Financial Stress Tied to Suicide Risk Among Veterans

A JAMA Network Open study found that veterans experiencing major financial stress were significantly more likely to die by suicide within the following year than those without money troubles.

Falling behind on mortgage payments was linked to a 40% increase in suicide risk, while having a vehicle or other asset repossessed nearly doubled the risk. Veterans facing multiple financial setbacks were the most vulnerable, but the study could have broader relevance as Americans increasingly contend with rising housing costs, record credit card debt, and growing losses from fraud and scam.

“Financial distress can escalate quietly,” says lead study author Eric B. Elbogen, a clinical psychologist and professor in the psychiatry and behavioral sciences department at Duke University School of Medicine. “But there are measurable signals that could help identify those at risk before a crisis turns deadly.”

The study is the first to combine national credit bureau records with healthcare and mortality data to examine how financial difficulties unfold in the months leading up to suicide. It was made possible because of integrated data available from the Department of Veterans Affairs.

However, the risk markers identified are not unique to veterans, Elbogen says, and “reflect challenges many Americans are facing right now.”

The study adds new evidence to a growing body of research linking economic hardship and mental health. Suicide rates have risen in the United States over the past two decades, with more deaths by suicide during periods of financial downturn and easing as the economy improves.

Unlike previous studies, which relied largely on surveys or self-reported financial stress, the researchers examined verified financial records and confirmed suicide deaths.

To conduct the study, researchers analyzed the records of about 5,000 veterans who died by suicide between 2015 and 2017 and compared them with 12,500 living veterans. Even after accounting for depression, post-traumatic stress disorder, and substance use, financial stress remained a strong and independent predictor of suicide.

The research also points to a potential path to prevention. Among veterans who were engaged in VA Healthcare, the link between financial stress and suicide was weaker, suggesting that a connection to care may help interrupt a crisis.

“Being connected to health care and support services appears to provide some protection,” Elbogen says. “That’s an important signal for how we might intervene earlier.”

Elbogen studies what happens when military service ends, tracing how financial strain, alcohol abuse, violence, or encounters with the criminal justice system can alter the course of veterans’ lives.

Based on the latest findings, financial stress may be an overlooked factor in assessing suicide risk. While clinicians routinely screen patients for depression and suicidal thoughts, they may be less likely to ask about mounting bills.

That gap may represent a missed opportunity for intervention. Although medical coding systems allow clinicians to document financial insecurity, it is unclear how consistently those tools are used in practice.

When financial hardship is identified, healthcare providers could help connect struggling veterans to support services such as debt counseling, housing support, and employment programs.

“This study shows that suicide prevention isn’t only about mental health,” says Elbogen, director of the VA National Veterans Financial Resource Center (FINVET).

“It’s also about understanding the financial realities people face and responding before those pressures become overwhelming.”

If you or someone you know is in crisis and considering suicide or self-harm, please seek support: Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Counselors are available 24 hours a day to listen and provide free and confidential support.

Funding for the research came from the Department of Veteran Affairs and Face the Fight funded the study with additional support from a VA Research Career Scientist Award for Kimbrel from the Department of Veteran Affairs Office of Research and Development.

Source: Duke University