Subgroups of Veterans at Heightened Suicide Risk After COVID-19 Diagnosis

A new study published in JAMA Network Open has identified 2 distinct subgroups of US veterans at heightened risk for suicide attempts and self-directed violence (SDV) within 1 year of COVID-19 infection. Drawing from a national cohort of more than 285 000 veterans diagnosed between May 2021 and April 2022, researchers used latent class analysis to examine how combinations of physical and mental health conditions, along with health care usage, contribute to post–COVID-19 suicide risk.

One high-risk group consisted of older veterans (≥65 years) with a high burden of chronic physical conditions, including hypertension and chronic pain. This group experienced 103.7 suicide attempts or SDV events per 10 000 veterans within 12 months of infection. The other, even higher-risk group included younger veterans with significant mental health comorbidities such as depression, posttraumatic stress disorder (PTSD), and substance use disorders. This younger group experienced 162.9 suicide attempts or SDV events per 10 000 veterans and was 14 times more likely to engage in such behaviors than the lowest-risk group.

The study also revealed stark disparities across gender and racial lines, with higher risk observed among female veterans and American Indian or Alaska Native and Asian veterans. Despite high medical care utilization, many veterans in the older subgroup had limited contact with mental health services, suggesting a need for increased screening in primary and inpatient care settings. For younger veterans with established mental health needs, researchers emphasized the importance of sustained engagement and culturally responsive interventions, especially following a major health event such as COVID-19.

Researchers say these findings highlight the need for suicide prevention strategies tailored to veterans’ specific risk profiles and call for renewed attention to care gaps affecting marginalized and underserved populations within the veteran community.

“The subgroups we identified may inform new policies and highlight potential mental health care gaps that warrant attention,” researchers concluded. “In particular, we found extremely high post–COVID-19 suicide attempt and SDV risk among female, American Indian or Alaska Native, and Asian veterans, highlighting the need for culturally appropriate and tailored prevention programs.”

Reference

Bui DP, Niederhausen M, Hickok AW, et al. Veterans at high risk for post-COVID-19 suicide attempts or other self-directed violence. JAMA Netw Open. 2025;8(3):e250061. doi:10.1001/jamanetworkopen.2025.0061