Women veterans face a suicide crisis that demands immediate attention. A new report from the Cohen Veterans Network Institute for Quality (CVN-IQ) has uncovered significant gaps in how we approach suicide prevention for women veterans and service members—gaps that could endanger the lives of women who serve.
This comprehensive gap analysis, conducted with generous support from Face the Fight, examined current lethal means safety counseling practices, and revealed concerning disparities in care. This research represents a crucial step forward in understanding how to better protect women veterans and service members.
The findings are clear: current suicide prevention strategies often fail to account for the unique experiences and needs of women veterans and service members. From misconceptions about how women veterans attempt suicide to inadequate screening protocols, these gaps leave military women without the targeted support they urgently need.
Understanding the Scope of the Crisis
Women veterans face suicide rates 92% higher than their civilian counterparts, while suicide is the second leading cause of death among active duty women. Additionally, military-affiliated women attempt suicide differently than both civilian women and military men.
Contrary to assumptions among many healthcare providers, firearms have become the most common method of suicide among women veterans and active duty service members. In 2022, veteran women were over 144% more likely to die by firearm suicide than their non-veteran peers – a stark departure from civilian women, who typically use other means. However, over half of suicide deaths among women veterans still involve non-firearm methods, including poisoning and suffocation – methods that are often overshadowed when discussing safety interventions for the military community due to being less common among military-affiliated men.
These statistics reveal a complex landscape that demands nuanced, gender-informed approaches to suicide prevention. Yet our research found that current lethal means safety counseling practices often take a one-size-fits-all approach that overlooks the specific risks and circumstances facing military-affiliated women.
Key Findings: Where Current Practices Fall Short
Interviews with seven leading authorities in suicide prevention research and practice revealed four critical areas where current approaches fail women veterans:
Gendered Misconceptions Create Dangerous Blind Spots
Healthcare providers frequently harbor misconceptions about how military-affiliated women engage in suicidal behaviors. Many providers still associate women veterans primarily with “less aggressive means” like overdoses or self-harm, failing to recognize that these women have military training with firearms and may be highly comfortable with their use.
One researcher explained that healthcare providers often state that overdoses and cutting came to mind when thinking about suicide among women veterans, while firearms did not. This dangerous assumption can lead to inadequate risk assessment and inappropriate safety planning.
Screening Protocols Miss Critical Risk Factors
Current screening practices focus heavily on firearm ownership rather than firearm access—a distinction that creates significant blind spots when assessing women veterans. National Firearms Survey data reveals that while only 24% of women veterans personally own firearms compared to 48% of men, they are much more likely to live in households with firearms they don’t own (14% vs. 2%).
The researchers shared comments from their own research participants, who indicate that they often answer “no” to questions about firearm ownership but are never asked about access. Given that many women veterans live with partners or family members who own firearms, this gap in screening means providers miss crucial information about suicide risk.
Military Sexual Trauma and Intimate Partner Violence Complicate Safety Planning
Military sexual trauma (MST) and intimate partner violence (IPV) create complex challenges for lethal means safety counseling that current guidance fails to address adequately. These experiences, which affect significant numbers of military-affiliated women, can simultaneously motivate firearm ownership for self-protection while elevating suicide risk.
CVN-IQ’s research revealed that women who have experienced MST or IPV may resist traditional safety counseling approaches that focus on removing firearms from the home, as these weapons may represent their primary means of personal protection. When abuse is on-going, women may have little control or support for firearm storage decisions. Experts emphasized that these situations call for tailored approaches to safe storage and highlighted the need for further research to develop and evaluate effective clinical strategies.
Cultural Disconnect Undermines Trust and Effectiveness
A significant cultural divide exists between healthcare providers and military-affiliated clients regarding firearms. Most providers lack the knowledge, familiarity, and comfort with firearms that their military clients possess. This disconnect can undermine therapeutic relationships and reduce the effectiveness of safety planning.
Expert participants noted that education on firearm culture was often where clinicians “turned the corner” in training and began to recognize the importance firearms held in their clients’ lives. Without this cultural competency, providers may struggle to engage women veterans in meaningful discussions about firearm safety.
What This Means for Women Veterans and Their Families
These research findings have profound implications for military-affiliated women and their loved ones. The gaps in current suicide prevention approaches mean that women veterans may not receive the targeted, culturally sensitive care they need during their most vulnerable moments.
These findings suggest the importance of advocating for comprehensive risk assessment that goes beyond simple ownership questions. Women should expect their healthcare providers to ask specifically about access to firearms in their homes, not just personal ownership.
Family members and partners also play a crucial role. Understanding that access to firearms—not just ownership—represents a risk factor can help families engage more effectively in safety planning discussions. This is particularly important given that many women veterans live in households with firearms owned by others.
The intersection of trauma history with firearm safety presents unique challenges that require specialized approaches. Women who have experienced MST or IPV need providers who understand the complex relationship between personal protection needs and suicide risk reduction, while those who face on-going IPV require harm reduction strategies that can be implemented for firearms they may not be able to control.
A Commitment to Better Care
At Cohen Veterans Network, we provide high-quality mental health care to women veterans, service members, and their families at our Cohen Clinics nationwide — and we’re committed to translating these research findings into actionable improvements in care at our clinics and for the mental health field!
To this end, our CVN Training team has developed two incredible, free resources to support health care providers with lethal means counseling:
- From Hesitation to Help: A Collaborative Approach to Lethal Means Safety Conversations in Clinical Practice – a 3-hour webinar designed to equip mental health clinicians with the tools and knowledge to utilize lethal means safety counseling as a method of suicide prevention. (2.75 CEs available). Learn more.
- Lethal Means Counseling for Military-Affiliated Women: A Toolkit for Mental Health Clinicians: A resource to complete with train module, resource handout, video trainings and discussion prompts. Get the Toolkit.
Melissa Litschi, PhD
Research Associate
Cohen Veterans Network Institute for Quality