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Association of suicide risk with transition to civilian life among US Military service members

APA Citation:

Ravindran, C., Morley, S. W., Stephens, B. M., Stanley, I. H., & Reger, M. A. (2020). Association of suicide risk with transition to civilian life among US military service members. JAMA Network Open, 3(9), e2016261. https://doi.org/10.1001/jamanetworkopen.2020.16261


Mental health

Branch of Service:

Multiple branches
Air Force
Marine Corps
Coast Guard

Military Affiliation:


Subject Affiliation:



Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)


Ravindran, Chandru, Morley, Sybil W., Stephens, Brady M., Stanley, Ian H., Reger, Mark A.


Importance Although interest is high in addressing suicide mortality after the transition from military to civilian life, little is known about the risk factors associated with this transition. To support the ongoing suicide surveillance work of the US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention, examining these factors is important for targeting suicide prevention efforts. Objective To examine the prevalence, patterns, and associated characteristics of suicide mortality among US service members after separation from military active status. Design, Setting, and Participants This retrospective population-based cohort study obtained demographic and military service data from the VA/Department of Defense Identity Repository. Individuals who served on active duty in the US Army, Navy, Air Force, Marine Corps, or Coast Guard after September 11, 2001, and who separated from active status between January 1, 2010, and December 31, 2017, were included in the cohort. Data analyses were conducted from September 9, 2019, to April 1, 2020. Main Outcomes and Measures Suicide mortality within 6 years after separation from military service. Results A total of 1 868 970 service members (1 572 523 men [84.1%]; mean [SD] age at separation, 30.9 [9.9] years) separated from the military during the study period. Through the end of the study period (December 31, 2017), 3030 suicides (2860 men and 170 women) were identified as having occurred within 6 years of separation from the military. Statistically significant differences in suicide risk were found by demographic and military service characteristics. Suicide rates after separation were time dependent, generally peaking 6 to 12 months after separation and declining only modestly over the study period. Male service members had a statistically significantly higher hazard of suicide than their female counterparts (hazard ratio [HR], 3.13; 95% CI, 2.68-3.69). Younger individuals (aged 17-19 years; HR, 4.46 [95% CI, 3.71-5.36]) had suicide hazard rates that were approximately 4.5 times higher than those who transitioned at an older age (

Publication Type:


Author Affiliation:

Veterans Integrated Service Network (VISN) 2, Center of Excellence for Suicide Prevention, CR


suicide risk, military seperation, transition to civilian life

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