A Phone Call Away
Story by Rick DiPalermo, Texas Veterans Commission
Multiple tours, inadequate dwell time between tours, strained relationships, and financial difficulties have contributed to the rising rate of suicide among active duty troops and veterans. According to a RAND study, 300,000 of the 1.7 million veterans of Iraq and Afghanistan will develop combat-related mental health issues. If these cases go untreated, they may develop into severe Posttraumatic Stress Disorder (PTSD), and people with a diagnosis of PTSD are at a greater risk to attempt suicide.
On Sept. 16, 2008, there was a hearing before the Subcommittee on Health of the Committee on Veterans’ Affairs U.S. House of Representatives One Hundred Tenth Congress, Second Session. Tom Tarantino, who is a Policy Associate for the Iraq and Afghanistan Veterans of America, submitted a written testimony regarding veteran suicide and the Department of Veterans Affairs’ (VA) outreach efforts.
While the rate of military suicides is closely monitored, the VA has been tracking the suicide rate for veterans. From 2002-2005, 141 veterans who left the service after Sept. 11, 2001, took their own lives. In 2006, there were 113 suicides among Iraq and Afghanistan-era veterans. The suicide rate for male veterans, ages 18-29, in 2006 was about 46 suicides per 100,000, compared with about 20 suicides per 100,000 for their nonveteran peers, and these are just the cases being tracked by the VA. For veterans of all generations, data on suicide is equally troubling. While veterans make up only 13% of the U.S. population, they account for 20% of the suicides. As evidenced by these statistics, suicide is likely to be a long term problem for veterans of Iraq and Afghanistan.
Resources
It is important to realize that even though it may feel as though there is no hope, recovery and healing are possible. If you are having thoughts of ending your life or if you know someone who is having these thoughts, it is important to seek help as soon as possible. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Mental Health Information Center has put together a downloadable information sheet (http://download.ncadi.samhsa.gov/ken/pdf/FastFacts/FastFact3.pdf) on suicide that provides valuable resources on suicide, as well as who you can call if you are in crisis.
SAMHSA has provided national leadership for suicide prevention and is consistent with the national strategy for suicide prevention. There are three major prevention initiatives within the Center for Mental Health Services.
The first of these initiatives is the Garrett Lee Smith Youth Suicide Prevention Grant Program. As of Oct. 1, 2008, more than 50 states, tribes, and tribal organizations, as well as 50 colleges and universities, have been receiving funding for youth suicide prevention programs through the Garrett Lee Smith Act.
The second initiative is a Suicide Prevention Resource Center, which is a national technical assistance Center that advances the field by working with states, territories, tribes, and grantees, and by developing and disseminating suicide prevention resources.
National Suicide Prevention Lifeline
The third major initiative is the National Suicide Prevention Lifeline, the program that has been at the centerpiece of the SAMHSA partnership with the VA to establish the Veteran Suicide Prevention Hotline.
The lifeline is a network of 133 crisis centers across the United States that receives calls from national, toll-free suicide prevention hotlines, primarily 1-800-273-TALK. The network is administered through a grant from SAMHSA to link to Health Solutions, which is an affiliate of the Mental Health Association of New York City.
Calls to 1-800-273-TALK are automatically routed to the closest of the 133 crisis centers across the country. Those crisis centers are independently operated and independently funded. They all serve their local communities in 47 states and operate their own local suicide prevention hotline numbers. They have agreed to accept local, state, and regional calls from the National Suicide Prevention Lifeline, and receive a small stipend for doing so.
In three states that currently do not have a participating crisis center, the calls are answered by a crisis center in a neighboring State. All the calls are free and confidential, and are answered 24 hours a day, 7 days a week.
By utilizing a national network of crisis centers with a trained staff linked through a single national toll-free hotline prevention number, the capacity to effectively respond to all callers is maximized. Early in 2007, SAMHSA and the VA began exploring strategies for a potential collaboration. It became quickly apparent that using the National Suicide Prevention Lifeline as a front end for the suicide prevention hotline would offer numerous and important advantages. Callers in crisis would hear the following message: “If you are a U.S. military veteran, or you are calling about a veteran, please press one.”
For Professionals
The VA has a manual titled, “Safety Plan Treatment Manual to Reduce Suicide Risk: Veteran Version”. This manual describes a brief clinical intervention, safety planning, that can serve as a valuable adjunct to risk assessment and may be used with veterans who have made a suicide attempt, have suicide ideation, have psychiatric disorders that increase suicide risk, or who are otherwise determined to be at high risk for suicide. It is a therapeutic technique that provides patients with something more than just a referral at the completion of suicide risk assessment. By following a pre-determined set of coping strategies, social support activities, and help-seeking behaviors, veterans can determine and employ those strategies that are most effective.
Developing a Safety Plan
Developing a safety plan involves the recognition of the signs that immediately precede a suicidal crisis. These warning signs can include personal situations, thoughts, images, thinking styles, mood, or behavior. One of the most effective ways of averting a crisis is to address the problem before it emerges fully.
Examples:
Thoughts: “I am a failure.” “I don’t make a difference.” “I am worthless.” “I can’t cope with my problems.” “I can’t take it anymore.” “Things aren’t going to get better.”
Images: “Flashbacks.”
Thinking Processes: “Having racing thoughts.”
Mood: “Feeling irritable.” “Feeling down.” “Worrying a lot.”
Behavior: “Spending a lot time by myself.” “Avoiding other people.” “Not doing activities that I usually do.” or “Using drugs.”
After the signs that are associated with a suicidal crisis have been identified, the veteran should list some activities that they could employ without needing to contact other people. Such activities function as a way to help the veteran take his or her mind off his or her problems and prevent suicide ideation from escalating. Without ever leaving the veteran alone, contact the Mental Health Department or call the Suicide Hotline for them. By calling for them, the veteran has a sense of security and motivation to get the assistance they need.
Contacting Resources
American Association of Suicidology: http://www.suicidology.org or 1-202-237-2280
American Foundation for Suicide Prevention: http://www.afsp.org
Community Awareness and Support Center (support for people affected by murder-suicide): http://www.caascenter.org
Jason Foundation: http://www.jasonfoundation.com
National Suicide Prevention Hotline: 1-800-SUICIDE (784-2433)
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
National Youth Violence Prevention Resource Center: 1-866-SAFEYOUTH (1-866-723-3968) or http://www.safeyouth.org
Substance Abuse and Mental Health Services Administration (SAMHSA): http://www.samhsa.gov
Suicide Prevention Advocacy Network (Span): http://www.spanusa.org
Yellow Ribbon Suicide Prevention Program: http://www.yellowribbon.org/
National Strategy for Suicide Prevention: http://www.mentalhealth.org/suicideprevention/
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