogeneity in types of changes between former MSMVs.
Conclusion: Findings reinforce that social isolation, social withdrawal, and lack of connection are risk factors and warning signs for suicide among former MSMVs. However, the significant proportion of participants who identified prosocial behavioral changes leading up to a former MSMV’s suicide attempt indicates that understanding variations in social connectedness and behaviors between MSMVs may be relevant to suicide prevention.
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