Preventing Suicide among Veterans
By Rebecca A. Clay
A workshop on suicide prevention and mental health promotion
at "The Road Home: The National Behavioral Health
Conference on Returning Veterans and Their Families"
presented some of the military's current strategies for
helping veterans cope.
Richard T. McKeon, Ph.D., M.P.H., Special Expert in
the Prevention Initiatives and Priority Programs Development
Branch at SAMHSA's Center for Mental Health Services
(CMHS), moderated the panel of experts.
A New Attitude
Col. Robert R. Ireland, M.D., D.Min. |
Lawrence E. Adler, M.D. |
The military's attitude toward suicide prevention has
changed dramatically, said Col. Robert R. Ireland, M.D.,
D.Min., Program Director for Mental Health Policy in
the Office of the Assistant Secretary for Health at the
U.S. Department of Defense.
In the old days, he said, leaders often wouldn't tolerate
any sign of weakness among the troops. In contrast, today's
leaders make it widely known that they want people to
take care of themselves. "If you're a lousy shot,
you go out on the range and practice," said Col.
Ireland. "If you're having mental health problems,
you work on that."
Each of the Nation's armed services—Army, Navy,
Marines, and Air Force—has its own suicide prevention
program, but they share common elements. "Suicide
prevention is more than just getting people together
and saying, ‘Don't kill yourselves,' " said
Col. Ireland.
His own approach emphasizes informality, part of his
effort to make mental health providers more approachable.
He writes scripts of hard-times scenarios and asks volunteers
to act out the over-the-top tales of failing marriages,
troubled kids, and financial woes. By customizing the
scripts for each locale, he helps units visualize what
trouble might look like and how they should respond.
Educating leaders is also key. The Air Force, for instance,
has a "Leader's Guide for Managing Personnel in
Distress," which lists common sources of trouble,
danger signs, and supportive actions leaders should take.
"It's cookbook mental health," said Col. Ireland.
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At the Clinical Level
Lawrence E. Adler, M.D., Director of the Veterans Integrated
Service Network 19 Mental Illness Research, Education,
and Clinical Center at the U.S. Department of Veterans
Affairs, then shifted the discussion to the clinical
level.
About 90 percent of people who die from suicide have
at least one of the serious mental illnesses in the Diagnostic
and Statistical Manual of Mental Disorders, Fourth Edition,
said Dr. Adler, noting that such disorders often have
genetic components. Because psychiatric illnesses significantly
increase the chance of suicide, Dr. Adler emphasized,
early identification and intervention are critical.
Other conditions, such as AIDS, brain and spinal cord
injuries, and sexual trauma, also increase the risk of
suicide. So do alcohol and substance abuse. And so does
access to weapons. Signs of potential trouble include
impulsivity, aggression, accidents, and withdrawal. Clinicians
even need to be aware of geographic risk factors, said
Dr. Adler.
He pointed out that rural areas and western states have
higher suicide rates.
Clinicians should also understand that behaviors that
seem illogical may make sense to patients, said Dr. Adler.
He described one patient who had a loaded pistol on the
seat of his car and a disconcerting habit of avoiding
traffic jams by veering into the wrong lane.
"What do I tell him—that we can get him on
medication and relaxed?" Dr. Adler asked. The paradox
is that in wartime such behavior makes perfect sense
for survival. "If this patient stops acting like
that, he'll be in grave danger once he goes back."
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Resources
SAMHSA's National Suicide Prevention Lifeline
www.suicidepreventionlifeline.org
(800) 273-8255
TTY: (800) 799-4889
Air Force Suicide Prevention Program
http://afspp.afms.mil
Army Center for Health Promotion and Preventive
Medicine
http://chppm-www.apgea.army.mil/dhpw/Readiness/
suicide.aspx
(410) 671-4656
Navy Environmental Health Center
www-nehc.med.navy.mil/hp/suicide
(757) 953-0959
Marine Corps Suicide Prevention Program
www.usmc-mccs.org/suicideprevention/ml/index.cfm
Centers for Disease Control and Prevention
www.cdc.gov/ncipc/factsheets/suicide-overview.htm
(800) 232-4636
TTY: (888) 232-6348
National Institute of Mental Health
www.nimh.nih.gov/suicideprevention
(866) 615-6464
TTY: (866) 415-8051
National Center for PTSD
www.ncptsd.va.gov/facts/problems/fs_suicide.html
(802) 296-6300
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Article
See AlsoThe Road Home: National Conference on Returning Veterans & Their Families
« See Part 1: Community Services Provide Safety Net
for Returning Veterans
« See Part 2: Community Services Provide Safety Net
for Returning Veterans
« Addressing Special Needs of Veterans
Recovery Month Includes Veterans »
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