Life after loss: Comparing student service member/veteran and civilian mental health characteristics among individuals exposed to death by suicide

National study of sleep health for student servicemembers/veterans

Objective: Investigate sleep health for student servicemember/veterans (SSM/Vs). Method: Data from the National College Health Assessment was used, including 88,178 participants in 2018 and 67,972 in 2019. Propensity score matching was used to compare SSM/Vs (n = 2984) to their most similar non-SSM/V counterparts (n = 1,355). Responses were analyzed using a multivariate analysis of covariance (MANCOVA). Results: SSM/Vs reported significantly higher levels of some sleep health issues than the matched peer group, including more instances of trouble falling asleep, waking too early, and higher rates of insomnia and sleep disorders. However, SSM/Vs reported fewer days per week feeling sleepy and similar impacts of sleep issues on academics when compared to the peer group. Conclusion: Institutions of higher education should consider training faculty and staff to recognize impacts of poor sleep health for SSM/Vs to establish effective practices to support this unique population.

The Effects of Suicide Exposure on Mental Health Outcomes Among Post-9/11 Veterans: Protocol for an Explanatory, Sequential, Mixed Methods Study

BACKGROUND

The toll associated with suicide goes well beyond the individual who died. This study focuses on a risk factor for veteran suicide that has received little previous empirical attention-exposure to the suicide death of another person.

OBJECTIVE

The study's primary objective is to describe the mental health outcomes associated with suicide exposure among veterans who served on active duty after September 2001 ("post-9/11"). The secondary objective is to elucidate why some veterans develop persistent problems following suicide exposure, whereas others do not.

METHODS

This is an explanatory, sequential, mixed methods study of a nationally representative sample of post-9/11 veterans enrolled in Department of Veterans Affairs (VA) health care. Our sampling strategy was designed for adequate representation of female and American Indian and Alaska Native veterans to allow for examination of associations between suicide exposure and outcomes within these groups. Primary outcomes comprise mental health problems associated with trauma and loss (posttraumatic stress disorder and prolonged grief disorder) and suicide precursors (suicidal ideation, attempts, and planning). Data collection will be implemented in 3 waves. During wave 1, we will field a brief survey to a national probability sample to assess exposure history (suicide, other sudden death, or neither) and exposure characteristics (eg, closeness with the decedent) among 11,400 respondents. In wave 2, we will include 39.47% (4500/11,400) of the wave-1 respondents, stratified by exposure history (suicide, other sudden death, or neither), to assess health outcomes and other variables of interest. During wave 3, we will conduct interviews with a purposive subsample of 32 respondents exposed to suicide who differ in mental health outcomes. We will supplement the survey and interview data with VA administrative data identifying diagnoses, reported suicide attempts, and health care use.

RESULTS

The study began on July 1, 2022, and will end on June 30, 2026. This is the only national, population-based study of suicide exposure in veterans and the first one designed to study differences based on sex and race. Comparing those exposed to suicide with those exposed to sudden death for reasons other than suicide (eg, combat) and those unexposed to any sudden death may allow for the identification of the common and unique contribution of suicide exposure to outcomes and help seeking.

CONCLUSIONS

Integrating survey, qualitative, and VA administrative data to address significant knowledge gaps regarding the effects of suicide exposure in a national sample will lay the foundation for interventions to address the needs of individuals affected by a suicide death, including female and American Indian and Alaska Native veterans.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51324.

An assessment of sense of belonging in higher education among student service members/veterans

The health, well-being, and integration of student service members/veterans (SSM/Vs) into higher education has become a growing focal point for college health practitioners and researchers. Methods: Secondary data analysis of "Campus Climate and Culture" module of the Healthy Minds Study (HMS), which included 8211 students. Analyses examined whether military status was associated with sense of belonging. Results: The relationship between military-affiliation and sense of belonging (low versus high) was statistically significant [χ² (2, 8211) = 10.855, p < 0.01], such that 42% of SSM/V reported low sense of belonging compared to their Reservist (33%) and civilian (28%) counterparts. Even after controlling for age, sex, year in school, and grade point average, SSM/V status (OR = 0.16, Wald = 6.17; p < 0.05), was negatively associated with sense of belonging. Conclusions: Results highlight a need for strategic college health initiatives to foster institutional inclusion and cohort building among SSM/V in higher education.

Those left behind: A scoping review of the effects of suicide exposure on veterans, service members, and military families

Veteran and service member suicide remains a significant public health concern. One factor that may impact suicide risk is suicide exposure-knowing someone who has died by suicide or attempted suicide. However, the majority of the extant literature has focused on nonmilitary samples, which may not generalize to military veterans and service members. The current review synthesizes findings regarding suicide exposure in military veterans, service members, their families, and military systems. Our review suggests that the relationship between suicide exposure, suicide risk, and mental health outcomes remains inconsistent. Future research should further explore this important area.