Twenty-One Times More Veterans Kill Themselves Than Die in Battle

Entrepreneur and philanthropist Waco Hoover is haunted by a statistic that is somewhere between devastating and appalling.  “Since 2001,” he says, “the number of US veterans who have died by suicide is 21 times the number killed in combat.”

Specifically, almost 150,000 US veterans have died by suicide during a period when 7000+ died in combat operations. "Over twenty-two veterans die by suicide every day,” Hoover says, “and this is a crisis that demands action—now. "

To get a feel for the gravity of this crisis, Hoover points out that single suicide is likely to affect, on average, 135 people.

To explain why one suicide affects so many people, consider that a typical suicide will likely touch 10 to 20 close relatives, and people who are each likely to experience profound grief, guilt, and trauma. Close friends, colleagues, and battle buddies may also suffer from survivor’s guilt or even develop PTSD.

It goes on. Cousins, aunts, uncles, in-laws, classmates, neighbors, and co-workers who had even casual interactions are likely to be affected. In addition, medical providers, therapists, religious leaders, and support groups may feel they failed to help. Colleagues and supervisors may struggle with workplace morale and emotional distress. Military units or veteran organizations often experience a loss that spreads far beyond direct relationships.

The 135-person estimate reveals why suicide prevention is a public health issue, not just an individual tragedy. The emotional cost of one suicide reverberates widely, making prevention strategies all the more critical.

So what are prevention strategies? For Hoover, the first consideration is the fact that a staggering 70% of veteran suicides involve firearms. As he wryly points out, “You can’t walk this back.  Suicide by firearm is almost certainly permanent”

It’s in stark contrast to other means to die by suicide, where 90% of survivors never attempt suicide again.  “When you think of a drug overdose as an example, if a person lives through that initial attempt, they get another chance at life. With a firearm, you don’t get a second chance.”

For this reason, Hoover believes, "More support and innovation focused on secure storage is crucial for saving lives." He’s pleased to report that, “The firearms industry is beginning to engage with the issue. The National Shooting and Sports Foundation (NSSF) is distributing 37-million-gun locks through its Project ChildSafe initiative.”

Secure storage of firearms is one front in the effort to reduce veteran suicides. But another is, changing the military culture that can discourage help-seeking. “This is especially true for older veterans,” Hoover says. “Older veterans make up 69% of veteran suicides. We need to normalize and encourage conversations about help-seeking.”  Programs like the American Legion’s Columbia Protocol training—aiming to train 100,000 members by the end of 2025—are making strides in making veterans feel more comfortable in asking for help.
Hoover wants to encourage other approaches as well.

• Psychedelic Research: "Stanford and Johns Hopkins are finding psychedelics can treat PTSD and suicidal ideation," Hoover is pleased to report. He’s enthusiastic about the careful and sophisticated research that’s being done today in the area of psychedelics.

• Coordinated Care: Telling a veteran to "just exercise" won’t work if depression isn’t properly treated. "Mental and physical health care must be fully integrated," he emphasizes.

• Upstream Prevention: “Financial strain, divorce, and isolation are warning signs,” he says. In his view, "We need to provide support in these areas long before a crisis hits."

• Private Sector Investment: “We can’t rely on philanthropy alone,” he warns. He’d like to see private sector investment in mental health innovation, the same way that private defense contractors help the military with their national security goals.  More private sector investment in mental health would have the advantage that it has the potential to be innovative, scalable, and sustainable.

Hoover concludes by saying, “In the case of our veterans, their service should be honored not just with words, but with life-saving action." He would like to see more community support care delivery transformation for stopping veteran suicides.