Mental Health Care Use and Barriers Among Veterans and Nonveterans With Suicidal Ideation: Findings From a National Survey

OBJECTIVE: Since 2001, suicide rates among veterans have exceeded and risen faster than those of nonveterans. Although policy efforts have expanded suicide prevention and mental health services in the Veterans Health Administration (VHA), limited data exist on service use and barriers among veterans at high risk for suicide, especially those outside VHA care. The authors estimated the prevalence rates of mental health service use in a national sample of veterans with recent suicidal ideation, compared rates with those of nonveterans, and identified barriers to care. METHODS: Data were drawn from pooled 2015-2019 National Survey on Drug Use and Health assessments (N=214,395 adults, including 11,875 veterans). Survey-weighted Poisson regression analyses adjusted for demographic covariates were used to compare mental health service use, unmet treatment needs, and treatment barriers between veterans and nonveterans with recent suicidal ideation. RESULTS: Among adults with suicidal ideation, veterans more commonly used mental health services than did nonveterans (56.0% vs. 47.3%) and had a higher likelihood of past-year outpatient treatment (adjusted prevalence ratio [APR]=1.26) and pharmacological treatment (APR=1.17). However, nearly one-third of both veterans and nonveterans reported unmet mental health needs. Veterans were less likely than nonveterans to endorse cost as a barrier to care (APR=0.65) but were more likely to endorse confidentiality concerns (APR=1.65). Fear of involuntary hospitalization and stigma were common in both groups. CONCLUSIONS: Despite higher service use and fewer cost-related barriers, veterans with suicidal ideation still reported high unmet needs, underscoring the importance of addressing persistent barriers and improving care quality for veterans at elevated suicide risk.