US military veterans commit suicide at much higher rate than people in the general population. One of the bright spots on the horizon is the potential for psychedelic medicines to treat suicide risk factors like major depression, post-traumatic stress disorder, and substance abuse disorders. We want people with these underlying conditions to get better by using psychedelic medicines. But how much will psychedelics reduce veteran suicide? To keep it simple we just looked at the numbers for major depression.
Depression As a Veteran Suicide Risk Factor
Twenty percent of veterans are or have been significantly depressed. The risk of suicide runs between 5% and 8% for individuals with major depression. This puts the potential risk of suicide by depressed veterans between 1% and 1.6% of the total veteran community. The incidence of suicide among all veterans in 2020 was reported at 31.7 per 100,000. This is 0.037%. It is clear that being significantly depressed greatly multiplies the risk of suicide among everyone, including US military veterans. The question we would like to address is if a veteran’s depression is successfully treated with psychedelics how much does this help in reducing the risk of suicide. Ideally, if the veteran is no longer depressed and has no other significant risk factors their risk of suicide will fall to the baseline level for veterans.
How Successful Are Psychedelics in Treating Depression?
A report out of Johns Hopkins University says that the psychedelic medicine psilocybin reliably relieves depression for at least a year. Their studies show that psilocybin-assisted therapy for depression resulted in 75% of depressed patients being better a year after treatment. 58% of those treated had no depressive symptoms a year after treatment. We will assume that the effects of treatment with psilocybin will last longer than a year or that, when they wear of, treatment can be repeated and be successful. This indicates psilocybin will be completely successful in treating depression 58% of the time and at least partially successful 75% of the time.
Projected Success of Psychedelics in Preventing Suicide in Depressed Veterans
We will make the assumption that depression is the only risk factor for suicide that a veteran has. That will rarely be the case but it lets us make a simple calculation to get started. 20% of veterans are significantly depressed at some time or other. The risk of suicide with major depression is between 5% and 8%. That puts the risk of suicide by depressed veterans at some time in their lives at 1% to 1.6% of all veterans. The success rate of psilocybin in treating major depression is 75% for improvement out to a year and 58% for total remission out to a year. We may expect a 58% to 75% reduction in the incidence of suicide by depressed veterans and therefore a reduction of the 1% to 1.6% figures down to 0.42% or 0.67% of veterans at risk for suicide due to depression at some point during their lives.
Depression and Other Suicide Risk Factors
A diagnosis of major depression goes with a significantly higher risk of suicide. It certainly makes sense that successful treatment of depression would reduce suicide risk. However, there are other risk factors for suicide and many of them are present when someone is depressed. For example, social isolation, breakup of a close relationship, loss of employment, and difficulty reintegrating into civilian society are all risk factors for suicide among veterans. While we can expect treatment with psilocybin to help reduce depression it will not necessarily help with risk factors that may have contributed to depression. As psilocybin treatment has been legalized in Australia and may soon be legal in the USA, we will see the exact amount of reduction in veteran suicide that psychedelics accomplish.
