Suicide prevention is frequently a matter of strategies.
In 1964, Academic Dean of the School of Medicine at Tufts University Louis Lasagna penned a modern translation of the Hippocratic Oath: “I swear to fulfill, to the best of my ability and judgment, this covenant: I will remember that there is an art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemists drug.
“I will advance the hard-won scientific gains of those in whose steps I walk, and gladly share such knowledge… and I will remember that I do not treat a fever or a cancerous growth but a human being whose illness may affect their family and economic stability.”
While the “surgeon’s knife” and “the chemist’s drug” remain essential tools, the reminder is that our mission is, first and foremost, a personal one – caring for the individual and providing resources necessary to facilitate their success. Often, the most necessary and effective instruments of healing are our relationships, and central to our calling is the development and spread of evidence-based best practices to benefit all.
Suicide is a national public health issue that impacts people from all walks of life, claiming the lives of nearly 45,000 people in the United States in 2019 and affecting countless more. The drivers of risk are complex, individualized and varied. To light the way forward, we must meet the diverse needs of Veterans with resources that have been shown to not only effectively reduce risk but also promote wellness and balance to protect against future risk.
More than three dozen projects to prevent suicide
The Suicide Prevention Program in the Office of Mental Health and Suicide Prevention (OMHSP) is leading the way forward with more than three dozen FY22 demonstration projects aligned to the goals of the White House Plan for Reducing Military and Veteran Suicide and the National Strategy for Preventing Veteran Suicide.
These efforts coordinate suicide prevention’s operational, clinical and research directions across program offices, Veterans Integrated Service Networks (VISNs), community partnerships and VA healthcare systems across the nation.
Demonstration projects allow the opportunity to quickly fund and assess innovations in suicide prevention while OMHSP continues its strategic operationalization of the 2018 National Strategy through a public health approach combining community and clinically based interventions in Suicide Prevention 2.0 and the Now Initiative.
Just one example of a prior demonstration project is VA’s collaboration with Forge VFR (Veteran and First responder) to better understand and explore potential approaches to substance use-related residential care for Veterans within a high risk and high need domain of service. Initial exploratory and descriptive data offered insightful feedback to inform prevention and intervention possibilities.
FY22 national strategic plan-aligned project priorities include the following:
- To promote suicide prevention as a core component of health care services and increase access to care across the spectrum, we are piloting integrated mental health services in pain and oncology clinics, and expanding mental health service supports in primary care and staffing among suicide prevention coordinators.
- To promote the dissemination of effective clinical practices, we are expanding the dissemination of evidence-based treatments for insomnia, short-term/intensive PTSD, anxiety, depression and substance use disorder treatments.
- To tailor solutions to at-risk subpopulations, we are implementing programs to reach Native, geriatric, LGBTQ+, rural Asian American, Pacific Islander Veterans and homeless Veterans.
Advancing emergency department safety planning
- To enhance crisis care and facilitate care transitions, we are advancing suicide prevention by bettering emergency department safety planning and post-discharge follow-up, RISK ID, and REACH VET to increase engagement for those at high-risk.
- To provide training to VHA and community staff on the prevention of suicide and related behaviors, we are developing new resources for suicide postvention, risk management consultation, early intervention/prevention.
- To engage and leverage partnerships within and outside the government, we are working across federal and state agencies, participating in governor’s challenges, and conducting community firearm safety trainings.
Piloting programs focused on early interventions
- To address upstream risk and protective factors, we are piloting programs focused on early interventions for Veterans at-risk of unemployment and establishing a National Center for Veterans Financial Empowerment to foster success amid economic stressors behind risk.
- To enhance engagement and broaden support networks, we are advancing peer-to-peer, coaching into care, and caring letter outreach programs.
- To promote healing and implement strategies to help prevent further suicides, we are providing consultation and postvention supports, suicide risk identification training, and acceptance and commitment training for health care providers.
- To promote research and expand the evidence base for effective treatment, we are supporting research in the national evaluation centers, states and Centers of Excellence.
Like the oath above, and “To the best of our ability and judgment,” we are advancing these efforts to save lives, offer hope, and light ways to combat the thoughts of suicide that threaten to overcome. We are grateful for the honor that serving this mission provides and the opportunity to facilitate the successes of Veterans everywhere.
National Suicide Prevention strategic directions, priority goals and cross-cutting principles are available at: Reducing Military and Veteran Suicide: Advancing a Comprehensive, Cross-Sector, Evidence-Informed Public Health Strategy and The National Strategy for Preventing Veteran Suicide.
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The VA staff is only interested in helping their paychecks and other VA staff members. I have been seeing help for suicide thoughts and the staff at my local VA do everything they can to protect inept staff. They have posters all over the hospital about protecting the rights of the Veterans, but the Veterans don’t have any rights. And what the heck is with the math test to write a comment
I have had VA patient advocates and VISN 23 Patient Safety Officer ignore emails I sent showing the injuries sustained due to my permanent disability after negligent VA healthcare. The emails were ignored. I have stated I am suffering and struggling and if they were not going to do anything to help me, the least they could do is refer me to someone that would. The emails were ignored. Although the VISN 23 Patient Safety Officer did state while on the phone with me that she didn’t mean to be rude but she was on her way to a bible study. I have no doubt she is studying hard about how to ignore pain and suffering of the veterans she is charged to protect. The bottom line is the VA does not care about veteran suicide, they care about their positions and their paychecks and that is it.
When veterans are placed on invisible “waitlists” for therapists and have received no mental health intervention for more than 18 months following a suicide attempt, it makes me wonder if any interventions are available or even in place. I’ve said this before and I’ll say it again: it looks like great PR in an article on the internet for the masses to read that you’re doing so much to atone for veteran suicide and prevent further loss. But the reality is, you aren’t. For every 100% service connected veteran who takes their own life, the VA is off the hook for their healthcare and a lifetime of pension and benefits checks. I’ve buried six of my brothers in your BS, and I’m sure it won’t stop there.
A lot of trying to help. One thing is missing. Independent investigation of each veteran suicide to determine the root cause of the Veteran’s choice to commit suicide. Treat each suicide like a high-profile murder. Find out why. It would be expensive and might lead to many ‘service connected’ decisions but how can you stop something you don’t know why it is happening.
This is the best remark on this page and a possible answer to this overwhelming problem plaguing our society with in and out of military service.
Though I do not feel this article is all that informative, I do agree with Mr Bass about some of the major components he expresses. I would like to see more statistics regarding the numbers of suicides among men versus women. I feel there is an inherent difference between the genders as to what a major component is. At my VA hospital, a lot of the women veterans I have talked to feel that it is still very much a “good old boys network” and women still aren’t being seen as real veterans. Feeling dismissed in this manner, I think, would tend to lead women to not be forthcoming to any of their providers about feeling suicidal.
Story and case in point. A woman veteran I know was seeing a MH counselor and feeling suicidal. During an appointment with this provider, she started to just take some heart medicine she had been prescribed. She was actually making a suicide attempt in her provider’s office. The provider called station police and had her taken to the ED for evaluation and possible a stomach pump. She was discharged from the hospital with a promise not to do that again and the rest of the heart medication was returned to her. She should have been admitted to the psych unit. At this point I am not sure and confident that the VA would treat any veteran but especially women veterans any differently now. The VA talks a good game, looks good on paper, but… This same VA hospital currently gives veterans a hard time about coming into any of the buildings “due to covid numbers”. Meanwhile, staff members are allowed to use facilities that are there for veterans, like the gym and pool while veterans are denied any use of these. Maybe someday when the VA gets it’s act together again and really, truly realizes it is there to take care of the veterans who bravely went out to protect this country first and foremost, veterans will actually be taken care of appropriately, including preventing them from committing suicide. If you feel neglected, not cared about, told you can’t enter the only place you have for your health and well being, it’s no wonder veterans commit suicide. The VA needs to do more than just talk the talk and farm veterans out to civilian providers. It needs to fulfill its mission “to care for him who has served and his family” according to Lincoln whom the VA is always quoting and says is their mission. Prove it!
Critical information for challenging times. One of the major components of suicidal ideation is loneliness and isolation issues. This needs to be addressed as a national issue and a broader global problem. Veterans are at higher risk due to trauma (PTSD) and feeling fragmented and disconnected. Awareness is critical and this is a major step in the right direction. Thanks for posting.