DAY 12 - Suicide Deaths in the Military

 

Suicide deaths in the military remain at crisis levels. Serving in the United States Armed Forces should not be a risk factor for suicide, and yet, it is. On the 12th day of Suicide Prevention Month, take a moment to learn more about the relationship between suicide and the military. Click on the flag above to learn about the veteran's crisis line. 
General Mark A. Milley is the 20th Chairman of the Joint Chiefs of Staff, the nation’s highest-ranking military officer, and the principal military advisor to the President, Secretary of Defense, and National Security Council. Below, he shares a video message about suicide in the armed forces and the military's response. 

DAY 10 - World Suicide Prevention Day 2021

 

Every year, World Suicide Prevention Day falls on September 10th. 

This year, take a moment to reach out to those you care about who have high risk factors for suicide.

If you know a trans person, or a child who is being bullied, reach out. If you know a veteran with PTSD or someone who endured childhood trauma that resulted in CPTSD, reach out. If you know someone who struggles with bipolar disorder, or major depressive disorder, or OCD, or any other mental illness, reach out. If you know someone who struggles with addiction or alcoholism or an eating disorder, reach out. Maybe you know someone who has attempted suicide before, or someone who has lost someone to suicide (both of which are suicide risk factors, too) - reach out.

Today is a good day to reach out to the people you are concerned about, the people you love, and the people whose lives have been touched by suicide. Sometimes one conversation, one reminder, one person telling another that they love them - sometimes this is all that is needed in order to shift someone from thinking about suicide, to thinking about getting help. 

Reach out.

What The Heart Can't Erase

The mind replays what the heart can't erase.

- HealthyPlace.com

Thinking today of all of the suicide loss survivors who have lost their loved ones to firearms. For many, the sounds of explosions or fireworks bring back unwanted memories, some of which can cause a PTSD activation that can make holidays like the 4th of July very traumatic.

For anyone who suffers from PTSD related to gun violence, here are some tips for coping this holiday weekend, provided by psychiatrist John Lipkin, M.D., from peacehealth.com.

Ask your neighbors to let you know if they plan to set off fireworks. Anticipating the noise can help you avoid being caught off guard. (If you’re uncomfortable talking with your neighbors about it, have a trusted friend or loved one check with them instead.) You might let others know you struggle with anxiety or PTSD and that fireworks can make it difficult for you. You can encourage them to celebrate the holiday as they wish, but just tell them it would help you to know when they expect to set off their fireworks. They might even decide to forego the fireworks out of kindness.

Prepare a self-care tool kit. Consider positive things you can use for healthy distraction and comfort. Look through photographs that give you joy. Listen to favorite soothing music. Enjoy the fragrance of fresh pine, lavender, cinnamon or peppermint. Spend time playing with or grooming your dog or other pet.

Cover your ears. Wear inexpensive foam ear protection. When fireworks start with greater intensity or frequency, try other acoustic earmuffs or noise-canceling earphones. Listen to calming music, an engaging audiobook or nature sounds to cope with the noise. Run a fan or other source of white noise to help mask and muffle the outside sounds. Retraining can help you remove negative associations to loud sounds and help you begin to experience them as more neutral.

Darken your room. If flashes of light bother you when you’re trying to sleep, shut the blinds, use a room-darkening curtain and/or wear an eye mask or bandana over your eyes.

Allow yourself to accept the reactions that you have. Don’t be self-critical, embarrassed or ashamed. Millions of people have startle and upset reactions. Remind yourself you are ok; these noises are temporary, and you are safe.

Plan a getaway. While it may not always be possible or necessary, consider going outside of the city or neighborhood. Enjoying nature miles away from civilization can be restorative. Watching a firework display, for example, on a distant beach with friends or family, might turn out to be an enjoyable experience. 

Practice self-regulation and grounding techniques to help make your body and mind feel safe and more secure. For example, position yourself to keep your back against something hard like a wall or a chair, sit so you feel the solid support of the floor beneath your feet if you are starting to feel fearful and unsafe. Think about what makes you feel grounded and supported in other ways. Wear long sleeves and trousers. A favorite hat may also help you feel more protected.

Practice S-L-O-W deep breathing. Emphasize breathing from the belly (diaphragm).  Emphasize the duration of exhalation, breathing out nearly twice as long as breathing in. Breathe in to a slow count of three to four and exhale to a slow count of six to eight. Notice how the air entering your nose and mouth is cool and how it’s warm going out. Imagine blowing out candles on a cake as you do this.

Notice your surroundings, look around and even if you feel unsafe, remind yourself that you are safe and not in harm’s way in your current surroundings. Describe to yourself what you see around you that can keep you grounded in your present reality.

Practice a 5-4-3-2-1 sensory exercise to feel centered, grounded and calm. Identify

• five things you can see
• four things you can hear
• three things you can feel
• two things you can smell
• one good thing you are grateful for or can say about yourself.

Practice mindfully eating a piece of fruit, noticing how it looks, the texture of its skin, the fragrance of its aroma, the temperature, flavor, and how it feels as you taste it. See how long you can enjoy each bite until you swallow it. Notice how it feels when you swallow each bite and before you take another.

Use an app for assistance. The National Center for Telehealth and Technology and the Veteran’s Administration National Center for PTSD has helped develop two effective, free apps for smartphones to help people cope with symptoms of anxiety, panic and PTSD. One app is called Virtual Hope Box (on Google and on Apple) and the other is PTSD Coach.

Finally, if you do find your PTSD activated and your symptoms linger, seek help. Professional trauma-focused therapy can help you to help cope with, reduce and sometimes eliminate these anxiety responses.

Whatever you do this holiday weekend, I wish you the best. As always, my fellow suicide loss survivors are very close to my heart, and so are those who struggle with PTSD. May you be surrounded by comfort and support this weekend, and always.

Her Father's Flag

Amon Gift, a US Army veteran, was 23 years old 

when he died by suicide, in January of 2017. 

The photo above is of Amon Gift's daughter, at his funeral.

I first published this photo as a Beauty of Grief feature. I've shared it many times since, as its heartbreaking message stands.

We are losing too many veterans to suicide.

If you want to see more of what I've written about suicide and the military, click here. 

The reasons for actively serving and veteran military related suicides are varied and complex. However, the importance of showing our support to individuals is critical. This is Memorial Day weekend. Reach out to someone who is serving or has served in the military. Let them know that they are loved and that you care.

Remember that close to 22 veterans a day are dying by suicide. Supporting military related suicide prevention should happen every day, as well.

If you are a veteran or actively serving member of the armed forces and you are feeling hopeless or suicidal - please reach out. You can start by calling the Veterans Crisis Line. Your service to the country is appreciated. Your life matters. You are needed in this world.

(Thank you to Kelsey Leann Tobin for permission to use the beautiful photo of her daughter, above.)

Michael Mantenuto

Michael Mantenuto was an American actor, college ice hockey player, and Army non-commissioned officer, best known for his performance as Olympic ice hockey star Jack O'Callahan in the 2004 Disney biopic Miracle on Ice.

Mantenuto played one season for the University of Maine Black Bears men's ice hockey team. The next season he transferred to the University of Massachusetts at Boston and played one additional season for their team. His then auditioned for the role of Jack O'Callahan, a player on the 1980 Olympic men's ice hockey team, who beat the Soviet Union team. He won that role in the movie, Miracle on Ice.

Manetnuto did not pursue acting as his career though. After a few more roles, he enlisted in the United States Army and served as a Special Forces communications sergeant, also known as a Green Beret. Army Times reported that during his service he was awarded the Army Commendation Medal, three Army Achievement Medals, three Good Conduct Medals and the Global War on Terrorism Service Medal.

Manetnuto suffered from frequent bouts of depression. On April 24, 2017, he died by suicide. Michael Mantnuto was 35 years old when he died.

Michael Mantenuto

May 13, 1981 – April 24, 2017

Her Father's Flag

Amon Gift, a US Army veteran, was twenty 23 years old 

when he died by suicide, in January of 2017. 

The photo abiove is of his daughter at his funeral.

I first published this photo as a Beauty of Grief feature in November of 2017. I try to share it again at lease once a year. Memorial Day seems a fitting day to share it again. Its heartbreaking message stands. We are losing too many veterans and active military members to suicide. And, as always - there are too many loss survivors left behind.

If you want to learn more about suicide and the military, I have written about it extensively here on this blog, including sharing statistics, research, and as always - the voices of those who have lost a loved one to suicide.

The reasons for the epidemic of military related suicide are varied and complex. However, the importance of showing our support to individuals is critical. While the overall rate of suicide related military deaths has decreased from 22 per day to 20 per day, suicide is still a leading cause of death for those who are veterans of the US military. And, of significant concern - records kept in 2018 suggest that the suicide rate of active duty members has reached the highest number during the entirety of record keeping. 

Today is Memorial Day. Reach out to someone who is serving or has served in the military. Let them know that they are loved and that you care.

Remember that supporting military related suicide prevention efforts should be happening every single day, as well.

If you are a veteran or actively serving member of the armed forces and you are feeling hopeless or suicidal - please reach out. You can start by calling the Veterans Crisis Line. Your service to the country is appreciated. Your life matters. You are needed in this world.

(Thank you to Kelsey Leann Tobin for permission to use the beautiful photo of her daughter, above.)

No Army is Better - DAY 19

The soldier is the Army. No army is better than its soldiers.
- Douglas MacArthur

No focus on suicide prevention would be complete if we did not include military and veteran suicides. And no statement about suicide prevention would be complete if we didn't note that as a country, we must do better by the men and women who are actively engaged or are retired from military service. 

The most recent figures show that the statistic of 22 veterans dying by suicide (per day) has decreased incrementally, and is now closer to 20 veterans dying.

This is hopeful, but we must do better.

There are many things we can do today: talk about this issue and become an advocate for change; vote in order to make suicide prevention resources easily available to all; insist on suicide prevention accountability by the VA (United States Department of Veterans Affairs); insist on research funding allocation for advances in PTSD and head injuries; and more. These things are just a start.

If you would like to see the military/veteran related posts that have been posted on this blog, you can find them here:

Military / Veteran Suicide Specific Posts:

• Too Many

• Today and Every Day

Our Voices Matter Interviews:

• Nancy Varella - In the Shape of a Heart

The Beauty of Grief Veteran / Military Posts:

• Holding Her Father's Flag

PTSD  Posts:

• A Whole Body Tragedy 

Documentaries:

• Veterans and PTSD - Resurface Documentary

Please Note: If you are a veteran or actively serving member of the armed forces and you are feeling hopeless or suicidal - please reach out. You can start by calling the Veterans Crisis Line. Your service to the country is appreciated. Your life matters. You are needed in this world.

Resurface - DAY FOUR

On Day Four of Suicide Prevention Month, I am thinking about the impact that PTSD (post traumatic stress disorder) has on individual lives. Those who have PTSD have a significantly increased risk of suicide. The research and data is heartbreaking. According to VeryWellMind.com, the link between tauma, PTSD, and suicide is undeniable. In their article, The Connection Between PTSD and Suicide (Matthew Tull, PhD), the current statistics look like this:

In a survey of 5,877 people across the United States, it was found that people who had experienced physical or sexual assault in their lifetime also had a high likelihood of attempting to take their own life at some point:

• Nearly 22% of people who had been raped had also attempted suicide at some point in their life.
• Approximately 23% of people who had experienced a physical assault had also attempted suicide at some point in their life.
• These rates of suicide attempts increased considerably among people who had experienced multiple incidents of sexual (42.9%) or physical assault (73.5%). They also found that a history of sexual molestation, physical abuse as a child, and neglect as a child were associated with high rates of suicide attempts (17.4% to 23.9%).
• People with a diagnosis of PTSD are also at greater risk to attempt suicide. Among people who have had a diagnosis of PTSD at some point in their lifetime, approximately 27% have also attempted suicide.

Last year during Suicide Prevention month, I published a blog post that focused on PTSD and Suicide. (A Whole Body Tragedy, 9/28/2019.) That post also focused on the data we have in regard to the relationship between having PTSD and dying by suicide.

This year though, I want to feature something related to effective treatment for PTSD. While there is a significant need for continued research into identifying treatment modalities that will address the many different aspects of PTSD, there are some individuals who are forging ahead with developing creative and successful methods of supporting those who are struggling with PTSD.

Bobby Lane, an Iraq war veteran is one of those people. The trauma he'd experienced while serving in the military was severe and he found that there was nothing available to abate his symptoms. He decided to take his life. However, he wanted to fulfill his lifelong goal of learning to surf, first. It was while he learned to surf that he realized that his suicidality decreased.

The short documentary (just over half an hour long) Resurface tells Bobby's story. Because of his experience surfacing, he asked himself the question - how could surfing change the lives of other military veterans? 

While surfing is not going to be practical or possible for all individuals who are dealing with PTSD, its success in treating veterans speaks to a larger message: PTSD and other mental illnesses can be treated in creative ways, not just the standard methods of using medication and talk therapy. In fact it is not surprising that surfing has therapeutic properties. Physical exercise, being outside in nature, and skills mastery, can all be important contributors to reducing the intensity of suicidal ideation.

The film Resurface came out two years ago this month. Recently, I showed the movie to a grief group that I facilitate as part of my job as a chemical dependency counselor. All of the clients who watched the film remarked that they felt inspired and more hopeful afterward.

I suggest that if PTSD is a part of your life, or the life of a loved one, that you consider adding this film to the resources you turn to when considering different treatment possibilities.

Currently, one of the easiest ways to access the film is on Netflix.  

One last note. Following my mother's suicide in 2002, I was wracked with grief. A friend took me surfing in order to help me manage my grief. I was in my early thirties at the time. I'd never surfed before, but my friend told me that a person is never to old to learn. So, I took lessons.

A few years ago, I wrote about the impact that those lessons had on me. In particular I remembered a conversation I'd had with my instructor. Her words were very symbolic and later I would realize how much surfing had in common with healing from the pain around grief and trauma. Here is some of what I wrote:

"The surf instructor explained what to do about the waves when you're  trying to get past the break. Dive in, she said. When the wave comes - if it is too high to get over - then you must dive in. This is the only way to get through."

Chelise Stroud relaxing on a longboard.
Honolulu, Hawaii, 2002

And I remember these words she told me, too: "If a wave tumbles you and you lose contact with your board, you might become confused. The darkness of the ocean water above and below can snatch your orientation with a swiftness that leaves you floundering and afraid.

Follow the bubbles, the instructor explained. You will see bubbles that are heading for the surface, as bubbles of air will do. Follow them. Follow these tiny little things, propel yourself toward the tiniest of signs - and you will emerge from the darkness - once again in the light.

Chelise Stroud catching a wave.

Honolulu, Hawaii, 2002

So I will end with this. For those of you who are enduring the painful symptoms of PTSD, consider creative and fun activities that will help you to manage the overwhelming feelings that you are experiencing.

If surfing does not appeal to you - I urge you to consider finding something that does. It is my wish that all of us whose lives have been impacted by trauma, find some relief.

We deserve fun.
We deserve joy.
We deserve to heal.

Chelise Stroud, at the beach.

Marin Headlands, Marin, California, 2019

Holding Her Father's Flag

Amon Gift, a US Army veteran, was twenty three years old 

when he died by suicide, in January of 2017. 

This photo is of his daughter, at his funeral.

I first published this photo as a Beauty of Grief feature. Its heartbreaking message stands. We are losing too many veterans to suicide.

If you want to learn more about suicide and the military, I have written about it extensively here on this blog, including sharing statistics, research, and as always - the voices of those who have lost a loved one to suicide.

The reasons and solutions to the epidemic of military related suicide are varied and complex. However, the importance of showing our support to individuals is critical. Today is Veterans Day. Reach out to someone who is serving or has served in the military. Let them know that they are loved and that you care.

Remember that close to 22 veterans a day are dying by suicide. Supporting military related suicide prevention efforts should be happening every single day, as well.

If you are a veteran or actively serving member of the armed forces and you are feeling hopeless or suicidal - please reach out. You can start by calling the Veterans Crisis Line. Your service to the country is appreciated. Your life matters. You are needed in this world.

(Thank you to Kelsey Leann Tobin for permission to use the beautiful photo of her daughter, above.)

Day 28 - A Whole Body Tragedy

PTSD is a whole-body tragedy, an integral human event 

of enormous proportions with massive repercussions.
― Susan Pease Banitt

Let's talk about Post-Traumatic Stress Disorder (PTSD). Our internal response to trauma is often the platform for suicidal thinking, behaviors, and completions. If we do not understand and address the role trauma plays in the lives of individuals who die by suicide, we won't achieve comprehensive suicide prevention.

To better understand the connection between suicide and PTSD, let's start with a definition. Post-traumatic stress disorder (PTSD) is a psychiatric condition that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. PTSD can also occur after sudden severe emotional trauma such as experiencing the unexpected loss or death of a loved one. Finally, PTSD can also occur after prolonged exposure to environments in which a person is being bullied, neglected, or suffering abuse (physically, sexually, mentally, emotionally, or otherwise).

To put this into perspective, let's look at some data:

• An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and up to 20 percent of these people go on to develop PTSD.
• An estimated 5 percent of Americans—more than 13 million people—have PTSD at any given time.
• Approximately 8 percent of all adults (1 of 13 people in this country) will develop PTSD during their lifetime.
• An estimated 1 out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD.

And again, putting the suicide/PTSD link into perspective, when we look at those who are the highest risk of suicide, a diagnosis or probable diagnosis of PTSD is pervasive:

Those serving in the military.
First responders.
Those having been bullied.
Individuals who identify as part of the LGBTQ community.
Those having suffered sexual abuse.
Those having suffered a head injury.
Survivors of suicide loss.

Given the close connection between trauma and death by suicide, we have to look at what is happening to the brain, during severe or prolonged traumatic events.

Many people incorrectly assume that PTSD is related to purely mental/emotional reactions to these events. This misconception is not only highly stigmatizing - it is also inaccurate. Unfortunately this stigma impairs our ability to prioritize the research needed to improve treatment of PTSD. Stigma suggests that PTSD only happens to those who are not emotionally strong enough to manage their feelings during and after trauma. This belief is very damaging because it further shames those who are suffering, and profoundly denigrates the deceased.

Here is a graphic that shows what is actually happening at the inception of PTSD:

What the graphic shows is that during trauma, your emotions and reactions are dictated by physiological responses and not by rational thinking. Survival mode is not conducive to well thought out rational behavior. By matter of necessity, we react based on sights, sounds and emotional stimuli. We are not reacting based on thoughts or access to cognitive information. Our behavior becomes singularly oriented toward avoidance of further pain and trauma. Our actions are guided by physiological changes in the brain, not thought processes. Here are the most important words in the graphic above, as they apply to our traumatic events:

This is NOT a cognitive choice.

The physical and mental response to trauma has nothing to do with thought, cognition, decision making, personality, weakness, or strength. It has everything to do with a brain's physiological response to the trauma.

Following trauma, some brains are unable, without effective treatment, to maintain consistent physiological stability. Some reasons are known, many more are not. More research is desperately needed.

For those with PTSD, they may have periods of significant stability, where they are able to manage many of life's normal ups and downs with appropriate levels of pain and frustration. When their PTSD is activated however, their reactions to normal stressors may seem heightened to a level that appears unreasonable. Some of the symptoms of PTSD include ongoing emotional distress, personality disturbances and/or changes, severe anxiety/aggression/depression and poor impulse control. All of these symptoms, while seemingly based in 'thought processes', are actually dictated by the same brain changes that occurred at the inception of the PTSD.

Some of the most successful treatments for PTSD involve behavioral therapies, not necessarily cognitive therapies. In other words, we are seeing success in treating those with PTSD when we work to provide them with skills for recognizing and managing symptoms when they occur. Traditional 'talk therapy' that encourages a person to remember and discuss events in their life, has shown a propensity for re-traumatizing those with PTSD. We must make long term and easily accessible behavioral (skills based) therapies available to all individuals who are suffering from PTSD.

There are other significant developments in PTSD research. Researchers have found that the condition can be detected via brain scans.

"Brain imaging studies have shown alterations in a circuit including medial prefrontal cortex (including anterior cingulate), hippocampus, and amygdala in PTSD. Many of these studies have used different methods to trigger PTSD symptoms (eg, using traumatic cues) and then look at brain function. Stimulation of the noradrenergic system with yohimbine resulted in a failure of activation in dorsolateral prefrontal, temporal, parietal, and orbitofrontal cortex, and decreased function in the hippocampus.173 Exposure to traumatic reminders in the form of traumatic slides and/or sounds or traumatic scripts was associated with an increase in PTSD symptoms, decreased blood flow, and/or failure of activation in the medial prefrontal cortex/anterior cingulate, including Brodmann's area 25, or subcallosal gyrus, area 32 and 24, as measured with positron emission tomography (PET) or functional MRI (fMRI)"

What do all those words above amount to? Again:

PTSD induced behaviors and 'decisions' or 'choices' actually reflect the physical impact of traumatic events on the brain's ability to respond, and do not reflect decisions or choices.

PTSD is a formidable enemy when it comes to suicide, but there is hope. With more research, we will be able to further streamline finding the best behavioral therapies to support those with PTSD symptoms, and we may be able to identify other treatments that could have a restorative effect on the damaged brain functioning that occurs when PTSD is present.

If you suffer from PTSD, know that your symptoms are not your fault and not a product of your being weak, or selfish, or 'unable' to handle your problems. Know that there is hope and there is help, and that many people are fighting to ensure that better treatments are on their way.

If you love someone with PTSD, please keep all of the above in mind, educate yourself further, advocate for your loved one so that they have access to support services and treatment of their own, and reach out for support for yourself. And always have the suicide prevention lifeline phone number (1-800-273-8255) on hand. (There is a special number for those in the military, as well.)

And if you have lost someone to PTSD, let me say this: For my generation and all of those prior, we have spent our entire lives conditioned to believe that when someone dies by suicide, they made a 'choice' of some kind. We take that belief and compare and contrast the 'choice' to die with a choice we think they could have made to stay alive and be a part of our lives.

The questions we are asking are agonizing. They are also inaccurate. With PTSD, the accurate question, is this:

What impacted my loved one's thought processes so that they were unable to make the choice to live?

That is the question that we must answer. Those answers will lead us to the solutions that will begin to appreciatively save lives.

We must end the stigma. Have the conversations. Make resources available. Fund the research.

BEGIN NOW.

Day 25 - Too Many

Sergeant Benjamin Bruce

June 29, 1993 - January 8, 2017

Many people are aware that the number of military suicides is at an epidemic level. It is impossible to work in the field of suicide prevention without seeing the connection. The second post in the Our Voices Matter series on this blog was an interview with Nancy Varella Lendway, a military mother who lost her son, Vito, shortly after he returned from having served in Aghanistan. I personally attend a local support group for survivors of suicide loss, and one of the members lost her brother, a military veteran, to suicide. In my online groups, there are always numerous members whose loved ones were military veterans (or actively serving) when they died by suicide. In fact, the photo above, which is from the services of Sergeant Benjamin Bruce, was provided to me by a woman in one of my online support groups. 

As with all aspects of suicide prevention and awareness, it is very important to understand the facts in order to get a better sense of the urgency of this situation.

• In the United States, military related suicides kill 20-22 people a day.

• Suicide is the leading cause of death among actively enlisted members of the military.

• 47 % of of those who are in the military and die by suicide are 25 years old, or younger.

• Since the beginning of the war in Afghanistan, suicide has killed more US military members than ISIS has.

• 83 % of those who die by suicide, do so here in the United States after they have returned from combat.

These things are known about military related suicide deaths. The cause for the high number of suicide  deaths is not as concrete. Likely, multiple factors are at play. As such - the vast majority of active duty or veteran service members are in higher suicide risk categories than the general public.

One risk factor is related to post traumatic stress disorder (PTSD). It is estimated that 10% - 30% of all service members returning from combat zones have prolonged PTSD-like responses, or the full blown disorder. PTSD has been shown to exacerbate suicidal ideation as well as increase the number and severity of suicide attempts that a person might have.

Another risk factor is related to head injuries. Those in combat zones are far more likely to experience head injuries, than someone in the general public might. Research has shown that individuals who have had a single concussion are three times as likely to die by suicide.

Adding to the above, being a survivor of suicide loss increases a person's risk of suicide, and given the number of suicides in the military, chances are greater than average that those who serve will know others who have died by suicide. Depending on the closeness with the individual/s who have died, the increased risk factor may be mild or it may be significant.

There are also concerns about the the poor access to psychiatric care for military vets. Right now, there are multitudes of complaints about how long it takes for the US Veterans Administration to see patients who are complaining of psychiatric symptoms - and there are equal concerns about the quality of care veterans are receiving. 

Finally, one of the major risk factors for suicide has to do with access to means. In other words - how easy is it for a suicidal person to access a means to complete the act of suicide. One of the most lethal means of suicide is use of a firearm. Those who serve in the military are far more likely to use a firearm when dying by suicide. In fact, in comparison with the general public, those in the military are also more likely to own firearms in their civilian life, and they are more likely to know exactly how to load and use them.

All of these facts contribute to suicidal feelings, intent, and very likely drive up the numbers of suicides completed. At the same time, because of the wide variety of causes, addressing military suicides is a complex effort that requires comprehensive overhauls in many areas.

Active duty personnel and veterans both, need access to better, stronger, and more consistent healthcare services. Services upon return from combat need to be very proactive and incorporate comprehensive suicide risk assessment. We must improve our ability to detect and treat disorders such as PTSD. We must take a look at the pro gun culture in our country as a whole. There are no easy answers, and many of these issues require lengthy and complex overhauls, but the time we've had to eschew overhauls in the name of simplicity has passed. Too many of the brave men and women who serve or have served in the US military, are dying. 

Too many people are suffering. Too many hearts are breaking.

Too many.

Special thanks to Kiko Carrie Yoshida, for allowing me to use the photo at the top of this post. Kiko, I am so sorry for your loss, my heart is with you, as it is with all of my fellow survivors of suicide loss. 

Day 11 - Never Forget

In addition to the endlessly heartbreaking tragedy of lives lost on September 11, 2001, we will never forget the incredible amount of bravery and sacrifice that was put forth by the fire fighters and police officers who rushed to the scene of the world trade center, on that day. 

When it comes to suicide prevention, we must not overlook those who serve as first responders to tragedies and life threatening situations. First responders have a suicide rate that is ten times that of the general population. In fact, in 2017, more police and fireman died by suicide than in the line of duty. EMT and Paramedic suicide rates are equally high.

If you are a first responder or if you know someone who is, please ensure that your station or place of business provides regular trainings and support services for compassion fatigue and PTSD.

Remember, you are appreciated and you are needed in this world.

Click below to learn more about a crisis call line specifically for those who work as first responders.

The Beauty of Grief

Holding her father's flag.

Amon Gift, a US Army veteran, was twenty three years old 

when he died by suicide, in January of 2017. 

This photo is of his daughter, at his funeral.

Thank you to Kelsey Leann Tobin for permission to use this beautiful photo.

In the United States, today marks the start of Veterans Day weekend. So, make an effort to thank a veteran. 

Honor veterans for their sacrifices and service, today and every day.

And always honor and remember the twenty two veterans a day who are losing their life to suicide. 

To put the crisis into perspective: 

In 2016, tragically, fourteen (14) active duty US military personnel were killed in action while serving in the War in Afghanistan.

During the same year, over seven thousand (7,000) veterans died by suicide.

Veterans should feel as if they are out of danger when they return from the front lines. We need to do more, and we need to start by having these conversations now.

In February of 2016 the United States Department of Veteran Affairs held the first ever Preventing Veteran Suicide—A Call to Action summit, which focused on improving mental health care access for Veterans across the nation and increasing resources for the VA Suicide Prevention Program.

As a result of that summit, the VA is undertaking a number of new measures to prevent suicide, including the use of predictive modeling to determine which Veterans may be at highest risk of suicide, so providers can intervene early. Veterans in the top 0.1% of risk, who have a 43-fold increased risk of death from suicide within a month, can be identified before clinical signs of suicidal ideation are evident in order to save lives before a crisis occurs.

The VA made a commitment to bettering services and treatment for veterans who were suffering from PTSD and other mental health conditions that were potentially fatal. Among their immediate priorities:

• Ensuring same-day access for veterans with urgent mental health needs at over 1,000 points of care.
• Expanding the staff, training, and locations for veterans' crisis call centers.
• Building new collaborations between Veteran programs in VA and those working in community settings. 
• Creating stronger inter-agency (e.g. Substance Abuse and Mental Health Services Administration, Department of Defense, National Institutes of Health) and new public-private partnerships (e.g., Johnson & Johnson Healthcare System, Bristol Myers Squibb Foundation, Walgreen’s, and many more) focused on preventing suicide among Veterans.

You too can make a difference in preventing suicide among veterans.

End stigma by having the discussions needed to ensure that these statistics are recognized as the urgent public health crisis that they represent.

Hold the Veterans Administration and the United States government accountable for following through with their commitment to do more. Keep apprised of current efforts toward veteran suicide prevention and keep those efforts in mind when voting.

Work with organizations that focus their efforts on preventing suicide among veterans. Click here to find a random sampling.

And always remember the sacrifices many have made to serve our country, thank veterans for their service, and let them know that as human beings they are appreciated, loved, and needed in this world.

Speak up for the veterans who are struggling with being suicidal. Make sure they know:

Their Voices Matter