Today, as Americans honor and remember members of the U.S. armed forces, comes some troubling news about the men and women who serve to protect our country and its interests: the alarming rate of suicide among veterans.

From 2008 to 2017, at least 60,000 U.S. veterans died by suicide, according to the VA’s 2019 National Veteran Suicide Prevention Annual Report. Data also shows that the problem is getting worse, despite the VA’s suicide prevention outreach efforts.

In 2017, for instance, more than 6,100 veterans took their own lives – an increase of 2% from 2016 and a total increase of 6% since 2008, the report found.

The suicide rate is especially severe among former National Guard and Reserve members who were never federally activated. Those members were not entitled to receive VA services. Within that group there was an average of 2.5 suicides per day, the report said.

According to, VA Secretary Robert Wilkie said that the VA “is working to prevent suicide among all veterans, whether they are enrolled in VA health care or not.” He said these efforts include “adopting a comprehensive public health approach to suicide prevention, using bundled strategies that cut across various sectors – faith communities, employers, schools and health care organizations, for example – to reach veterans where they live and thrive.”

By the VA’s own admission, the veteran suicide crisis has grown “beyond the VA’s capacity to address it,” according to

Any efforts to beat back the epidemic of veteran suicides will likely be successful only once officials understand the underlying causes.

A study funded by the VA’s Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) and published in November 2018 offers some clues. Researchers found that post-9-11 veterans – those who served in Iraq and Afghanistan – were much more likely to have suicidal thoughts if they suffered multiple traumatic brain injuries (TBIs) compared to veterans who suffered one TBI or none at all.

TBI is considered the “signature injury” of post-911 veterans. The U.S. Department of Defense and the Defense and Veterans Brain Injury Center estimate that 22 percent of combat casualties from post 9-11 conflicts involve TBIs. Most of those TBIs are concussions or other brain injuries that are mild in severity, but for those who suffer more than one TBI, the repercussions can be long-lasting and severe.

TBI symptoms typically include headaches, irritability, sleep disorders, memory lapses, slower thinking, mood swings, and depression. In fact, veterans with TBI reported having a significantly poorer quality of sleep and much higher rates of depression than non-TBI veterans, and both poor sleep and depression are major risk factors for suicidal ideation.

Physicians know that immediate and proper care for concussion and other TBI is essential to recovery and possibly lowering long-term risks, but beyond that, successful treatment of TBI remains largely elusive. Treatment usually focuses on the symptoms of TBI because the underlying causes are complex and varied and beyond modern medicine’s ability to repair.

Dr. Robert Shura, a neuropsychologist at the W.G. (Bill) Hefner VA Medical Center in North Carolina and lead author of the study, said that risk could also be primarily tied to a series of difficult life events or traumas that can have a cumulative effect. Combat veterans, of course, endure a lot of emotionally and psychologically difficult circumstances.

“For example, during deployment, a service member is exposed to traumatic events, possible stressful situations at home, and chronic sleep deprivation,” Dr. Shura said, according to VA Research Communications“On returning home, the Veteran may struggle with chronic pain, difficulty adjusting, continued sleep issues, depression, and heavy alcohol use. TBI may have little to do with all of that. But those with multiple TBIs may be more likely than others to have that cumulative trajectory and thus thoughts of suicide.”

Mike Andrews and Stephanie Monplaisir in our office are concerned about TBI and active with the Alabama Head Injury Foundation. They would be happy to talk with you about TBI concerns or to provide more information or resources.

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