This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Efforts to prevent military and veteran suicides have been hindered by a lack of accurate data and a failure to understand the root cause of the issue, with one study showing that the rate of suicide among veterans could be as much as 37% higher than the number reported by the Department of Veterans Affairs.
"There's no way we can combat veteran suicide without knowing what is causing it, where it's coming from, and the highest number," Jen Satterly, the co-founder and CEO of the All Secure Foundation, told Fox News Digital.
But their mission to fight for the men and women who have fought for their country faces many obstacles, including a lack of understanding of just how far-reaching the issue is.
That obstacle came into greater focus after a recent study showed that the VA could be undercounting veteran suicides by over 30%, startling new information to some but no surprise to Satterly and her colleagues.
"Part of my advocacy in this arena of the veteran space has been trying to get accurate numbers and reporting," Satterly said. "There has been a discrepancy in the numbers for years now, so this is actually no surprise to us in our organization."
While the oft-cited "22 a day" number has been widely circulated since the release of a VA report on veteran suicides in 2014, Satterly pointed out that there were multiple flaws in the research. Overdose numbers were not being counted in the statistics, while communication between the various stakeholders has never been streamlined to provide a full accounting.
"It's very difficult," Satterly said. "There is, as you can imagine, a level of privacy that families want to protect their loved ones. Oftentimes, I understand that a family might not want to come forward and say this was a death by suicide versus saying it was an accidental overdose."
According to the authors of the study, which was dubbed Operation Deep Dive, there has also been a widespread failure to track former service members who took their own lives years after serving.
"The difference in the data is likely due to undercounting of FSMs' (former service members) deaths and the greater specificity of the decedent’s demographics, military experience, and death details available to Operation Deep Dive," the study said.
After compiling data in eight states, the researchers found that if the same trend were to hold nationwide, the actual rate of veteran suicides per day would be closer to 44.
"What we found is across the nation with the states is that they undercount veteran deaths by about 18%, which means someone who served in the military is not annotated as having served in the military 18% of the time," Jim Lorraine, president of America’s Warrior Partnership, the organization behind the study, told Fox News Digital. "Inversely, the communities are counting people who never served in the military as service members 7% of the time so that's a combined error rate of 25%."
An effort to streamline the data and come to an accurate number could be a massive undertaking, Satterly noted, requiring an increase of funding and an overhaul of how departments share information. However, she noted the government has the ability to track the information, with every member of the military having a permanent record showing their branch, unit and years served.
Another issue is the failure to understand why current and former military members take their own lives.
"As we look at our Vietnam veterans who are now in their 70s… the issues can be very different for them now," Satterly said. "They're battling a lot of physical ailments, cancer, a whole slew of things that are coming forward through Agent Orange and other exposures."
"To understand why people are dying by suicide might look very different between different communities and different times served," Satterly said.
Satterly also pointed out that there is a misconception that most or all military suicides are the result of war trauma or a lack of purpose after service members take the uniform off when in reality there are other factors that could play an even larger role, such as an unstable home life, divorce and financial issues, all of which could come into play when a person decides to take their own life.
While those factors play a role in suicides for the general population, current and former service members are especially at risk. Due to the nature of their work, many of them have suffered from traumatic brain injuries or post-traumatic stress disorder, two issues that can make suicide a more likely outcome.
Satterly also pointed out that mental health remains a stigmatized issue within the military, with current and former service members not seeking help before a crisis deepens out of fear for appearing weak.
The All Secure Foundation has aimed to tackle that problem in its outreach to the military community, providing service members and veterans with the information and tools they need before issues spiral downward.
"We spend our days going around to different posts and different bases trying to really break apart the stigma that they're facing," Satterly said.
The All Secure Foundation attempts to frame taking care of mental health as an issue of training, noting that military members are constantly trained to go to war but not for what comes after.
"You've been trained on how to shoot, move, communicate and medicate…. Who trained you to come home from war?" Satterly said they ask service members. "So now you realize you don't need to ask for help, you just need to ask for training… that takes a huge weight off of the stigma, I can handle this, I've been trained."
"You have to treat it like an injury, so I believe what language we use is really critical moving forward," Satterly said. "We don't say PTSD, we use PTSI, post-traumatic stress injury. Because we do know that you can see it through brain scans and that it can be healed. I think that takes a tremendous pressure off our service members, that it's not a matter of willpower, it's not a matter of weakness."