Who Do Service Members and Veterans Tell? Patterns of Disclosing Suicidal Thoughts Prior to Firearm Suicide Death

Background: US service members and Veterans are at elevated risk for firearm suicide. Understanding to whom they disclose suicidal thoughts and/or plans is important to inform suicide prevention efforts. Aims: To better understand the extent to which military and Veteran firearm suicide decedents disclose their suicidal thoughts to others as well as how disclosure differ by sex and race. Methods: This study uses a subset of data from the National Violent Death Reporting System (NVDRS) to better understand frequency of disclosure of suicidal thoughts and/or plans among military service members and Veterans who died by firearm suicide, and explore which sources were disclosed to. Results: A total of 28,600 individuals with a history of military service died by firearm suicide from 2013 to 2021, and 21.2% disclosed suicidal thoughts and/or plans in the month prior to their death. The most common disclosure source was a family member (30.5%). Limitations: Limitations include missing data and an inability to distinguish between those with current and former military status. Conclusions: Findings suggest that the majority of military and Veteran firearm suicide decedents do not disclose suicidal thoughts in the month prior to their death. Those who do make disclosures tend to choose nonprofessional sources. Given this, community-based primary suicide prevention efforts may be key in helping reduce firearm suicide risk.