Guest Columnist speaks on Veterans Suicide

Part three of a 4-part series
Let’s Build on this Momentum!
By Dr. Keita Franklin
Co-Director of the Columbia Lighthouse Project
Suicide is one of the biggest preventable public health crises of our time. We know that death by suicide does not discriminate; it affects people from all different backgrounds, occupations, ages, races, ethnicities, and walks of life. It is the 10th leading cause of death in the U.S. and in 2019, 47,511 Americans died by suicide with an estimated 1.38 million attempts.
That same year, 6,261 Veterans died by suicide. Yet for the first time in over twelve years, we saw our first reduction in the rates of suicide in both the Veteran and the Non-Veteran populations. In 2018-2019, there was a 7.2 percent reduction in the rate of Veteran suicide, and that same year there was a 2.1 percent decrease in the overall non-veteran rate. What have we done that was different — and what could be some of the contributing factors that we need to continue to reinforce to sustain this momentum?
Two years ago — when I led suicide prevention efforts at the Department of Veteran Affairs—my team and I worked hard to implement broad-based public health approaches; this meant extending suicide prevention outside the traditional hospital setting. This was a radical departure from traditional or historical approaches to suicide prevention.
Existing efforts focused on providing evidence-based care once a Veteran reached the clinical setting were well established and proving to make a difference — but more needed to be done. In other words, reaching Veterans where they ‘work, live and thrive’ — not just where they get medical care. So this broad application of intensive public health efforts — through work with Governors, local communities, first responders, universities, and workplaces is what was different. We are starting to see some results — but should proceed with caution as these results can be easily reversible if we don’t continue to focus our collective efforts on key capabilities that need it most.
What else is promising? The recent advancement of the 988 three-digit legislation for crisis response is another incredible advancement for the field of suicide prevention. In July 2022 when this legislation is fully implemented, we can expect individuals in crisis to not only have a swift three-digit outreach for help but also a follow-on plan for long-term crisis stabilization support. These institutional investments should help us reach our goal of the reduction of suicide by 20 percent by 2025.
Finally, we saw further endorsement and advancement of the key screening protocols — like the Columbia Suicide Risk Reduction Tool —being used by everyday people, not just in hospital-based clinical settings. We saw workplace colleagues take an interest in learning how to identify if one of their peers was struggling; we saw teachers learning how to screen for suicide risk; parents, and friends, and neighbors got more comfortable and gained increased understanding about the importance of asking directly about thoughts of suicide.
This type of normalization when it comes to suicide risk screening should advance even more as we continue our efforts to double down on suicide prevention.
Finally, President Biden recently advanced an executive strategy for military and Veteran suicide prevention efforts that highlighted the important role of lethal means safety.
Firearms are the most common method of suicide in the United States and about 85 percent of suicide attempts with a firearm end in death. Simply having access to a gun triples one’s risk for death by suicide.
The White House aims to mitigate this by providing consumers easier access to secure gun storage and safety devices as well as promoting new best practices for firearms dealers that include educating customers on firearm safety and security. This is a great start; however, more can be done. Reaching out to non-traditional partners like the National Rifle Association, riffle ranges across the nation,
and engaging with the pharmaceutical industry for more out-of-the-box innovative safety net type solutions will also be critical. The bottom line is that preventing suicide is an issue that Americans from all walks and beliefs can and should get behind.
Please educate yourself on the signs of risk and be prepared to engage if you are worried about a friend or loved one.
Signs include:
—Extreme mood swings
—Showing rage
—Withdrawing or isolating from others
—Sleeping too little or too much
—Acting anxious or agitated
—Substance abuse
—Talking about feeling hopeless or trapped
—Talking about wanting to die
—Relationship struggles
—Legal issues
—Financial struggles
—Feeling like a burden on your family or those around you.
November 20th is International Survivors of Suicide Loss Day, and it shares a month with another day of honor and remembrance: Veteran’s Day. These days of observation should provide all of us an opportunity to re-double our efforts to sustain the momentum moving forward in the reduction of suicide.
Resources to Bookmark Since you never know exactly what resources you’ll need to use when supporting someone considering suicide, I recommend bookmarking and reviewing the resources below for easy access when needed:
—American Association of Suicidology: A membership-based organization
focused on providing evidence-based resources and advocacy for suicide
prevention efforts.
—The Columbia Protocol: Offers an evidence-based tool to rate the risk
of suicide in individuals, which can be used by anyone including
healthcare professionals, schools, and loved ones.
—Suicide Prevention Resource Center: Check out webinars and online
courses to build your knowledge around suicide prevention.
—American Foundation for Suicide Prevention: Provides support to
individuals or loved ones in need as well as opportunities for anyone
to join in raising awareness about suicide.
—Mental Health America Youth Screening Test: This free test allows you
to identify whether a pediatric individual should seek further
—Zero Suicide: A Framework built of seven essential elements for
health and behavioral health care systems to prevent suicides.
—Psych Armor: Provides resources to Americans so they can effectively
engage with and support military service members, Veterans, and their
—TAPS: Offers care to those grieving the loss of a loved one who died
while serving in the Armed Forces.
Hotline Numbers to Save
—National Suicide Prevention Lifeline: 1-800-273-8255. Press 1 for the
Veterans Crisis line
—Trevor Line 1-866-488-7386
—Teen Line: 1-310-855-HOPE (4673)
* * * * *
Maramis Choufani is the Managing Editor of the Las Vegas Tribune. She writes a weekly column in this newspaper. To contact Maramis, email her at

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