Since 9/11, four times as many U.S. service members and veterans have died by suicide than have been killed in combat, according to a new report.

The research, compiled by the Costs of War Project at Brown University, found an estimated 30,177 active duty personnel and veterans who have served in the military since 9/11 have died by suicide, compared with 7,057 killed in post 9/11 military operations. The figures include all service members, not just those who served in combat during that time.

The majority of the deaths are among veterans who account for an estimated 22,261 of the suicides during that period.

“The trend is deeply alarming,” the report says. “The increasing rates of suicide for both veterans and active duty personnel are outpacing those of the general population, marking a significant shift.”

April 16, 201901:45

The Department of Veterans Affairs releases information on deaths by suicide, but it does not distinguish by conflict. The report’s author, Thomas “Ben” Suitt III, took the VA data and estimated the total number of veteran suicides based on their ages and other factors.

A total of 5,116 active duty service members have died by suicide since Sept. 11, 2001, the report says. Figures for the National Guard and Reserves are not available for the first 10 years, but from 2011 to 2020 an estimated 1,193 National Guard and 1,607 Reservists have died by suicide.

In an interview, Suitt said the number 30,177 is likely well below the actual number of suicides for active duty and veterans. He believes one of the reasons the numbers continue to climb is indifference by the American public.

“For veterans to come home to an uncaring civilian population or to an uncaring public, that must be devastating,” Suitt said.

Other factors include the increase of improvised explosive devices causing more traumatic brain injuries, post-traumatic stress and other medical and emotional factors connected to suicidal ideation, Suitt said.

Suitt said his research found that some service members may not get the medical treatment they need, making them more vulnerable to suicidal behavior.

“There was a sense that an active service member would rather lie on a screening to be able to stay in the military,” he said.

“If they have a traumatic brain injury but no other physical injuries, they downplay the injuries to stay in their career.”

His research found that some service members felt they would lose their sense of identity by being discharged early for a medical issue and they “would do anything to avoid leaving the military.”

The Defense Department did not immediately respond to a request for comment.

“Veteran suicide remains a challenging and heartbreaking issue that VA is fully committed to working in partnership with federal, tribal, state, and local government to find innovative ways to reduce suicides and deliver expedient care to those in need,” said VA press secretary Terrence Hayes.

Suitt expressed regret that some Americans don’t know that men and women are still serving in post 9/11 conflicts.

“The public needs to care. They really, really should,” he said.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Source: | This article originally belongs to Nbcnews.com

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