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Suicide Prevention Training 2017: Supporting Veterans in Crisis

Learn how to respond to statements of hopelessness and suicide risk from Veterans. Discover the warning signs and steps to take to provide care and connect them to resources.

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Suicide Prevention Training 2017: Supporting Veterans in Crisis

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  1. IDVA CVSO Annual VA Suicide Prevention Training 2017

  2. What if a Veteran you’re serving says…. “I wish I could just go to sleep and not wake up.”

  3. What if a Veteran you’re serving says…. “If I weren’t here, my family would be better off.”

  4. What if a Veteran you’re serving says…. “If my claim doesn’t go through, I’m done!”

  5. What if a Veteran you’re serving says…. “If I can’t get this pain to go away, I might as well just shoot myself”

  6. What tools are in your tool belt? Do you ask questions to probe into a Veterans emotional pain? Do you feel equipped to respond to these kind of statements, and screen for suicide? For someone in an emotional crisis, do you feel confident on how to do a “warm handoff” to a clinical provider and connect that Veteran to Suicide Prevention support and resources?

  7. Suicide in the United States • 41,425 annual deaths by suicide among U.S. population • Nationally, suicide is the 10th leading cause of death • Suicide is the 11th leading cause of death overall in Indiana • Nationally, suicide is the 3rd leading cause of death among 15-24 yr old males • Suicide is the 2nd leading cause of death among 15-24 yr old male Hoosiers • 16,121 U.S. deaths from homicide per year • Less than 1/2 the number of annual suicides • Homicide is the 16th leading cause of death in the U.S. (Centers for Disease Control and Prevention, 2013 and the Indiana Mortality Report ,2014)

  8. Veteran Suicide Statistics, 2014 • ~20 Veterans died from suicide each day = 18% of all U.S. adult suicides (decreased from 22% in 2010) • 6 of the 20 were users of VA services • ~66% involved a firearm • ~65% were aged 50 years or older • Risk of suicide was 21% higher among Veterans compared to U.S civilian adults • 18% higher among male Veterans • 2.4 times higher among females Veterans

  9. ~6 VHA users per day (30%)

  10. Suicide Data, 2001-2014 • Since 2001, suicide rate increased by 23% for U.S. civilian adults and 32.2% for Veterans • Increased by 0.3% for U.S. civilian males • Increased by 30.5% for Veteran males • Increased 39.7% for U.S. civilian females • Increased 85.2% for Veteran females

  11. Operation S.A.V.E. Operation S.A.V.E. will help you act with care and compassion if you encounter a Veteran who is in suicidal crisis. The acronym “S.A.V.E.” helps one remember the important steps involved in suicide prevention: • Signs of suicidal thinking should be recognized • Ask the most important question of all • Validate the Veteran’s experience • Encourage treatment and Expedite getting help

  12. Importance of identifying warning signs Many Veterans may not show any signs of intent to harm themselves before doing so There are behaviors which may be signs that a Veteran needs help Veterans in crisis may show behaviors that indicate a risk of harming themselves

  13. Signs of suicidal thinking • 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

  14. Signs of suicidal thinking • The presence of any of the following signs requires immediate attention: • Thinking about hurting or killing themselves • Looking for ways to die • Talking about death, dying or suicide • Self-destructive or risk-taking behavior, especially when it involves alcohol, drugs or weapons

  15. Typical myths and realities Myth or reality: Asking about suicide may lead to someone taking his or her life.

  16. Typical myths and realities Reality: Asking about suicide does not create suicidal thoughts. The act of asking the question simply gives the veteran permission to talk about his or her thoughts or feelings.

  17. Asking the question • Are you thinking about killing yourself? • Have you had thoughts about taking your own life? • Are you thinking of suicide? DON’T ask the question as though you are looking for a “no” answer • “You aren’t thinking of killing yourself are you?”

  18. Also consider asking…. • *Have you wished you were dead or wished you could go to sleep and not wake up? • *Have you actually had any thoughts of killing yourself? • *Have you ever done anything, started to do anything, or prepared to do anything to end your life? *questions taken from the Columbia-Suicide Severity Rating Scale (C-SSRS) Screener

  19. “If my claim doesn’t go through I’m done!” • Example response: • So what do you mean by done? • I mean, I’m done….I’ve got nothing to live for • Have you wished you were dead or wished you could go to sleep and not wake up? • All the time • Have you actually had any thoughts of killing yourself? • Well, no, I’m not going to do anything like that.

  20. “If I can’t get this pain to go away, I might as well just shoot myself” • Example response: • Have you actually had any thoughts of killing yourself? • Yes • Have you been thinking about how you might kill yourself? • I just told you, I’ve thought about just shooting myself • Have you started to work out the details….do you intend to carry out this plan? • I don’t know, I just don’t want to be in pain anymore • Have you ever done anything, started to do anything, or prepared to do anything to end your life? • I have a gun at home....and I loaded it the other day thinking I would just get it over with, but I stopped and put it away when my wife came home from the store.

  21. When talking to a Veteran about suicide • Remain calm • Listen more than you speak • Maintain eye contact • Act with confidence • Do not argue • Use open body language • Limit questions-let the Veteran do the talking • Use supportive, encouraging comments • Be honest-there are no quick solutions but help is available

  22. Validate the Veteran’s experience Talk openly about suicide. Be willing to listen and allow the Veteran to express his or her feelings. Recognize that the situation is serious Do not pass judgment Reassure that help is available

  23. Encourage treatment and Expediting getting help Always Remember: • Use the Veterans Crisis Line – call them for guidance • Same day, walk-in Mental Health access is available at the VA • Monday-Friday during regular business hours – non-emergent walk-in • 24/7 Mental Health professionals in the VA Emergency Room • If you ever have to call 911 when a Veteran is in a crisis, ALSO call the Veterans Crisis Line to inform them  they can notify the VA Suicide Prevention Coordinator who can also reach out to the Veteran • Know your local VA Suicide Prevention Coordinator – use as a VA Mental Health point of contact

  24. Reporting Your Knowledge of Veteran Suicidal Behavior • Please communicate to your local VA Suicide Prevention Coordinator (SPC)…. • If you learn about a Veteran suicide (or suspect a death could be suicide). • If you learn about a non-fatal Veteran suicide attempt. • If a Veteran goes to a Non-VA hospital due to suicidal thoughts or behavior.

  25. Indy VA response, within 24 business day hours Indy VA same-day access, if clinically indicated Immediate 24/7/365 crisis response at Canandaigua or Atlanta

  26. Veteran Suicide Data: VHA users vs. Non-VHA users • Since 2001, the rate of suicide among Veterans who use VA services increased by 8.8%  for those who did not use VA the rate of suicide increased by 38.6% • The rate among male Veterans who use VA services increased 11%  for those males who did not use VA the rate increased by 35% • The rate among female Veterans who use VA services increased 4.6%  for those females who did not use VA the rate increased by 98%

  27. FYTD Cumulative Average Daily Calls Answered by the VCL: 1,322.8 FYTD Percent Calls Answered by the VCL at Canandaigua VAMC: 70% FYTD Percent Calls Answered by the Back-Up Center Network: 30%

  28. Ft. Wayne & Marion, Indiana Northern Indiana Healthcare System –Ft. Wayne & Marion VA campuses Suicide Prevention Coordinator 800-360-8387 x75075 Chicago, Illinois Jesse Brown VA Suicide Prevention Coordinator 312-569-8009 Danville, Illinois Danville VA Suicide Prevention Coordinator 217-554-3163 Dayton, Ohio Dayton VA Suicide Prevention Coordinator 937-268-6511 x1849 Indianapolis, Indiana Indianapolis VA Suicide Prevention Coordinator 317-988-3213 Cincinnati, Ohio Cincinnati VA Suicide Prevention Coordinator 513-861-3100 x6900 Marion, Illinois Marion (IL) VA Suicide Prevention Coordinator 618-997-5311 x54211 Louisville, Kentucky Louisville VA Suicide Prevention Coordinator 502-287-4011

  29. Handout: Indiana Veteran and Military Suicide Prevention and Mental Health Access: Quick Reference

  30. For questions, or for a supply of Suicide Prevention Crisis Materials to distribute in your community Contact: Travis Field, MA, MSW, LCSW Lead Suicide Prevention Coordinator Office: 317-988-3213 Ashley Maynard, MSW, LCSW Suicide Prevention Coordinator Office: 317-988-4327 Brad Claypool Suicide Prevention MSA Available 12-4PM Office: 317-988-3451

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