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Veterans with a moderate or severe traumatic brain injury are more than twice as likely as those without a TBI to commit suicide, researchers report.

Additionally, veterans with a moderate or severe TBI are at a higher risk of dying by suicide with a firearm.

Experts call traumatic brain injury (TBI) the “signature injury” of combat veterans returning from the Iraq and Afghanistan wars. As many as 23% of veterans of these conflicts return home with a TBI as a result of an explosion, objects hitting their heads, falls, or other causes.

TBIs, which run the gamut from a concussion to severe brain damage, can cause headaches, sleep disorders, memory problems, slower thinking, and depression. They’ve also been linked to mental illness and drug overdose.

According to the Department of Defense, 22% of all combat casualties from Iraq and Afghanistan result from brain injuries, roughly double the rate of the Vietnam War.

Approximately 57,000 veterans from the Afghanistan and Iraq conflicts are getting treatment or getting evaluated for TBI or possible TBI-related conditions in the US Department of Veterans Affairs’ healthcare system.

The findings suggest medical practitioners need to pay special attention to veterans with TBIs to identify early risk factors for suicide, says Rachel Sayko Adams, a scientist at the Institute for Behavioral Health at the Heller School for Social Policy and Management at Brandeis University.

Doctors may overlook TBIs and fail to diagnose them amidst other behavioral health problems following deployment. Since TBI symptoms can show up months, even years, later, medical practitioners should screen for TBI on an ongoing basis, Adams says.

The findings also suggest that veterans with a history of moderate or severe TBI would benefit from talking with a provider about safety planning in relation to firearm access, Adams says.

“Healthcare providers can speak to patients who they think may be at risk for suicide to identify objects, such as firearms, that might be dangerous in their environment, and come up with plans or safeguards to try to reduce access to these objects like gun locks.”

Researchers reviewed electronic medical records of 1.4 million veterans treated at the Veterans Health Administration between 2006 and 2015 and also consulted the National Death Index for information about veteran mortality and cause of death.

The paper appears in the Journal of Head Trauma Rehabilitation. Additional coauthors are from VHA Rocky Mountain Mental Illness Research Education and Clinical Center in Colorado.

Source: Brandeis University