Suicide is the 10th leading cause of death in America and the 8th leading cause of death in Minnesota.
The most recent statistics indicate that Veterans make up more than 14% of all suicides, despite accounting for only 8% of the population. On average, 20 Veterans die by suicide every day in the United States.
Suicide is not a mental health problem, it is a public health problem.
The odds are that one day you will know someone who is considering suicide. Do you know what to do?
I recently attended a presentation by one of the newly appointed Education and Outreach Specialists for Suicide Prevention from the Minneapolis VA. The information she provided was geared towards Veterans, but applicable to everyone.
What to do:
Validate. Let the Veteran tell you their story. Don’t pretend to know what they went through, because you can’t. Everyone experiences and is affected by situations differently.
Know the warning signs. For Veterans, suicide is more common in people who had multiple or lengthy deployments, are familiar with weapons, and/or were assaulted while serving (males and females).
Other warning signs to look out for in Veterans and civilians alike (some obvious, others not so obvious):
- seems sad all the time
- increased alcohol or drug use
- having difficulty sleeping or sleeping more than usual
- seems anxious or agitated
- mood changes (including sudden signs of relief or improvement)
- feelings of excessive guilt/shame or “moral injury”
- expresses feelings of failure
- withdraws from family and friends
- loses interest in hobbies, work, or school
- giving away prized possessions
- feelings of being trapped
- talks about having no sense of purpose and all it seems they see is the crisis
- use of concerning hashtags, negative emoticons, or following feeds or posts that promote negative behaviors
- visiting or calling people to say goodbye.
In general, trust your instincts.
If you are worried about someone, ask questions. Yes. Even ask that question. Be direct as possible, “Are you thinking of killing yourself?” Or, “Are you thinking of suicide?”
Although it may seem better to ask them in less direct ways, such as “Are you thinking of harming yourself?” it is important to remember that to the person considering suicide, their mental and emotional state may be such that they honestly consider suicide to be anything but “harm.”
Encourage treatment. Treatment should be whatever works, not necessarily what you think the person needs. Expedite getting help.
Means restriction. Firearms are involved in about half of all suicide deaths.No, the VA will not take your guns away forever. However, they may ask what to temporarily do with someone’s guns to keep them safe. Is there a friend or loved one who could hold onto them? Are you willing to lock the guns up or remove all ammunition from your home?
Firearms are not the only way individuals die by suicide, but it guns are more lethal. Less than one percent of nonfatal suicide attempts are with a gun.
By all means, if concerned about other potential suicide methods restrict those! For example, if the person you are concerned about has access to a lot of prescription medications, is there a safer place to keep those medications? Are there any medications that have been discontinued and could be disposed of? Would the person be willing to allow you or another loved one to administer their medications?
The belief that if someone is suicidal they will find a way to kill themselves no matter what is not always true. Besides, why not do everything in your power to make it more difficult or a slower process. According to the Violence Policy Center, 48% of suicide attempt patients reported less than 20 minutes elapsed between the first thought of suicide and the actual attempt.
Means restriction may provide an individual who is suicidal with just enough time to reconsider or ask for help.
Promote Veteran employment. Unemployment increases the risk of suicide. There are several “Veteran friendly” employers— Cargill, Home Depot and Starbucks are just a few.
Remember that women serve. Do not assume that the Veteran is the male.
According to the U.S. Department of Veterans Affairs, “Women Veterans are more likely to die by suicide than non-Veteran women: In 2016, the suicide rate of women Veterans was nearly twice the suicide rate of non- Veteran women, after accounting for age differences.”
Two possible theories: women Veterans have more access to lethal means and gender bias. Women Veterans are often overlooked by their own communities, including those specifically created to support Veterans.
Use technology for good. There are several apps, websites, and other resources that may prove beneficial. This is especially helpful for individuals who live in rural areas or otherwise have difficulty accessing treatments.
For Veterans:
Check out the VA App Store. Some of the apps to try: T2 MoodTracker, Mindfulness Coach, My3, Mood Coach, CBT-i Coach, ACT Coach, Breathe2Relax, Parenting2Go, CEMM Virtual Medical Center, MOVE! Coach, and 311VET.
Other useful technology:
Clinical Video Telehealth (CVT) to Home: The program allows a VA provider at one of VA Butler’s facilities to talk to a Veteran right from their home. Veterans need to have internet access and a web camera to participate. www.butler.va.gov/services/Telehealth.asp
To learn more, please call VA Butler’s Telehealth Coordinator at 800.362.8262, ext. 6528
www.MNme.us The Minnesota Military & Veterans Exchange (MNme) is a coalition and community with one simple goal: to create a rallying point for all things related to creating healthier military and veteran communities.
Save this number to your phone:
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)— Press 1 for Military and Veterans
The National Suicide Prevention Lifeline is a United States-based suicide prevention network of 161 crisis centers that provides a 24/7, toll-free hotline available to anyone in suicidal crisis or emotional distress.
Another number to have handy:
Coaching Into Care: 1-888-823-7458
Coaching Into Care is a national telephone service of the VA which aims to educate, support, and empower family members and friends who are seeking care or services for a Veteran.
Use a “We” approach. We can put a plan together. We can figure this out. Let them know they are not alone and that you care.
What NOT to do:
If you think someone may be thinking about suicide, never, ever, ever utter these words:
“You aren’t thinking of doing something stupid?” Or, “Now, don’t do anything crazy.”
For one thing, to them it isn’t stupid or crazy. For another, they need support and not more judgment.
Other phrases to avoid:
“They committed suicide.” A better way to say this is, “They died by suicide” or “They died by a self-inflicted injury.”
Why? Because the word committed makes it sound as if suicide is a criminal act. Suicide is not a crime and nothing good ever follows the word “committed” (e.g. committed adultery, committed murder).
Another poor choice of words is “successful suicide attempt” or “unsuccessful suicide attempt.” Suicide should not be described in terms that imply achievement.
Please don’t joke about how you’d rather die than..it’s not funny. And encourage young people to be considerate and lose the negative talk. Stop them if they say things like, “that girl should just kill herself.”
And if you hear someone else say they should just kill themself, be concerned. Always inquire, even if they may be joking.
To start the conversation, try something more along the lines of:
“Sometimes when people are [insert stressor] they have negative thoughts. Are you having negative thoughts of suicide or dying?”
Then check in and follow up with them:
“How are your thoughts today?” “How is your mental wellness?”
Final thoughts:
Remember the acronym SAVE
S= signs of suicidal thinking recognized
A= ask the most important question of all
V= validate the Veteran’s experience, and
E= encourage treatment and expedite getting help.
To learn more (for free!): https://psycharmor.org/courses/s-a-v-e/
It is normal to have your own strong emotions when someone you care about confides they are feeling suicidal. Staying calm is key. You may be the only one getting this important information.