Despite efforts, veteran suicides remain alarming
The statistics are jarring, and they don't seem to be changing.
An estimated 22 veterans take their own lives every day in the United States, according to the U.S. Department of Veterans Affairs.
In Minnesota, it's a similar pattern. A St. Cloud Times analysis of death records found that 102 people who had served in the armed forces killed themselves in Minnesota in 2013.
Veterans in Minnesota are dying by suicide at a rate more than double that of the general population — an estimated 30 per 100,000 last year, compared to 12.5 per 100,000 in the general population.
While there have been numerous cases of veterans who served in Iraq and Afghanistan taking their own lives in recent years, it's not just recently deployed veterans who are dying by suicide.
In fact, the largest number of suicide deaths are older men, said Dan Reidenberg, executive director of Suicide Awareness Voices of Education, a national nonprofit based in Bloomington.
The vast majority of veterans who commit suicide are older than 55 years, Reidenberg said. Many have had lengthy battles with post-traumatic stress, substance abuse, anxiety or other problems, he said.
"They live with these things for years and sometimes decades," he said. "And then they start facing some of the other issues that the general population has, with physical limitations, concerns about income, concerns about their purpose and their role in life, their ability to function independently."
The St. Cloud VA Health Care System continues to see a high volume of calls from the national veterans crisis line that result in a consultation with local staff, said Mary Jo Pine, suicide prevention coordinator.
In fiscal year 2014, Pine had about 125 consults. Not every call results in a consultation, however. Many veterans call just to talk to someone, she said.
While many of the callers are older veterans, Pine said the number of younger veterans has increased in the past year or so. In some ways, that's a good sign.
"It tells me they're reaching out," Pine said.
Restricting the lethal means
During his tenure as coordinator of the Central Minnesota Mental Health Center in Buffalo, Dr. William Tregaskis talked to people who attempted suicide and often heard a common sentiment.
"What most people say is it's not that they really want to die," said Tregaskis, now a psychologist for Allina Health's Buffalo Hospital. "It's just that they can't stand the pain at the moment. ... That acute state of despair is unbearable."
Suicide tends to be a very impulsive act, at least at the end. About 45 percent of people who attempt suicide make the final decision within 10 minutes of the act, Reidenberg said.
"It takes a lot to actually get to that place to take your life," he said. "And many times it is last minute. Something snaps, and the brain seems to go into this overdrive toward suicide."
People who are contemplating suicide usually don't want to die — they just want the pain to stop, Pine said. For veterans with firearms, that can be especially deadly.
"They're going to reach for the most lethal means, and that's what they do," she said.
Veterans' familiarity and comfort with weapons puts them at a higher risk for suicide, experts say.
"For people in the military, they're trained, and so they know how to use it," Reidenberg said. "It is their best friend. It's their closest thing to them."
Many suicide prevention advocates are stressing "means restriction," or limiting a suicidal person's access to the means to end their life, such as drugs or weapons.
The VA encourages veterans who are struggling to consider giving their firearms to someone for safekeeping, or to use the gun locks the VA provides for free.
All the other means someone might consider using to end their life offer time and a chance for intervention, Pine said.
"A firearm does not," she said.
Focus on mental health
Mental illness is a factor in the vast majority of suicides.
An estimated 90 percent of people who kill themselves have a diagnosable psychiatric illness at the time of their death, Reidenberg said.
However, many are either undiagnosed or misdiagnosed. And there is still a shortage of mental health treatment beds available, especially for adolescents, Reidenberg said.
There's been an increase in awareness about the problem of suicide, but it hasn't resulted in more dollars available to combat the problem, Reidenberg said. The state allocates less than $200,000 a year for suicide prevention, he said.
"It's just unreal for one of the leading causes of death for people in our state," he said.
Studies have shown that veterans being treated in the VA system are less likely to attempt suicide, so Pine spends much of her time urging veterans to enroll for care at the VA. But many are reluctant, she said.
While there's much more awareness about suicide, there's still a stigma around mental health issues, Pine said.
"People are still looking at mental health conditions differently than other medical conditions, and it's keeping them from getting the care they need," she said.
Experts urge people to know the warning signs and risk factors that put people at greater risk of suicide.
"We want people to know that if somebody's talking about suicide or they're looking for a way to die, that's really serious and somebody needs to recognize that and do something about it right away," Reidenberg said. "They cannot not do anything. It needs to be their first and only priority."
Warning signs of suicide
These signs may mean someone is at risk for suicide. Risk is greater if a behavior is new or has escalated and if it seems related to a painful event, loss or change.
- Talking about wanting to die or to kill oneself.
- Looking for a way to kill oneself, such as searching methods online or buying a gun.
- Talking about feeling hopeless or having no reason to live.
- Talking about feeling trapped or in unbearable pain.
- Talking about being a burden to others.
- Increasing the use of alcohol or drugs.
- Acting anxious or agitated; behaving recklessly.
- Sleeping too little or too much.
- Withdrawn or feeling isolated.
- Showing rage or talking about seeking revenge.
- Displaying extreme mood swings.
Additional warning signs:
- Preoccupation with death.
- Suddenly happier, calmer.
- Loss of interest in things one cares about.
- Visiting or calling people to say goodbye.
- Making arrangements; setting one's affairs in order.
- Giving things away, such as prized possessions.
Veterans Crisis Line: Veterans and their loved ones call 800-273-8255 and press 1 or send a text message to 838255.
National Suicide Prevention Lifeline: 800-273-TALK (8255).
Talk About It
Share stories and strategies for coping in a new online place for Central Minnesota veterans and their families at www.facebook.com/scarsofservice
Follow the #ScarsofService hashtag on Twitter.
And join the discussion as Terry Ferdinandt and Hector Matascastillo take questions from readers on sctimes.com.
About the reporters
Kirsti Marohn has been a reporter at the St. Cloud Times since 1998. She has covered local and state government, social issues and the environment. Her father was a U.S. Marine and her husband served in the Minnesota National Guard prior to 9/11.
Marohn became interested in writing about veterans after hearing about the struggles many have faced since returning from Iraq and Afghanistan, and how community resources were not always adequate to help them.
You can follow Marohn on Facebook and on Twitter @kirstimarohn.
David Unze has been a reporter at the St. Cloud Times since 1997. He has covered primarily courts, public safety and higher education.
The problems that Iraq and Afghanistan veterans face came to his attention through the interactions that police and the courts have with veterans in crisis. He also learned about the challenges that vets face when they return home and try to resume their education.
You can follow Unze on Facebook and on Twitter @sctimesunze.