A scoping review of military and Veteran families within international suicidality and suicide prevention research

The impacts of suicidality on families are well known, which is particularly relevant in at-risk populations, such as active duty military personnel and Veteran communities. This scoping review describes how military and Veteran families have been conceptualized within suicide prevention research. A systematic, multi-database search was conducted, and 4,835 studies were screened. All included studies underwent quality assessment. Bibliographic, participant, methodological, and family-relevant data was extracted and descriptively analyzed into Factors, Actors, and Impacts. In total, 51 studies (2007 - 2021) were included. Most studies focused on suicidality rather than suicide prevention. Factor studies described family constructs as a suicidality risk or protective factor for military personnel or Veterans. Actor studies described families' roles or responsibilities to act in relation to the suicidality of military personnel or Veterans. Impacts studies described the impacts of suicidality on military and Veteran family members. The search was limited to English language studies. There were few studies on suicide prevention interventions for or including military and Veteran family members. Family was typically considered peripheral to the military personnel or Veteran experiencing suicidality. However, there was also emerging evidence of suicidality and its consequences in military-connected family members.

Cluster analysis of Canadian Armed Forces veterans living with chronic pain: Life After Service Studies 2016

Objective: This study explored the heterogeneity of Canadian Armed Forces veterans living with chronic pain to inform service needs planning and research using cluster analysis. Design: We used a national cross-sectional Statistics Canada population survey. Participants: Participants included 2754 Canadian Armed Forces (CAF) Regular Force veterans released from service between 1998 and 2015 and surveyed in 2016. Methods: We used cluster analysis of veterans with chronic pain based on pain severity, mental health, and activity limitation characteristics. We compared clusters for sociodemographic, health, and service utilization characteristics. Results: Of 2754 veterans, 1126 (41%) reported chronic pain. Veterans in cluster I (47%) rarely had severe pain (2%) or severe mental health problems (8%), and none had severe activity limitations. Veterans in cluster II (26%) more often than veterans in cluster I but less often than veterans in cluster III endorsed severe pain (27%) and severe mental health problems (22%) and were most likely to report severe activity limitation (91%). Veterans in cluster III (27%) were most likely to report severe pain (36%) and severe mental health problems (96%), and a majority reported severe activity limitations (72%). There was evidence of considerable heterogeneity among individuals in terms of socioeconomic characteristics, pain characteristics, mental and physical health status, activity limitations, social integration, and service utilization indicators. Conclusions: About half of Canadian veterans living with chronic pain infrequently endorse severe pain or serious mental health issues without severe activity limitations. The other half had more complex characteristics. The heterogeneity of CAF veterans with chronic pain emphasizes the need for support systems that can address variability of needs.

Group identity, diffi cult adjustment to civilian life, and suicidal ideation in Canadian Armed Forces Veterans: Life After Service Studies 2016

Introduction: Suicide risk is higher in Canadian Armed Forces (CAF) Veterans than the Canadian general population (CGP). Suicidality is understood to be caused by incompletely clarified, complex interacting combinations of multiple factors. One of the precipitating factors for suicide is thought to be the social identity challenges known to occur in major life transitions. Methods: The 2016 Life After Service Studies survey representatively sampled Regular Force Veterans stratified by two release groups: earlier in 1998 to August 2012 ( n = 1,575) and more recently in September 2012 to 2015 ( n = 1,180). The linked dataset included socioeconomic and military characteristics and well-being indicators in multiple domains. Weak group identity was indicated by weak sense of local community belonging and/or not feeling part of a group with shared attitudes and beliefs. Associations were evaluated with multiple logistic regression. Results: Suicidal ideation, weak community belonging, and perceived difficult adjustment to civilian life were more prevalent in Veterans soon after release (September 2012 to 2015) than in Veterans released earlier (1998 to August 2012). Suicidal ideation and weak community belonging were more prevalent in the Veterans than in the CGP. In the more recently released Veterans, weak group identity was endorsed by the majority with suicidal ideation (93.3%). In adjusted regression models, mental health problems had the strongest association with suicidal ideation (adjusted odds ratio [AOR] = 13.4–79.3); however, weak group identity was moderately strongly associated with both difficult adjustment (AOR = 2.4–4.1) and particularly suicidal ideation (AOR = 3.8–9.0), independently of mental health problems. Discussion: Weak group identity was associated with difficult adjustment to civilian life and suicidal ideation in CAF Regular Force Veterans within 3.6 years after military release. These findings indicate the importance in suicide prevention of attending to social identity during transition to post-military life.