Thirty thousand dead from suicide in 20 years among American service-members and veterans. Brown University’s Costs of War Project, utilizing data from the Department of Defense (DoD) and the Department of Veterans Affairs (VA), calculates that four times as many men and women who have served in the US military since 9/11 have died by suicide than were killed in the post-9/11 wars. The vast majority of those killed by suicide have been veterans, meaning men and women not still in uniform. While the rate of suicide among active-duty service-members is alarmingly high, the rate among veterans is even more so, and, in particular, it appears highest among combat veterans.

Anyone who served in combat in Iraq or Afghanistan may likely now know more friends killed by suicide than killed by the Taliban or by Iraqi insurgents. The same possibly for veterans who fought in Vietnam, Korea, and World War II. Suicide after taking part in war, and its killing, is not a new phenomenon, and its likely cause, guilt, is understood if seldom discussed.

Greek and Roman histories speak of suicide and what we now call invisible wounds. Our greatest literary voices, like Shakespeare and Homer, wrote of it. Following the American Civil War, period sources describe suicide, alcoholism, drug overdose, and exposure due to homelessness that killed and debilitated hundreds of thousands of veterans.  In America’s other “good” war, World War II, 1 in 7 combat veterans were discharged as psychiatric casualties. In an era where a psychiatric diagnosis was often shunned and avoided, and when post-traumatic stress disorder would not become a medically recognized diagnosis until the 1980s, hundreds of thousands of World War II veterans were mentally and emotionally devastated. However, the discussion of what World War II veterans were going through, and then Korean veterans, was censored by the US government. The Vietnam War, as it did so many other things in our society, changed the discussion on the psychological and psychiatric consequences of war. Suicide among Vietnam veterans became an open secret widely discussed, if not among the public than among veterans.

It would not be until the 1990s that the VA and the DoD would begin addressing these issues in a manner that demonstrated any commitment to understanding the problem and, perhaps, finding a solution. In 1991, a VA study of Vietnam veterans found that combat-related guilt was the best predictor of suicide in veterans. While this may have been apparent to those who have been to war and those who understood war’s true nature, this was a politically difficult finding. This idea that guilt within veterans over their actions in war was the leading cause of high suicide rates goes against the moral and religious core of American Exceptionalism and the narratives of freedom and democracy that support American wars and interventions. For if soldiers are coming home and killing themselves, in large numbers because what they had done was morally wrong, then what did that say about the wars these men and women had been fighting and about the government and society for which they were fighting?

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Suicide after taking part in war, and its killing, is not a new phenomenon, and its likely cause, guilt, is understood if seldom discussed.

Matthew Hoh