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Center for Compassionate Care Innovation

Mental Health Awareness Month: Suicide Prevention through Engagement

Breaking Down Barriers to Treatment Options May Engage Veterans and the Community

The rate of suicide among Veterans is a concern and a top priority clinical priority for the Veterans Health Administration (VHA) that requires a focused, national approach to engage with all Veterans. There is a great need not only to address suicide among Veterans already getting care from VHA, but also to engage the broader Veteran population.

“There isn’t one way to deal with [suicide], or even one way to think about it. What we need to do is look at the groups of people at risk of suicide and develop different strategies for different groups,” said Dr. Harold Kudler, Acting Assistant Deputy Under Secretary for Health for Patient Care Services.

Some of the health factors that contribute to suicide risk include major depression, alcohol or drug use disorders, chronic illness, posttraumatic stress disorder (PTSD), and chronic pain—associated with long term use of opioids and other medications that can be habit-forming. Many Veterans are diagnosed with a combination of these health concerns.

VHA has studied these conditions for nearly 100 years and is the leading expert in the field, Dr. Kudler said. However, there remains a lot of work to be done to understand these conditions and how they relate to suicide risk. That creates a challenge for Veterans and their healthcare providers who must balance waiting for scientific research to validate new treatments with finding solutions to improve health and well-being now.

Engaging Veterans Through Care Expansion

One avenue along which VA engages Veterans experiencing these conditions is the Center for Compassionate Care Innovation (CCI). This Center is designed to collaborate with VA and non-VA hospitals and clinics to offer emerging therapies using small scale clinical demonstration projects as a response to Veterans’ requests for alternatives for difficult-to-treat health concerns including PTSD, traumatic brain injury, and chronic pain. Through these clinical demonstrations, the VHA provides care access and options for Veterans who want to explore emerging treatments for which research is ongoing in the wider scientific community, particularly after evidence-based treatments have not met desired therapeutic outcomes.

“CCI stands for partnering with Veterans,” Dr. Kudler said. “It’s breaking down barriers and helping form the kinds of alliances that cross old boundaries that [VHA] didn’t used to cross very easily. I think that’s truly valuable.”

Other VA resources include VHA Office of Mental Health and Suicide Prevention’s Be There campaign to combat Veteran suicide, which offers online education and a 24/7 hotline for Veterans, their loved ones, and community members who may be concerned about a Veteran. The online educational resources also may help community members who simply want to know more about Veterans and suicide.

Veterans share their stories of recovery to help others who are facing similar challenges in the Make the Connection outreach campaign developed by the Office of Mental Health and Suicide Prevention. These stories may help family members and friends better understand the experiences of Veterans, as well, and potentially assist loved ones to identify warning signs of a mental health crisis or even a possible suicide attempt.  In some cases, there is time to intervene between symptoms of a mental health crisis and an attempt. 

“People who commit suicide often practice a lot, even if it’s just through mental rehearsal,” said Dr. Jamie Davis, Health Systems Specialist at VHA CCI.

Engaging the Community

Engaging with the larger community about Veterans and their individual health concerns is imperative for suicide prevention initiatives, according to Dr. Kudler. Only 20 percent of health care providers outside of VHA ask patients if they are a Veteran, according to a recent study by the Rand Corporation of providers in New York State. According to the report, 2.3 percent of those providers were able to provide clinically competent care that can address the needs of Veterans and active duty Service Members.

One way to address the needs of Veterans, family members, and providers is through education and outreach. The Psych Armor Institute, a military non-profit organization, offers S.A.V.E training. This training is a free 25-minute online course designed for community members to understand Veteran suicide risk, warning signs, and meaningful ways to help. This training was developed by VHA’s Office of Mental Health and Suicide Prevention. To ensure the community is engaged, if everyone who works with Veterans completes the training and asks one other person to take the training, the result will be broader awareness of risks and intervention techniques. Through this education, a family member or co-worker may feel empowered to talk with a Veteran about the Veteran’s experience of service and the issues they may be facing since coming home, identify risk factors, and encourage the Veteran to seek help.

“There is a need for us to mobilize as a nation to do this job well,” Dr. Kudler said.

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Posted June 18, 2018