title: Military Sexual Trauma and Suicide Mortality.
abstract: The Veterans Health Administration health system uses a clinical reminder in the medical record to screen for military sexual trauma. For more than 6 million Veterans, this study assessed associations between military sexual trauma screen results and subsequent suicide mortality.
  
  
  
  For Veterans who received Veterans Health Administration services in fiscal years 2007-2011 and were screened for military sexual trauma (5,991,080 men; 360,774 women), proportional hazards regressions evaluated associations between military sexually trauma and suicide risk. Models were adjusted for age, rural residence, medical morbidity, and psychiatric conditions, obtained from medical records at the year military sexual trauma screening occurred. Analyses were conducted in 2014.
  
  
  
  Military sexual trauma was reported by 1.1% of men and 21.2% of women. A total of 9,017 Veterans completed suicide during the follow-up period. Hazard ratios for military sexual trauma were 1.69 (95% CI=1.45, 1.97) among men and 2.27 (95% CI=1.76, 2.94) among women. Suicide risk associated with military sexual trauma remained significantly elevated in adjusted models.
  
  
  
  Study results are among the first population-based investigations to document sexual trauma as a risk factor for suicide mortality. Military sexual trauma represents a clinical indicator for suicide prevention in the Veterans Health Administration. Results suggest the importance of continued assessments regarding military sexual trauma and suicide risks and of collaboration between military sexual trauma-related programs and suicide prevention efforts. Moreover, military sexual trauma should be considered in suicide prevention strategies even among individuals without documented psychiatric morbidity.
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California; Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California; National MST Support Team, VA Mental Health Services, Department of Veterans Affairs, Menlo Park, California. Electronic address: rachel.kimerling@va.gov.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California; National MST Support Team, VA Mental Health Services, Department of Veterans Affairs, Menlo Park, California.
authors.forename: Kerry
authors.initials: K
authors.lastname: Makin-Byrd
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health Operations, Department of Veterans Affairs, Ann Arbor, Michigan.
authors.forename: Samantha
authors.initials: S
authors.lastname: Louzon
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health Operations, Department of Veterans Affairs, Ann Arbor, Michigan.
authors.forename: Rosalinda V
authors.initials: RV
authors.lastname: Ignacio
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health Operations, Department of Veterans Affairs, Ann Arbor, Michigan; VA Center for Clinical Management Research, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
authors.forename: John F
authors.initials: JF
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D000092864:Suicide Prevention