Disorder-specific risk factors of suicidal behaviour among serving and veteran Canadian Armed Forces Members with baseline mental health diagnoses.

Objectives: Many Canadian Armed Forces (CAF) members and veterans will receive a mental disorder diagnosis, and a high percentage will also experience suicidal behaviours. This study examined demographic characteristics, distal and proximal risk factors, and protective factors, and their relationship to suicidal behaviour (ideation, plans, and attempts) among CAF members and veterans who met criteria for a mental disorder at baseline.

Methods: Data from the 2018 CAF Members and Veterans Mental Health Follow-up Survey (n = 2941) were utilized. Mental disorder diagnoses were assessed through structured diagnostic interview. Generalized linear models were conducted using subsamples of individuals with a lifetime baseline diagnosis of (a) major depressive episode (MDE), (b) posttraumatic stress disorder (PTSD), and (c) an anxiety disorder (AD; social phobia, generalized, panic).

Results: Across mental disorder subsamples of those with MDE and AD, land environmental command at baseline was associated with increased prevalence of suicidal behaviour. Risk factors for suicidal behaviour across all subsamples included baseline suicidal behaviour, greater level of self-medication and avoidant coping style, greater level of baseline work stress, greater number of traumatic experiences, persistence or recurrence of index mental disorder, current comorbid mental disorder, current physical health condition, exposure to "other" traumatic experiences, and alcohol use disorder. Protective factors across all subsamples included greater level of current problem-solving coping style. Disorder-specific factors were also identified.

Conclusion: This study identified characteristics of individuals living with mental disorders who might be at high risk of suicidal behaviour, highlighting potential areas for targeted interventions in this key population.