A national examination of suicidal ideation, planning, and attempts among United States adults: Differences by military veteran status, 2008–2019

There is a widening disparity in suicide deaths between United States (U.S.) military veterans and nonveterans. However, it is unclear if there are similar differences in suicidal ideation, planning, and attempts that often precipitate these deaths. A better understanding of trends in suicidal thoughts and behaviors could illuminate opportunities for prevention. We examined pooled cross-sectional data (N = 479,801 adults) from the 2008 to 2019 National Survey on Drug Use and Health. We examined differences in past-year suicidal ideation, suicide planning, and suicide attempts between U.S. veterans (n = 26,508) and nonveterans (n = 453,293). We conducted post hoc analyses to examine for differences in these relationships by race/ethnicity and sex. Lastly, we examined trends in these outcomes over time and tested for differences in trends by veteran status. Overall, veterans had significantly greater odds of past-year suicidal ideation (aOR = 1.33, 95% CI 1.20 to 1.47) and suicide planning (aOR = 1.52, 95% CI 1.30 to 1.78) compared to nonveterans. However, the association between veteran status and past-year suicide attempt was not statistically significant (aOR = 1.29, 95% CI 1.00 to 1.68). These relationships did not differ by race/ethnicity or sex (ps > 0.05). Among all adults, there were significant linear increases in past-year suicidal ideation, planning, and attempts (ps < 0.001). However, these trends did not differ between veterans and nonveterans (ps > 0.05). Veterans may be more likely to experience suicidal thoughts and behaviors than nonveteran adults. Upward trends in suicidal thoughts and behaviors among both veterans and nonveterans from 2008 to 2019 highlight opportunities for intervention.