Veteran Suicide Rates Decline, But Remain Elevated for Those with Brain Injuries
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A significant drop in suicide rates among U.S. military veterans since 2020 offers a glimmer of hope, though the risk remains substantially higher for those with traumatic brain injury (TBI), according to new research published in JAMA Network Open.
New data from the University of Utah reveals a turning point in a decades-long climb in veteran suicide, signaling the potential impact of increased prevention efforts. The study underscores the complex challenges facing veterans, particularly those grappling with the long-term effects of TBI.
The “Healthy Warrior Effect” adn Its Reversal
Researchers initially observed what was termed the “Healthy Warrior Effect,” a period where veterans demonstrated lower suicide rates compared to the general population. “When we started looking at this earlier, there was actually a protective effect for being a veteran,” explained a lead researcher. However, this protective benefit began to erode as the War on Terror continued.
Analysis indicated that around 2006, veteran suicide rates began to increase, coinciding with repeated deployments following the events of 2001 and 2002. Notably, the study found that deploy
The Complexity of Addressing Impulsive Behavior
While the decline in suicide rates is encouraging, experts caution against complacency. Addressing impulsive behavior, a significant factor in suicide risk, requires a multifaceted approach.though, experts emphasize that a single solution is unlikely to be effective. “They’ve got a variety of different approaches to help people… reduce impulsive behavior,” one researcher noted. “One size never fits all for any kind of mental health condition or treatment.”
The Personal Impact of Research and the Long-Term Consequences of TBI
The research is deeply personal for Mary jo Pugh, the principal investigator and a professor of epidemiology at the University of Utah. A former Air force nurse medically retired after sustaining polytrauma injuries, including TBI, in a car accident, Pugh channeled her experiences into a Ph.D. in developmental psychology and dedicated her career to understanding the long-term effects of military service.
Eight years ago, Pugh established TORCH (Trajectories of Resilience, Community and Health) at the University of Utah, assembling a cohort of over 2.5 million service members and veterans who served on active duty after 9/11 to conduct population-based analyses of TBI and related outcomes.
Her team’s groundbreaking work on TBI has earned Pugh the Outstanding Research Accomplishment award at the 2025 Military Health System research Symposium. This research demonstrates that the consequences of TBI-affecting roughly one in five post-9/11 veterans-extend far beyond suicide risk.
Expanding Health Risks Linked to TBI
TORCH’s research reveals a strong correlation between TBI and other long-term health issues, including dementia, substance use disorder, and cardiovascular disease. “Documenting these patterns of risk is a crucial step toward implementing preemptive interventions to help veterans stay healthy,” Pugh stated.
Recent studies have also identified an elevated risk of cancers of the central nervous system (CNS), such as glioblastoma, among female veterans with TBI. An analysis of data covering 422,715 female veterans with 1,229 cancer deaths from 2002 to 2020 revealed a mortality rate ratio almost six times higher than the general population. This finding aligns with other studies linking brain injuries to increased CNS cancer risk, even in civilian populations.Researchers believe that inflammation associated with TBI,coupled with environmental exposures like burn pits,may synergistically increase this risk. “If you have a more severe injury where there’s a blood-brain barrier breach… and if your injury occurs in a situation where there might be fire or flames… that might get into the brain and increase the likelihood of having an exposure that’s synergistic with the TBI,” pugh explained.
Further data about the study can be found in JAMA Network Open: https://jamanetworkopen.2025.30216.
While the recent decline in veteran suicide rates is a welcome advancement, the continued elevated risk for those with TBI underscores the urgent need for thorough, long-term care and continued research into the lasting effects of these injuries.
