Suicide Prevention Basics

Crisis feels different for everybody and can stem from a wide range of situations. Some Veterans are coping with aging, stress, or lingering effects stemming from their military service, which were never addressed. Many recent Veterans have difficulty with their relationships or the transition back to civilian life.

Times of crisis can be related to chronic pain, anxiety, depression, sleeplessness, anger, or even disturbing memories of combat service.

Watch encouraging messages of support about reaching out for help.

VA Resources
Many VA resources exist to support Veterans, including suicide prevention staff, crisis call and chat line, and to support providers to assess suicide risk and safety planning. These resources are reviewed in this mini-clinic.

VA Suicide Prevention Coordinators
VA Suicide Prevention Coordinators are present at each VA to connect with and support Veterans and providers in times of crisis. Use the VA resource locator to find the contact information for your local VA suicide prevention coordinator. You can also call your local VA Medical Center and ask the operator to connect you to the suicide prevention coordinator.

Veterans, family members, or care providers can initiate a free and confidential conversation with an experienced and caring VA responder by calling the Veterans Crisis Line. If you are concerned about the safety and well-being of a Veteran call 1-800-273-8255 and press 1. Use the Veterans Chat to get online support anonymously. A text message can also be sent to 838255 to connect to a VA responder. These resources can be used even if a Veteran is not registered with VA or enrolled in VA health care.

If you have any questions, please refer to the FAQs page for more information about the Crisis and Chat line.

Suicide Risk Assessment

People experience emotional and mental health crises in response to a wide range of situations—from difficulties in their personal relationships to the loss of a job. For Veterans, these crises can be heightened by their experiences in military service. It’s important to recognize the signs that someone is in crisis. Below is a list of warning signs and resources to assist you in recognizing warning signs of suicide risk.

If these signs are present, the Veteran can contact the Veterans Crisis Line at 1-800-273-8255 and Press 1 or chat online at http://www.VeteransCrisisLine.net/chat. It can also be helpful for the Veteran to take a self-check quiz at http://www.vetselfcheck.org/.

Sometimes, a crisis may involve thoughts of suicide. Learn to recognize these warning signs: 

• Hopelessness, feeling like there’s no way out
• Anxiety, agitation, sleeplessness, or mood swings
• Feeling like there is no reason to live
• Rage or anger
• Engaging in risky activities without thinking
• Increasing alcohol or drug abuse
• Withdrawing from family and friends

The presence of the following signs requires immediate attention: 

• Thinking about hurting or killing yourself
• Looking for ways to kill yourself
• Talking about death, dying or suicide
• Self-destructive behavior such as drug abuse, weapons, etc.

Watch a video of a Veteran discussing his experience of some of these warning signs.

For more information on assessing suicidality, please reference the materials in the drop down menu.

Safety Planning

A safety plan is a written list of coping strategies and sources of support that clients can use during or preceding suicidal crises.

Safety planning:

• Is a therapeutic technique that provides clients with something more than just a referral following a suicide risk assessment
  
  
• Provides the client with an agreed upon list of potential coping strategies and a list of individuals or agencies that veterans can contact when needed
  
  

Veterans can draw on the safety plan to determine and employ those strategies that are most effective.

Safety Plan Treatment Manual
This manual (MS Word) was developed for use by VA clinicians and staff. It 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 details how clinicians and clients may collaboratively develop and use safety plans as an intervention strategy to lower the risk of suicidal behavior. This approach is consistent with the Recovery Model, which views Veterans as collaborators in their treatment and fosters empowerment, hope, and individual potential.

Safety Plan Pocket Card 
The pocket card, availble in Color and Black & White (PDFs), describes safety planning and is intended for reference purposes.

To receive the Safety Plan Pocket Card and other suicide prevention materials in printed form, contact your local VA Suicide Prevention Coordinator using the online resource locator at http://www.veteranscrisisline.net/resourcelocator.

Educational Materials for Clients

Veterans Crisis Line Print Materials: You can download Veterans Crisis Line materials, including public fact sheets, and print them from your own computer. Multiple versions of full-color and black and white posters are available for download in both 8.5’’ x 11’’ and 11’’ x 17’’ formats. You can also download and insert your own contact information or event details in a Veterans Crisis Line flyer.

How to Recognize When to Ask for Help: This information sheet contains information on suicide prevention such as, understanding the warning signs, myths and realities, and Veteran specific risks.

VA ACE Card (PDF) and VA ACE Brochure (PDF): The VA ACE Card is a pocket guide, supported by the VA ACE Brochure which provides more in depth information. The purpose of ACE is to help Veterans, their family members and friends learn that they can take the necessary steps to get help. The acronym ACE (Ask, Care, Escort) summarizes the steps needed to take an active and valuable role in suicide prevention.

Suicide Attempt Survivor Family Resource Guide (PDF): This guide is designed to provide Veterans and their families with resources that can serve as sources of information and support. The guide contains information on self-care, care for others (particularly children), and care for the suicide attempt survivor.
The resource guide is now also available in Spanish: Informacion y Apoyo para los Sobrevivientes del Suicidio: Guía de Recursos del Departamento de Veteran Affairs para las familias que estén lidiando con el suicidio

How to Talk to a Child about a Suicide Attempt in Your Family: The following information sheets are intended to serves as guides for adults to use when talking with a 4-8, 9-13 or 14-18 year-old child about a suicide attempt in the family. They are not intended to replace the advice of a mental health professional. In fact, it may be best to use these guides along with professional support if you or your child is struggling with how to talk about this difficult topic. It is important to consider the child's level of development and ability to understand events when deciding how to talk with them about this issue.

• Talking to Your 4-8 Year Old
• Talking to Your 9-3 Year Old 
• Talking to Your 14-18 Year Old

Specialized Training

The Suicide Risk Management Training for Clinicians
The Suicide Rick Management Training for Clinicians (PDF) is a guide intended to provide information necessary to recognize and bring into treatment Veterans who are struggling with suicidal thought.

The goals of the training include:

• Understand the prevalence and scope of suicide in our society and among our veteran population
• Understand assessment of potentially suicidal veterans
• Recognize warning signs and make necessary referrals
• Become familiar with risks related to suicide in patients presenting with other medical and psychiatric concerns
• Learn about systemic and environment risks related to treating suicidal veterans
• Recognize the importance of what is termed “means restriction”
• Understand the basic concepts of formulating a safety plan

Operation S.A.V.E.
Operation S.A.V.E training will help you act with care and compassion if you encounter a person who is suicidal. The acronym summarizes the steps needed to take an active and valuable role in suicide prevention.

• Signs of suicidal thinking
• Ask questions
• Validate the person’s experience
• Encourage treatment and Expedite getting Help

Additional Resources

Cool Tool

Free Confidential Support: The VA Crisis Chat Line
Veterans, family members, or care providers can initiate a confidential chat. Caring, qualified VA professionals are standing by to provide free and confidential support. Use the Veterans Chat to get online support anonymously, 24 hours a day, 7 days a week, 365 days a year —even if you’re not registered with VA or enrolled in VA health care. Responders will work with you to help you get through any personal crisis, even if that crisis does not involve thoughts of suicide.

The VA Crisis Chat Line can be found at: http://www.veteranscrisisline.net/ChatTermsOfService.aspx.