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And now let's talk about a painful statistic. Twenty veterans commit suicide each day according to the Department of Veterans Affairs. That rate is somewhat higher than suicide among civilians. But female veterans have a rate between two and five times higher than civilian women, and the number has grown steeply over the past decade. As NPR's Quil Lawrence reports, there are just no easy explanations.
QUIL LAWRENCE, BYLINE: It seems like a contradiction. Suicide is rising, but it's so rare that it's hard to study.
LYNSAY AYER: We can't ask deceased people about what factors might have led up to the completion of suicide.
LAWRENCE: Lynsay Ayer studies military suicide at the RAND Corporation.
AYER: The completion of suicide is overall rare in the general population, and so we can talk with people who have attempted suicide or have thought about suicide.
LAWRENCE: Those aren't always the people who end up actually killing themselves, but it's as close as you can get. When RAND wanted to glean what they could from female vets who have thought about suicide, the obvious place to go was Canandaigua, N.Y. That's where the Department of Veterans Affairs runs one of two call centers for the Veterans Crisis Line. The hundreds of operators there may be the largest pool of knowledge about what brings female veterans to the edge of suicide.
LETRICE TITUS: She had her weapon and barricaded herself in the bathroom, would not leave, and had a loaded gun and said she was going to kill herself.
LAWRENCE: Letrice Titus, an Army veteran, has been answering phones here for four years.
TITUS: She wanted me to make calls to, like, her mom and her siblings and so she could say goodbye. And I told her, no, because you're going to live today, so there's no need to say goodbye, you know, and let's just focus on you staying safe.
LAWRENCE: Titus says women call with the same issues as men - post-traumatic stress disorder, financial stress on top of loneliness and depression. The end of a relationship or a custody battle can be a trigger. She says female veterans have their own issues as well. Many VA clinics are less than inviting for women, or they find themselves the only female in a group therapy session. Not ideal, says Letrice Titus, because a common issue for women who call the crisis line is rape and the way the military handles it.
TITUS: Talking about military sexual trauma, females often do not report it because then they're looked at as, oh, you are the barracks whore or no one's going to believe you or it'll get investigated and you'll still get in trouble.
DANIELLE SIMPSON: And so I think that that's really traumatizing when you - you know, you have to live with that the rest of your life, that this happened to me. And a lot of times it turns into a crisis because there's been no justice.
LAWRENCE: Danielle Simpson also works at the crisis line. She's heard about sexual assault from women and men. She says less traumatic issues can build up, that transition to civilian life can be overwhelming.
SIMPSON: This winter, I spoke with a female veteran who - she had been in Afghanistan, seen combat. And so she was really dealing with a lot of PTSD, and then coming home and being expected to be this soft, caring, warm mother and wife that she was expected to be in civilian life. And she was really struggling with that transition.
LAWRENCE: The stress may come from different places for male or female vets. There's one thing they have in common, though - guns. Kelly Lannon is an Iraq vet who works at the crisis line.
KELLY LANNON: Women in the military, they are trained just like the men are to use guns, how to use them properly. I think that they're less scared of guns than maybe a civilian would be because they have such significant experience with it.
LAWRENCE: Civilian women usually favor pills, which take time and aren't always fatal. Female veterans are about 33 percent more likely than civilians to use a gun, according to VA statistics, and that number has grown in the past decade. Guns are instantaneous and much more deadly. Quil Lawrence, NPR News. Transcript provided by NPR, Copyright NPR.