Suicidal Ideation in Combat Veterans: A Literature Review

Tracy L. DuShane

doi:doi:10.11648/j.reports.20260603.13

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Suicidal Ideation in Combat Veterans: A Literature Review

Tracy L. DuShane^*

Published in Reports (Volume 6, Issue 3)

Received: 13 October 2025 Accepted: 14 November 2025 Published: 11 August 2026

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Abstract

Suicide among combat veterans represents a complex and urgent public health concern, with rates of suicidal ideation and behavior significantly exceeding those observed in the general population. This elevated risk is closely associated with co-occurring mental health conditions, including posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, and moral injury. Additionally, cultural and systemic barriers—such as stigma, reduced help-seeking behaviors, and challenges in accessing care—further complicate prevention and intervention efforts within this population. This manuscript provides a focused review of peer-reviewed literature published between 2020 and 2025, examining the intersection of mental health symptomatology and suicide risk among combat veterans and first responders. Particular attention is given to identifying evidence-based crisis intervention strategies, including trauma-informed approaches and rapid response models tailored to high-risk populations. The review also explores the role of peer support interventions in engaging individuals who may be reluctant to access traditional mental health services, highlighting their effectiveness in fostering trust and promoting early intervention. In addition, the manuscript addresses the importance of integrating spiritual and cultural considerations into suicide prevention frameworks. Culturally responsive care, including attention to military identity, moral injury, and diverse belief systems, is emphasized as a critical component of effective intervention. Finally, gaps in the current literature are identified, and directions for future research are proposed, with an emphasis on improving accessibility, enhancing intervention efficacy, and developing integrative, multidisciplinary approaches to suicide prevention among combat veterans.

Published in	Reports (Volume 6, Issue 3)
DOI	10.11648/j.reports.20260603.13
Page(s)	57-62
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Suicidal Ideation, Combat Veterans, PTSD, Crisis Intervention, Military Mental Health, Veteran Suicide Prevention, Trauma, Peer Support

References

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[2]	Akbar, R., Arya, V., Conroy, E., Wilcox, H. C., & Page, A. (2023). Posttraumatic stress disorder and risk of suicidal behavior: A systematic review and meta-analysis. Suicide and Life-Threatening Behavior, 53(1), 163-184. https://doi.org/10.1111/sltb.12931
[3]	Amato, J., Kayman, D., Lombardo, M., & Goldstein, M. (2017). Spirituality and Religion: Neglected Factors in Preventing Veteran Suicide?. Pastoral Psychology. 66. 1-9. https://doi.org/10.1007/s11089-016-0747-8.
[4]	American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596
[5]	Brandt, M. K., Sandahl, H., & Carlsson, J. (2023). The Impact of Religion and Spirituality on Suicide Risk in Veterans and Refugees With Posttraumatic Stress Disorder. The Journal of nervous and mental disease, 211(1), 65–73. https://doi.org/10.1097/NMD.0000000000001583
[6]	Edwards, E. R., Smith-Isabell, N., Epshteyn, G., Greene, A. L., Gorman, D., Hubay, D., Losieniecki, R., Appelt, C., Osterberg, T., Walker, M., Geraci, J., & Goodman, M. (2024). Veteran suicide thoughts and attempts during the transition from military service to civilian life: Qualitative insights. Death studies, 1–13. Advance online publication. https://doi.org/10.1080/07481187.2024.2414283
[7]	Gonzalez, J. (2023). Military Cultural Competency for Veteran Mental Health Counseling in Civilian Settings. Psychology, 14, 371-424. https://doi.org/10.4236/psych.2023.143022
[8]	Kelly, L. M., Rash, C. J., Alessi, S. M., & Zajac, K. (2020). Correlates and predictors of suicidal ideation and substance use among adults seeking substance use treatment with varying levels of suicidality. Journal of substance abuse treatment, 119, 108145. https://doi.org/10.1016/j.jsat.2020.108145
[9]	Kittel, J. A., Monteith, L. L., Holliday, R. et al. Geospatial estimates of suicidal ideation and suicide attempt prevalence in the U.S. veteran population (2022). Inj. Epidemiol. 12, 32 (2025). https://doi.org/10.1186/s40621-025-00584-y
[10]	Kostas-Polston, E. A., Terehoff, C. B., Nash, L. N., Brown, A. M., Delabastide, Z. A., Andersen, E. W., Brown, W. J., Stucky, C. H., Norcross, K. R., Smith, H., Randall, N. R. (2023). Patterns in Urogenital Health in Active Duty Servicewomen: A Prospective Cross-Sectional Survey Evaluating Impacts of Water, Sanitation, and Hygiene Resources Across Three Military Environments, Military Medicine, Volume 188, Issue 7-8, July/August 2023, Pages e2567–e2575, https://doi.org/10.1093/milmed/usad042
[11]	Martin, C. E., Stayton Coe, L. E., Pease, J. L., & Chard, K. M. (2023). Suicidal ideation in Veterans enrolled in evidence-based psychotherapy for posttraumatic stress disorder. Psychological services, 20(3), 465–473. https://doi.org/10.1037/ser0000598
[12]	Montana Suicide Prevention Strategic Plan 2025. https://dphhs.mt.gov/assets/suicideprevention/2025StateStrategicSuicidePreventionPlan.pdf
[13]	Ramchand R. (2022). Suicide Among Veterans: Veterans' Issues in Focus. Rand Health Quarterly, 9(3), 21. https://pmc.ncbi.nlm.nih.gov/articles/PMC9242579/
[14]	Ruiz, F., Burgo-Black, L., Hunt, S. C., Miller, M., & Spelman, J. (2022). A practical review of suicide among veterans: Preventive and proactive measures for health care institutions and providers. Public Health Reports, 138(2), 223–231. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031829/
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[17]	The Holy Bible. (2010). New International Version. Zondervan.
[18]	U.S. Department of Veterans Affairs. (2024). 2024 National Veteran Suicide Prevention Annual Report. https://www.mentalhealth.va.gov/docs/data-sheets/2024/2024-Annual-Report-Part-1-of-2_508.pdf

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DuShane, T. L. (2026). Suicidal Ideation in Combat Veterans: A Literature Review. Reports, 6(3), 57-62. https://doi.org/10.11648/j.reports.20260603.13

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ACS Style

DuShane, T. L. Suicidal Ideation in Combat Veterans: A Literature Review. Reports. 2026, 6(3), 57-62. doi: 10.11648/j.reports.20260603.13

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DuShane TL. Suicidal Ideation in Combat Veterans: A Literature Review. Reports. 2026;6(3):57-62. doi: 10.11648/j.reports.20260603.13

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@article{10.11648/j.reports.20260603.13,
  author = {Tracy L. DuShane},
  title = {Suicidal Ideation in Combat Veterans: A Literature Review},
  journal = {Reports},
  volume = {6},
  number = {3},
  pages = {57-62},
  doi = {10.11648/j.reports.20260603.13},
  url = {https://doi.org/10.11648/j.reports.20260603.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.reports.20260603.13},
  abstract = {Suicide among combat veterans represents a complex and urgent public health concern, with rates of suicidal ideation and behavior significantly exceeding those observed in the general population. This elevated risk is closely associated with co-occurring mental health conditions, including posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, and moral injury. Additionally, cultural and systemic barriers—such as stigma, reduced help-seeking behaviors, and challenges in accessing care—further complicate prevention and intervention efforts within this population. This manuscript provides a focused review of peer-reviewed literature published between 2020 and 2025, examining the intersection of mental health symptomatology and suicide risk among combat veterans and first responders. Particular attention is given to identifying evidence-based crisis intervention strategies, including trauma-informed approaches and rapid response models tailored to high-risk populations. The review also explores the role of peer support interventions in engaging individuals who may be reluctant to access traditional mental health services, highlighting their effectiveness in fostering trust and promoting early intervention. In addition, the manuscript addresses the importance of integrating spiritual and cultural considerations into suicide prevention frameworks. Culturally responsive care, including attention to military identity, moral injury, and diverse belief systems, is emphasized as a critical component of effective intervention. Finally, gaps in the current literature are identified, and directions for future research are proposed, with an emphasis on improving accessibility, enhancing intervention efficacy, and developing integrative, multidisciplinary approaches to suicide prevention among combat veterans.},
 year = {2026}
}

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TY  - JOUR
T1  - Suicidal Ideation in Combat Veterans: A Literature Review
AU  - Tracy L. DuShane
Y1  - 2026/08/11
PY  - 2026
N1  - https://doi.org/10.11648/j.reports.20260603.13
DO  - 10.11648/j.reports.20260603.13
T2  - Reports
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JO  - Reports
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EP  - 62
PB  - Science Publishing Group
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UR  - https://doi.org/10.11648/j.reports.20260603.13
AB  - Suicide among combat veterans represents a complex and urgent public health concern, with rates of suicidal ideation and behavior significantly exceeding those observed in the general population. This elevated risk is closely associated with co-occurring mental health conditions, including posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, and moral injury. Additionally, cultural and systemic barriers—such as stigma, reduced help-seeking behaviors, and challenges in accessing care—further complicate prevention and intervention efforts within this population. This manuscript provides a focused review of peer-reviewed literature published between 2020 and 2025, examining the intersection of mental health symptomatology and suicide risk among combat veterans and first responders. Particular attention is given to identifying evidence-based crisis intervention strategies, including trauma-informed approaches and rapid response models tailored to high-risk populations. The review also explores the role of peer support interventions in engaging individuals who may be reluctant to access traditional mental health services, highlighting their effectiveness in fostering trust and promoting early intervention. In addition, the manuscript addresses the importance of integrating spiritual and cultural considerations into suicide prevention frameworks. Culturally responsive care, including attention to military identity, moral injury, and diverse belief systems, is emphasized as a critical component of effective intervention. Finally, gaps in the current literature are identified, and directions for future research are proposed, with an emphasis on improving accessibility, enhancing intervention efficacy, and developing integrative, multidisciplinary approaches to suicide prevention among combat veterans.
VL  - 6
IS  - 3
ER  -

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Author Information

Tracy L. DuShane

School of Behavioral Health Sciences, Liberty University, Lynchburg, United States

Contact Email

http://orcid.org/0009-0003-5964-9496

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Plain Text BibTeX RIS

APA Style

DuShane, T. L. (2026). Suicidal Ideation in Combat Veterans: A Literature Review. Reports, 6(3), 57-62. https://doi.org/10.11648/j.reports.20260603.13

Copy | Download

ACS Style

DuShane, T. L. Suicidal Ideation in Combat Veterans: A Literature Review. Reports. 2026, 6(3), 57-62. doi: 10.11648/j.reports.20260603.13

Copy | Download

AMA Style

DuShane TL. Suicidal Ideation in Combat Veterans: A Literature Review. Reports. 2026;6(3):57-62. doi: 10.11648/j.reports.20260603.13

Copy | Download

@article{10.11648/j.reports.20260603.13,
  author = {Tracy L. DuShane},
  title = {Suicidal Ideation in Combat Veterans: A Literature Review},
  journal = {Reports},
  volume = {6},
  number = {3},
  pages = {57-62},
  doi = {10.11648/j.reports.20260603.13},
  url = {https://doi.org/10.11648/j.reports.20260603.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.reports.20260603.13},
  abstract = {Suicide among combat veterans represents a complex and urgent public health concern, with rates of suicidal ideation and behavior significantly exceeding those observed in the general population. This elevated risk is closely associated with co-occurring mental health conditions, including posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, and moral injury. Additionally, cultural and systemic barriers—such as stigma, reduced help-seeking behaviors, and challenges in accessing care—further complicate prevention and intervention efforts within this population. This manuscript provides a focused review of peer-reviewed literature published between 2020 and 2025, examining the intersection of mental health symptomatology and suicide risk among combat veterans and first responders. Particular attention is given to identifying evidence-based crisis intervention strategies, including trauma-informed approaches and rapid response models tailored to high-risk populations. The review also explores the role of peer support interventions in engaging individuals who may be reluctant to access traditional mental health services, highlighting their effectiveness in fostering trust and promoting early intervention. In addition, the manuscript addresses the importance of integrating spiritual and cultural considerations into suicide prevention frameworks. Culturally responsive care, including attention to military identity, moral injury, and diverse belief systems, is emphasized as a critical component of effective intervention. Finally, gaps in the current literature are identified, and directions for future research are proposed, with an emphasis on improving accessibility, enhancing intervention efficacy, and developing integrative, multidisciplinary approaches to suicide prevention among combat veterans.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - Suicidal Ideation in Combat Veterans: A Literature Review
AU  - Tracy L. DuShane
Y1  - 2026/08/11
PY  - 2026
N1  - https://doi.org/10.11648/j.reports.20260603.13
DO  - 10.11648/j.reports.20260603.13
T2  - Reports
JF  - Reports
JO  - Reports
SP  - 57
EP  - 62
PB  - Science Publishing Group
SN  - 2994-7146
UR  - https://doi.org/10.11648/j.reports.20260603.13
AB  - Suicide among combat veterans represents a complex and urgent public health concern, with rates of suicidal ideation and behavior significantly exceeding those observed in the general population. This elevated risk is closely associated with co-occurring mental health conditions, including posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, and moral injury. Additionally, cultural and systemic barriers—such as stigma, reduced help-seeking behaviors, and challenges in accessing care—further complicate prevention and intervention efforts within this population. This manuscript provides a focused review of peer-reviewed literature published between 2020 and 2025, examining the intersection of mental health symptomatology and suicide risk among combat veterans and first responders. Particular attention is given to identifying evidence-based crisis intervention strategies, including trauma-informed approaches and rapid response models tailored to high-risk populations. The review also explores the role of peer support interventions in engaging individuals who may be reluctant to access traditional mental health services, highlighting their effectiveness in fostering trust and promoting early intervention. In addition, the manuscript addresses the importance of integrating spiritual and cultural considerations into suicide prevention frameworks. Culturally responsive care, including attention to military identity, moral injury, and diverse belief systems, is emphasized as a critical component of effective intervention. Finally, gaps in the current literature are identified, and directions for future research are proposed, with an emphasis on improving accessibility, enhancing intervention efficacy, and developing integrative, multidisciplinary approaches to suicide prevention among combat veterans.
VL  - 6
IS  - 3
ER  -

Copy | Download