The Fort Hood shooting reignited the national debate over the surge of suicides among those who served in Iraq and Afghanistan. But older veterans have been largely overlooked in the conversation.
Nearly 70 percent of all veterans who commit suicide are age 50 or older, according to the Veterans Affairs Department. This is double the suicide rate for the same age group in the nonveteran community.
Although national tracking of veteran suicide rates is unreliable at best, the VA estimates that 22 veterans commit suicide each day. This means approximately 8,030 veterans kill themselves every year, more than 5,540 of whom are 50 or older.
Some veterans' advocates say it's easier for older veterans to feel America has forgotten their sacrifices.
"You know, 'We're just old guys, and we're going to die, so why pay much attention to them?' ...That's kind of the feeling that some of our members have," said Tom Berger, executive director of the Vietnam Veterans of America national health council.
But on Capitol Hill, efforts to combat veteran suicides—specifically among older veterans—are largely missing in the flurry of mental-health and VA legislation. Two omnibus veterans bills in the Senate include a provision to extend enrollment eligibility for VA health care from five years after the end of service to 15 years, which would account for possible delayed effects of war. Sen. John Walsh, D-Mont., who introduced one of the omnibus bills, is the first Iraq War combat veteran to serve in the Senate.
But only veterans of the Iraq and Afghanistan wars would be eligible for the 15-year deadline.
Berger, who served in the Navy in Vietnam, laments that expanding the enrollment eligibility does nothing for Vietnam veterans. But he added that the extension "would have made a world of difference" for veterans directly after the war, when suicide rates first tend to spike.
Berger credited the recent shootings on military bases for being "one of the things that has propelled the mental-health issue … to the forefront," but he added that the Vietnam Veterans of America has been "dealing with mental-health issues for a long time."
The VA estimates that 30 percent of Vietnam veterans suffer from posttraumatic-stress disorder, compared with 11 to 20 percent of Iraq and Afghanistan veterans.
Many Vietnam veterans suffered an especially difficult transition back into civilian life due to the widespread protests against the war. Even now, when searching "Why are Vietnam Veterans … " in Google, the first few words that pop up to complete the sentence are "homeless," "crazy," and "hated."
The stigma attached to Vietnam may have made some veterans reluctant to immediately seek the help they needed when they first returned from service, Berger said. "It's taken a long time for us to overcome that negative image," he said.
A study released last year by the VA recommends that the department increase its suicide-prevention measures for those who served in Vietnam. VA officials estimate that only one in five veterans who commit suicide were enrolled in VA health care. The VA's updated suicide information earlier this year showed a decrease in the suicide rate for middle-aged male veterans who use VA health care, compared with an increase for the same age group of veterans who don't.
Robert Bossarte, who coauthored the VA study, said that despite initial worries that older veterans wouldn't use the Veterans Crisis Line, the opposite has proven true.
"The greatest proportion of callers is in fact middle-aged adults," he said.
Many aging veterans face the same issues as the general population in growing older, such as declining health and mobility, which can fuel feelings of loneliness and isolation. Older people also tend to suffer from more chronic pain, especially if they have endured a war wound.
But for veterans, mental health—including PTSD—is also a key factor.
"We know that psychiatric disorders play a very large role," Bossarte said.
Walsh's bill does try to tackle PTSD with a provision that would force the Pentagon to reexamine troops who were discharged for PTSD-related behaviors, which can include nightmares, flashbacks, changes in personality, sleeping disorders, and suicidal thoughts.
For now, Berger is reserving his opinion on the legislation, but he stressed that "the devil is in the details."
"Ordering the VA to do something doesn't mean it's going to get done the proper way," he said. "Just saying 'They should do this' and 'They should do that' doesn't mean they're going to do it."