More than 20% of Iraq and Afghanistan war veterans are reportedly suffering from post-traumatic stress disorder (PTSD), and more than 450,000 service members have been diagnosed with at least 1 traumatic brain injury over the past 20 years.
It’s perhaps not surprising, then, that depression, anxiety, homelessness, substance use disorders, and suicide are more common in veteran populations. Nearly 17 veterans die by suicide each day, according to Steven Lieberman, MD, Veterans Health Administrations’ Acting Under Secretary for Health, who touched on this issue at AMSUS 2025, held in Maryland in March 2025. Despite millions of federal health dollars being poured into mental health initiatives for veterans, suicide rates remain high in this population, and this cycle has prompted several health officials to closely examine the risk factors for suicide and ways to better address the situation.
Risk Factors
A study published in February 2025 that analyzed data from the first year of the Veterans Affairs (VA)-wide Comprehensive Suicide Risk Evaluations (CSREs) focused on veterans who received a CSRE assessment from a VA clinician.1 The CSRE program launched nationally 6 years ago, and the study looks at suicide deaths among veterans both in the first 30 days and those who received an assessment during its first year. There were 791 suicides following the 269,374 CSREs that were completed for 153,736 Veterans Health Administration patients between November 2019 and December 2020. Of those, 144 suicides occurred within 30 days after a CSRE, and the remainder occurred in the year following the CSRE.
While most of those veterans who died by suicide after a CSRE had been classified as having an especially high risk of near-term or long-term suicide based on their answers on the CSRE scale, there were also suicide deaths among those who fell into the lower-risk category on their CSRE, according to the study researchers. The study noted that veterans who were actively experiencing suicidal thoughts, had made suicide plans, had access to firearms, or had a history of mental health inpatient stays were most likely to die by suicide, compared with others who had been through a CSRE but didn’t have these risk factors.
Recognizing the Signs
Early intervention is key to addressing mental health concerns. Early signs of possible mental health symptoms, according to a recently issued statement from TRICARE, may include:
- Eating or sleeping too much or too little
- Pulling away from people and usual activities
- Having trouble concentrating
- Feeling numb or like nothing matters
- Experiencing unexplained aches and pains
- Feeling hopeless or helpless
- Smoking or drinking more than usual2
Actions Being Taken Now
“Even one suicide a day is too high,” Lieberman said during AMSUS, urging veterans to avail themselves of the numerous mental health services available to military, including the Military Crisis Line or Veterans Crisis Line, which involves dialing 988 and then 1 for those who may be contemplating suicide. The COMPACT Act also allows eligible veterans in an acute suicide crisis to go to any VA or non-VA healthcare facility for no-cost emergency healthcare.
TRICARE patients who are overseas can reach out via a chat online at www.veteranscrisisline.net/get-help-now/chat/, to find out the best phone option depending on location. TRICARE also offers a range of mental health resources, including military hospitals, clinics, and civilian network providers, which can be located at Tricare.mil.
Preventive Actions
Officials with the VA last month announced the availability of approximately $52.5 million in grants for community-based organizations that provide suicide prevention or emergency clinical services to veterans at risk of suicide.
The grants will be awarded through VA’s Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, which was established as part of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019. In alignment with VA’s National Strategy for Preventing Veteran Suicide, which was developed during the first Trump Administration, Fox grants foster a public-health approach to suicide prevention that blends community-based efforts with evidence-based clinical strategies.
Since its launch in 2022, the Fox grant program has awarded $157.5 million to 95 organizations across 43 states, US territories, and tribal lands.
Grant applications are due by 4:59 pm ET, July 18, 2025, and VA will choose awardees by September 30. Organizations can apply for grants worth up to $750,000 and may apply to renew awards from year to year throughout the length of the program. Information on how to apply is available at mentalhealth.va.gov/ssgfox-grants.
“Reducing veteran suicide starts with reaching veterans when and how it’s most convenient for them. One of the best ways to accomplish this mission is by working with community-based organizations,” VA Secretary Doug Collins said in a press release that announced the funding.3
Study Ahead
In a hearing before the Senate Veterans’ Affairs Committee held in early May, Sen. John Boozman (R-AR) asked VA Secretary Collins to expand on the agency’s continuing plans to address mental health and suicide among veterans, specifically mentioning Collins’ comments made during an earlier Cabinet meeting with President Donald Trump.
During that meeting and later at the hearing, Collins mentioned he is open to exploring the issue of using psychedelic medicines to address the serious mental health issues that impact veterans. Psychedelic drugs are a class of substances that alter consciousness or awareness and can be organically or synthetically produced.
In previous discussions, Collins has explained he has had “eye-opening” conversations with HHS Secretary Robert F. Kennedy Jr about psychedelics, and in his response, he said he is “committed to doing whatever we can to provide veterans and those who have maybe not responded to traditional care and others, especially in the area of PTSD and also [traumatic brain injury]—the other issues that we’re dealing with that lead to a lot of what we’ve seen in suicide and death by suicide.”4
To prevent serious self-injury or harm, VA strongly discourages self-medicating with psychedelics or any other unprescribed substances, but a study is pending that will examine prescribed psychedelics.
Writing in a press release issued late in 2024, officials with the VA noted that for the first time since the 1960s, methylenedioxymethamphetamine (MDMA)-assisted therapy for PTSD and alcohol use disorder among veterans will likely be the subject of a study.5
Working with researchers from Brown University and Yale University through a $1.5-million grant, the VA will evaluate, in a randomized fashion, psychotherapy sessions enhanced by MDMA.
The study is scheduled to take place at the Providence VA Medical Center in Rhode Island and the West Haven VA Medical Center in Connecticut and is anticipated to begin enrollment this year. As with all VA studies, treatments will be conducted in a clinical setting with strict safety protocols and following all appropriate federal guidelines for conducting studies with controlled substances. Pharmaceutical-grade MDMA will be used, and study participants will be closely monitored to ensure their well-being throughout.
References
- Saulnier KG, Bagge CL, Ganoczy D, et al. Suicide risk evaluations and suicide in the Veterans Health Administration. JAMA Netw Open. 2025;8:e2461559.
- TRICARE Communications. TRICARE is your partner in mental health care [press release]. May 14, 2025. Accessed May 16, 2025. https://newsroom.tricare.mil/News/TRICARE-News/Article/4186526/tricare-is-your-partner-in-mental-health-care
- Veterans Affairs. VA announces $52M in available suicide prevention grant funds. May 21, 2025. Accessed May 28, 2025. https://news.va.gov/press-room/va-announces-52-million-in-available-suicide-prevention-grant-funds/
- Jaeger K. Trump’s VA secretary tells senators that psychedelics have potential to mitigate the veteran suicide crisis. Marijuana Moment. May 7, 2025. Accessed May 12, 2025. www.marijuanamoment.net/trumps-va-secretary-tells-senators-that-psychedelics-have-potential-to-mitigate-the-veteran-suicide-crisis/
- Veterans Affairs. VA funds first study on psychedelic-assisted therapy for veterans [press release]. December 3, 2024. Accessed December 9, 2024. https://news.va.gov/press-room/va-funds-first-study-on-psychedelic-assisted-therapy-for-veterans/