A mixed methods analysis of U.S. military veterans’ suicidal ideation experiences during the COVID-19 pandemic: Prevalence, correlates, and perceived impact

Abstract

This mixed methods study sought to increase understanding of veterans’ experiences of suicidal ideation (SI) during the COVID-19 pandemic, including prevalence, correlates, and perceived impact. A national survey of veterans (n=567) was conducted from 12/2020 to 2/2021. Quantitative analyses (weighted to the veteran population) examined SI prevalence and correlates. Qualitative thematic analysis of veterans’ free text responses was used to examine veterans’ lived experiences regarding the perceived impact of the pandemic. Among veterans, 9.6% (95% CI: 6.8, 12.5) experienced past-year SI, and 5.0% (95% CI: 2.8, 7.3) experienced past-month SI, estimates of prevalence during the early phase of the pandemic. Additionally, 3.1% (95% CI: 1.4, 4.7) reported experiencing increased SI frequency, and 2.2% (95% CI: 0.7, 3.6) reported experiencing increased SI intensity, during the pandemic. SI (past-year, past-month, and increased frequency during the pandemic) was more prevalent among veterans who were younger, Black, had minor(s) at home, screened positive for posttraumatic stress disorder, screened positive for depression, obtained lifetime mental health treatment, and accessed past-year outpatient mental health care. In qualitative analyses, Veterans with increased SI frequency described multi-faceted negative impacts of the pandemic, including in regard to their mental health, employment, and family. Negative perceptions of the personal impact of the pandemic were strongly associated with SI (past-year, past-month, and increased frequency). Supporting veterans who have been negatively impacted by the pandemic, including with respect to mental health and family functioning, may be particularly important to addressing SI in the aftermath of the COVID-19 pandemic and for prevention in future pandemics.