September 29, 2017
Find out what the VA and Congress are doing to fight this national crisis.
This week, the VA winds down its suicide prevention awareness month campaign and outreach efforts.
During September, the VA released findings of a detailed analysis of veteran suicide data from all 50 states, as well as Puerto Rico and the District of Columbia. The analysis was part of its earlier comprehensive examination of more than 55 million records, from 1979 to 2014, as the VA sought to develop and evaluate suicide prevention across the country.
“These findings are deeply concerning, which is why I made suicide prevention my top clinical priority,” said VA Secretary Dr. David Shulkin in a press release earlier this month.
“I am committed to reducing Veteran suicides through support and education.” Shulkin said. “We know that of the 20 suicides a day that we reported last year, 14 are not under VA care. This is a national public health issue that requires a concerted, national approach.”
Closing out the month, Congress held a hearing this week to consider several bills to address mental health services in the VA and veteran suicides, as well as a hearing on Wednesday, Sept. 27, where Shulkin offered testimony to the Senate Committee on Veterans’ Affairs regarding how he is addressing suicide prevention in his department.
“Suicide is a terrible, terrible loss of life – a preventable loss of life,” said committee chair Sen. Johnny Isakson (R-Ga.) in his opening remarks before the committee. “It is a disease, and it is preventable, and there are many things we can do to set the example, including promoting training through our staff and throughout government.”
As the largest integrated suicide prevention program in the country, the VA has over 1,000 mental health professionals, but more must be done to address the mental health needs of veterans accessing the system, six of whom die by suicide every day, as well as the larger number of veterans-the 14 committing suicide each day who aren’t accessing the system because there are not enough health care providers or because other barriers preventing them from getting the necessary care in or outside the system.
While Shulkin outlined a number of initiatives undertaken in recent months, including establishing a suicide prevention advisory group, developing a patient record flagging system to identify and monitor patients, and establishing a suicide prevention program at every facility, the secretary urged the committee’s support in helping him to get more mental health professionals into the VA system, more research dollars, and more public awareness across America, as suicide is everyone’s business.
“Our goal is to eliminate suicide,” said Shulkin. “As stated earlier, six Americans will die during the course of this hearing – I think about this every day – I think about how many veterans are dying every day because we aren’t effective at addressing this problem.”
He went on to emphasize data show VA health care treatment saves lives, but it can’t help those veterans not in its system. The VA intends to remain committed to eliminating veteran suicides through more aggressive efforts aimed at risk identification, effective treatments, research, and strategic partnerships.
Additionally, the House Committee on Veterans’ Affairs held a hearing the day prior to consider several bills aimed at preventing suicide and providing enhanced care for veterans suffering from mental health conditions. Some of these bills include:
The message in both hearings this week was clear: There is much more to be done to reverse the trend on veteran suicides, and MOAA will work with the secretary and members of Congress to make sure the VA has the tools and resources it needs to address this critical public health problem in order to eradicate veteran suicide.
MOAA members can help too. Learn more about the VA’s suicide prevention program and how you can Be There to Save a Life .
Female Vet Rate 250% Higher Than Non-Vet.
According to newly released statistics from the U.S. Department of Veteran Affairs (VA), a female veteran is 2.5 times more likely to commit suicide than a non-veteran American adult woman. This U.S. veteran suicide statistics report analyzed suicide data for all 50 states, looking at the cross-sections of age and gender as well as the most common suicide methods. Among the top findings of the report:
“Every Veteran suicide is a tragic outcome,” The VA said in one of the facts sheets of the report. “Regardless of the numbers, one Veteran suicide is too many. VA is leading national efforts to understand suicide risk factors, develop evidence-based intervention strategies, and provocatively identify and care for Veterans who are in crisis or at a risk for suicide.” Other key findings in the report:
With the shocking statistics of female veteran deaths by suicide, the VA has made efforts to cater to female veterans by developing the Women Veterans Call Center, a free resource to call or chat anonymously with online. The center receives on average 80 calls per day and makes 1,000 daily calls to women veterans. The call center is available Monday through Friday 8am-10pm ET and Saturdays 8am-6:30pm ET at 855-829-6636.
“We can all play 53 a role in preventing suicide and it doesn’t require a grand gesture of complicated task,” the VA said on its suicide prevention website. “Your actions can help someone going through a tough time to feel less alone.”
Source: The Daily Dot | Brianna Stone | September 19, 2017
PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.
It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger.
Not every traumatized person develops ongoing (chronic) or even short-term (acute) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.
A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.
To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.
It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children (less than 6 years of age), these symptoms can include:
Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge. For additional information, visit the Learn More section below. The National Institute of Mental Health (NIMH) offers free print materials in English and Spanish. These can be read online, downloaded, or delivered to you in the mail.
Anyone can develop PTSD at any age. This includes war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or many other serious events. According to the National Center for PTSD , about 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others.
Not everyone with PTSD has been through a dangerous event. Some people develop PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also lead to PTSD.
It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.
Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.
Some factors that increase risk for PTSD include:
Some resilience factors that may reduce the risk of PTSD include:
Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.
The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.
If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.
The most studied medications for treating PTSD include antidepressants, which may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside. Antidepressants and other medications may be prescribed along with psychotherapy. Other medications may be helpful for specific PTSD symptoms. For example, although it is not currently FDA approved, research has shown that Prazosin may be helpful with sleep problems, particularly nightmares, commonly experienced by people with PTSD.
Doctors and patients can work together to find the best medication or medication combination, as well as the right dose. Check the U.S. Food and Drug Administration website (http://www.fda.gov/ ) for the latest information on patient medication guides, warnings, or newly approved medications.
Psychotherapy (sometimes called “talk therapy”) involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.
Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.
Effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms, and skills to manage the symptoms. One helpful form of therapy is called cognitive behavioral therapy, or CBT. CBT can include:
There are other types of treatment that can help as well. People with PTSD should talk about all treatment options with a therapist. Treatment should equip individuals with the skills to manage their symptoms and help them participate in activities that they enjoyed before developing PTSD.
How Talk Therapies Help People Overcome PTSD
Talk therapies teach people helpful ways to react to the frightening events that trigger their PTSD symptoms. Based on this general goal, different types of therapy may:
It may be very hard to take that first step to help yourself. It is important to realize that although it may take some time, with treatment, you can get better. If you are unsure where to go for help, ask your family doctor. You can also check NIMH’s Help for Mental Illnesses page or search online for “mental health providers,” “social services,” “hotlines,” or “physicians” for phone numbers and addresses. An emergency room doctor can also provide temporary help and can tell you where and how to get further help.
To help yourself while in treatment:
Caring for yourself and others is especially important when large numbers of people are exposed to traumatic events (such as natural disasters, accidents, and violent acts). For more information, see the Learn More section, below.
In the last decade, progress in research on the mental and biological foundations of PTSD has lead scientists to focus on better understanding the underlying causes of why people experience a range of reactions to trauma.
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including PTSD. During clinical trials, treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Doctors at NIMH are dedicated to mental health research. The studies take place at the NIH Clinical Center in Bethesda, Maryland and require regular visits. After the initial phone interview, you will come to an appointment at the clinic and meet with one of our clinicians. Find NIH-funded studies currently recruiting participants with PTSD by using ClinicalTrials.gov (search: PTSD).
To search for a clinical trial near you, you can visit ClinicalTrials.gov . This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world. ClinicalTrials.gov gives you information about a trial’s purpose, who may participate, locations, and phone numbers to call for more details. This information should be used in conjunction with advice from health professionals.
You can download or order free copies of the following booklets and brochures in English or en Español:
Despite change in leadership and promises to address ongoing problems with its veteran suicide line, nearly 30 percent of calls to the Department of Veterans Affairs were redirected to outside emergency centers, according to an inspector general report released Monday.
“We found that [Veterans Crisis Line] staff did not respond adequately to a veteran’s urgent needs during multiple calls to the VCL and its backup call centers,” the report said.
When the VCL program was started in 2007, VA management initially estimated that approximately 10 percent of calls would be rolled over to a backup center.
In fact, call rollover to backup centers increased between April and November 2016, peaking at more than 108,000, or a 28.4 percent rate.
In November, calls to the backup centers hit a peak of nearly 18,000 – a nearly 35 percent rollover rate.
In February 2016, the IG issued a report detailing how some suicide calls were being sent to voicemail or callers did not always receive immediate assistance from VCL and/or backup center staff.
The IG then called for the department to implement seven separate recommendations, but as of December 16, 2016 none were in place, Monday’s report said.
House Committee on Veterans’ Affairs Chairman Phil Roe, M.D. (R-Tenn.) expressed frustration, saying it is “unacceptable that issues with the Veterans Crisis Line have still not been addressed.”
Communications Director Tiffany McGuffee Haverly told Fox News the committee will hold a hearing April 4 to examine ongoing issues with the Veterans Crisis Line.
Sen. Johnny Isakson, R-Ga., chairman of the Senate Committee on Veterans’ Affairs, echoed Roe’s reaction to the IG report.
“The findings in this latest report identify an unacceptable disconnect between the Clinical Advisory Board and the Veterans Crisis Line in obtaining the clinical input necessary to make policy decisions. The Veterans Crisis Line should be collaborating with clinical services every step of the way,” he said in a statement.
Amanda Maddox, spokesperson for Isakson, told Fox News the committee was “informed by the inspector general that they do not believe there is a need for legislation. Our committee is currently looking into additional oversight options as well.
The IG also reported that management had not set any standards for the length of wait times when a veteran calls.
“We found that VCL leadership had not established expectations or targets for queued call times or thresholds for taking action on queue times. A veteran could be queued for 30 minutes, for example, and that wait time might not be reflected in hold time data; however, the result of the delay is the same, whether the veteran was in a queue or on hold,” the IG said.
The IG also criticized the absence of sustained and permanent leadership at the VCL, which functioned without a director for 10 months in 2015 before a permanent replacement was named.
But that director resigned in June 2016 and as of December 2016, no permanent director has been hired. Furthermore, supervisory staff did not identify the deficiencies in their internal review of the matter.
Recent veterans have committed suicide at a much higher rate than people who never served in the military, according to a new analysis that provides the most thorough accounting so far of the problem.
The rate was slightly higher among veterans who never deployed to Afghanistan or Iraq, suggesting that the causes extend beyond the trauma of war.
“People’s natural instinct is to explain military suicide by the war-is-hell theory of the world,” said Michael Schoenbaum, an epidemiologist and military suicide expert at the National Institute of Mental Health who was not involved in the study. “But it’s more complicated.”
The study brings precision to a question that has never been definitively answered: the actual number of suicides since the start of the recent wars.
Though past research has also found elevated suicide rates, those results were estimates based on smaller samples and less reliable methods to identify veteran deaths. The government has not systematically tracked service members after they leave the military.
“People’s natural instinct is to explain military suicide by the war-is-hell theory of the world. But it’s more complicated.”
— Michael Schoenbaum, an epidemiologist and military suicide expert at the National Institute of Mental Health
The new analysis, which will be published in the February issue of the Annals of Epidemiology, included all 1,282,074 veterans who served in active-duty units between 2001 and 2007 and left the military during that period.
The analysis matched military records with the National Death Index, which collects data on every U.S. death. It tracked the veterans after service until the end of the 2009, finding a total of 1,868 suicides.
That equates to an annual suicide rate of 29.5 per 100,000 veterans, or roughly 50% higher than the rate among other civilians with similar demographic characteristics.
The issue of veteran suicide has become a political cause for activists and legislators. One statistic has become a rallying cry: 22 veterans take their own lives each day.
That figure is a national estimate based on a Department of Veterans Affairs analysis of death records from 21 states. Though it is usually cited in the context of the recent wars, most of those suicides involved older veterans, who account for the vast majority of the nation’s 22 million former service members.
Among veterans in the current study, there was one suicide a day.
The rates were highest during the first three years out of the military.
Veterans who had been enlisted in the rank-and-file committed suicide at nearly twice the rate of former officers. Keeping with patterns in the general population, being white, unmarried and male were also risk factors.
Men accounted for 83% of the veterans in the study and all but 124 of the suicides. They were three times more likely than women to take their own lives.
Female veterans, however, killed themselves at more than twice the rate of other women — a difference much bigger than the gap between male veterans and non-veterans.
A likely explanation is that women with military experience are much more likely than other women to attempt suicide with firearms, dramatically increasing the likelihood of death, said Mark Kaplan, an epidemiologist and suicide expert at UCLA.
Overall, the suicide rates for recent veterans set them apart from veterans of past generations.
In the Vietnam era, suicide rates were elevated for veterans suffering from post-traumatic stress or those wounded in action. But on the whole, suicide rates for veterans in their first few years out of the military were lower than in the general population, according to research.
The elevated rate today could reflect differences in who served, the study’s authors speculate. In the days of the draft, troops represented a wider cross-section of society. The long wars in Afghanistan and Iraq may have attracted more volunteers prone to risk-taking and impulsive behaviors.
“We don’t have the data to know,” said Tim Bullman, a mortality expert and health statistician at the VA and coauthor of the paper.
Another possibility, he said, is that a weak economy during the recent wars made the transition to civilian life more difficult.
More puzzling is the suicide rate for veterans who never went to Afghanistan or Iraq. It was 16% higher than for those who did.
Bullman said one reason could be that service members with psychological problems were often held back from deployment. He added that that suicide prevention efforts had focused on service members and veterans who did go to war.
Experts have also suggested that the military may have become a less forgiving and nurturing place over the course of the wars. “The stresses are not limited to the individuals who are sent to war,” Schoenbaum said.
A more detailed accounting of veteran mortality is on the horizon. A massive new data trove is being assembled by the Pentagon and the VA. Known as the Suicide Data Repository, it links national death records to military and healthcare data.
Among veterans who have served since 1974, the project has identified more than 2 million deaths of all types between 1979 and 2011, according to Robert Bossarte, a VA epidemiologist helping oversee the effort.
For each death, researchers will be able to learn the veteran’s deployment history, education and other information.
Researchers plan to build on the current study — which does not include reservists or veterans who served after 2007 — and look at suicide rates for all 3.7 million veterans who served since 2001.