Women & Suicide
Article in review: O’Brien, R.W., Tomoyasu, N. (2021). Editorial – Women and suicide – Moving forward on a challenging problem, Medical Care Vol 59, No 2, Supp 1, 4-5.
A 2021 volume of the publication Medical Care took a special look at the most contemporary research about women and suicide. The volume urges a greater understanding of the factors contributing to the increase in suicide among women, an improvement in the development and implementation of suicide prevention for women, and increased treatments in relation to gender issues. It also highlights some of the recent efforts to identify unique suicide risk factors among women and deliver effective interventions for women in general, women service members, and women veterans.
The introductory editorial of the volume details how death by suicide among women is increasing and at a rate that is faster than that of the overall population. Between 2005 and 2017, the suicide rate in the adult American population increased 22% while amongst women in particular; this rate was 34% over the same period. The American Centre for Disease Control also found that from 2000 to 2016, suicide rates amongst men rose 21% while among women this figure was 50%.
Another population experiencing an increase in suicide rates is veterans. The American Department of Defence indicated that between 2011 and 2018 there were “significant” increases in the age-adjusted and sex-adjusted rates of suicides, in the air force and marines, along with notable increases in the army and navy. Suicide rates in these groups are now equivalent to that of the general population, after having been lower for many years.
With increasing numbers of women entering the forces, there are understandably now also an increasing number of women veterans. There has been an increase in the amount of women veterans of 6.5% between 2005 and 2017. Over this period, the increase in the suicide rates of these women veterans was reflected as a 61% increase. Following age adjustments, the figures translated into death by a suicide rate of 16.8 per 100,000. The same rate was 39.1 per 100,000 veterans, however, it is the increase of more than 60% that needs to be analysed. The suicide rate for veteran women compared to non-veteran women is 2.2 times higher than non-veteran women.
Suicidality amongst women veterans before, during, and after service
Women in the military encounter risk factors specific to their experiences in the forces. Recent research suggests that for most women who experience suicidality while in the forces, the onset of suicide ideation, suicide attempts, and non-suicidal self-injury had typically occurred prior to their insisting in the military. The prevalence of suicide ideation and attempts typically increases once a woman has left the forces and there is research to suggest that interpersonal violence, mental health concerns, and substance abuse elevate the risk of suicide for veterans. Post-military experiences such as non-military-related trauma, lack of supportive relationships, substance use, and prescriptions of sedatives may also be suicide risks.
Interventions that consider gender
There is a growing amount of research related to the types of interventions that prove more valuable for women, and women veterans. Typically, those interventions that aim to increase women’s self-worth through positive relationships are the most beneficial. This contrasts with the more traditional, male-focused interventions that emphasise their sense of purpose and achievement of the ideal self.
The editorial outlines the opportunity for more research in these areas, and the expansion of research to include other often at-risk groups; lesbian, gay, bisexual, and transgender veterans, and other women who fall through the gaps of mainstream care. The creation of women-centric crisis line services is suggested, and a greater understanding of the impact of social and community facets on suicide risks is encouraged. Research on these topics and others related to the experience of women veterans will continue to build academic and professional momentum and help us to support any woman at risk of suicide.