Credit: U.S. Army

Oklahoma veterans and active-duty military personnel are killing themselves at twice the rate of civilians, despite increased efforts to address the problem.

The 2011 suicide rate for soldiers was about 44 per 100,000 population, according to an Oklahoma Watch analysis of Oklahoma State Department of Health data. This rate includes active-duty military as well as veterans from the post-9/11 wars in Iraq and Afghanistan, the Gulf War, Vietnam, Korea and World War II. The civilian rate for people over the age of 18 was about 22 per 100,000.

In 2011, 141 of the state’s 684 suicides were veterans, according to state health department records.

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The veteran suicide rate in Oklahoma is down from a peak of about 46 in 2008, but researchers said that year had increased suicides due to the Great Recession. The rate dropped to about 39 in 2009 and has since climbed back up.

The rates were calculated by analyzing death certificates, which include military status. The state doesn’t differentiate between active-duty personnel and veterans, but it appears likely that most are veterans based on age groups at risk for suicide. The 2011 figures are the most recent data available that can be compared with population numbers.

The increased numbers and rates of suicides come at a time when the U.S. Department of Veterans Affairs has received budget increases for mental health services, and suicide risk for service members has stirred an ongoing national discussion.

The Joshua Omvig Veterans Suicide Prevention Act of 2007 aimed to lower suicides by authorizing a national campaign to increase mental health awareness, education, counseling and suicide-prevention research. The Oklahoma Department of Mental Health and Substance Abuse Services recently allocated $500,000 in new funding for suicide prevention programs, including veterans outreach.

The Oklahoma suicide figures appear to track national trends. An analysis by News21, an investigative journalism program based at Arizona State University, found that veteran suicides across the United States increased from 2005 to 2011.

In 2005, the national suicide rate for veterans was about 29 per 100,000. It increased to about 34 per 100,000 in 2011. The civilian rate grew as well. On average, about one out of five suicides is a veteran.

Nailing down the reason why military service members die by suicide is difficult. A common assumption is that soldiers have been traumatized by combat experience or repeated deployments. But a recent study funded by the Department of Defense shows that combat deployment didn’t have a significant impact on suicide risk. Instead, mental illnesses and alcohol and drug abuse were more common suicide indicators.

Trying to understand why a person dies by suicide is sometimes impossible, particularly if the person leaves no message behind. Family members often are left wondering whether a simple conversation or health referral would have made a difference.

Steve Buck, deputy commissioner of the state mental health department, said the state has implemented what are considered to be the best strategies to prevent suicide deaths. But not every area of the state has equal access to prevention programs or methods.

Some areas might have access to community health clinics staffed by mental health professionals, while others might have access to family doctors trained in identifying symptoms of potential suicide victims, Buck said.

Buck said he was confident the state could get the numbers down, but doing so would require more money to spread effective treatments to every part of the state. It also would require greater public education to reduce the stigma of talking about and treating mental illness and suicide.

“If we get to the point to where we value helping people address depression at the same level that we value reducing their use of tobacco, we are going to start making a lot of headway,” Buck said. “Mental health in many ways is physical health.”

One reason for the increase in suicides has been older veterans observing the experiences of soldiers deployed in Iraq and Afghanistan, said retired Maj. Gen. Rita Aragon, Oklahoma secretary of military and veterans affairs. These older veterans are in high suicide-risk age groups. Seeing younger soldiers experience the horrors of war and experience post-combat trauma opens old wounds, she said.

In Oklahoma, the demographic group most at risk for suicide consists of white males between the ages of 40 and 60, according to data from the U.S. Centers for Disease Control and Prevention. The increased number of suicides in the state could be attributed in part to the large number of white veterans reaching that age bracket.

Contributing factors could include repeated deployments and separation from families and friends, said Mike Brose, director of the Mental Health Association in Tulsa. These experiences cause some military service members to withdraw, abuse alcohol and other substances and neglect their responsibilities, Brose said.

Families who see suicidal indicators such as these should ask military family members if they are thinking of hurting themselves, persuade them to seek help and refer them to an appropriate agency, he said.

This QPR method — question, persuade and refer — empowers everyone to be on the lookout for people thinking of suicide, Brose said.

“There will never be enough health professionals to stem the tide,” he said. “We need to educate the general public to get them the confidence and tools in the toolbox to intervene with their loved ones.”

Brose cited programs such as Tulsa’s Coffee Bunker, which provides a place for veterans and service members to come together to talk over coffee and snacks. It’s a better alternative, he said, than meeting at a bar to swap war stories.

Once a veteran is identified as at-risk, the suicide prevention team at the nearest VA facility will work to find the right care, said Juanita Celie, suicide prevention coordinator at the Oklahoma City VA Hospital.

Every situation is different, so a veteran suffering from situational stress might need someone to talk to while a veteran suffering from post-traumatic stress disorder might need medication or even hospitalization, Celie said.

“You have to tailor the intervention that is going to work for them,” she said.

Aragon, who is a member of Gov. Mary Fallin’s cabinet, said she doesn’t think traditional methods of referrals, medication and counseling are enough. She has been working with state lawmakers and medical experts to evaluate a new treatment regimen involving hyperbaric oxygen chambers.

Oklahoma State University is currently running tests on veterans and civilians to determine whether the chambers, which allow users to breathe pressurized pure oxygen, are an effective treatment for the kind of traumatic brain injuries experienced by some combat veterans.

“We don’t have anything that tells us (traditional methods) are working, because numbers keep going up,” Aragon said. “I see this as the strongest and best answer we have to suicide. It is treating the actual illness that has caused a great many of these folks to take their lives.”

Chase Cook was an Ethics and Excellence in Journalism Foundation News21 Fellow who was part of the team that produced the News21 project, “Back Home: the Enduring Battles Facing Post-9/11 Veterans.”

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