September 2019
Spotlight - Suicide Prevention

September is National Suicide Prevention Month in the US and includes World Suicide Prevention Day on September 10 th and National Suicide Prevention Week from September 9 th - 13 th . Though suicide is tragic in any population, veterans and servicemembers appear to face a suicide rate 1.5 times higher than the general public. Although veterans make up only 8.5 percent of the American population, they account for 18 percent of all adult suicides .

A June 2018 US Department of Veterans Affairs (VA) National Suicide Data Report revealed that an alarming average of 20.6 veterans and active-duty servicemembers commit suicide every day. More than a year later, there is debate on whether this trend has slowed. In March of this year, the VA stated their suicide prevention efforts had been effective. Less than a month later, three successive suicides committed in VA parking lots rekindled the debate.

Research suggests that mental health concerns, including posttraumatic stress disorder (PTSD) and depression, are significantly associated with suicide contemplation. Additional risk factors include substance abuse disorders, traumatic brain injury (TBI), and perceived stigma from servicemembers, fellow veterans, and the public. However, research has also revealed that having a sense of purpose and control in one’s life, as well as having increased post-deployment social support, may be the keys to reducing suicide rates in military and veteran populations.

Social support can come from a variety of sources, including the government, the courts, medical institutions, non-profit organizations, families, and friends. Regardless of which category you fall in, this issue of the Veterans Justice and Mental Health Newsletter will provide you with tips, guides, and resources to help you recognize warning signs and take appropriate action to help reduce the risk of veteran suicide. Read on to learn more!

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Additional Resources

Shahrzad Mavandadi, Erin Ingram, Johanna Klaus, and David Oslin
After controlling for other factors in a sample of over 15,000 veterans who had presented at a primary care program for mental health, perceived social support, frequency of negative social exchanges, and degree of social integration were significantly and positively associated with the presence of comorbid suicidal ideation.

Cristina M. López, Cynthia L. Lancaster, Allison Wilkerson, Daniel F. Gros, Kenneth J. Ruggiero, and Ron Acierno
Residual insomnia symptoms were significantly associated with smaller gains in PTSD treatment among a clinical trial of Behavioral Activation and Therapeutic Exposure (BA-TE) in a sample of 232 veterans.

Andrea Finlay, Mandy Owens, Emmeline Taylor, Amia Nash, Nicole Capdarest-Arest, Joel Rosenthal, Jessica Blue-Howells, Sean Clark, and Christine Timko
Of 191 studies concerning the effects of the criminal justice system on veterans’ health, 91 percent were observational. The field lacked controlled trials and an integrative framework. Input from multiple related disciplines would strengthen the literature.

Patience Moyo, Xinhua Zhao, Carolyn T. Thorpe, Joshua M. Thorpe, Florentina E. Sileanu, John P. Cashy, Jennifer A. Hale, Maria K. Mor, Thomas R. Radomski, Julie M. Donohue, Leslie R. M. Hausmann, Joseph T. Hanlon, Chester B. Good, Michael J. Fine, and Walid F. Gellad
Among 1,181 veterans who received at least one opioid prescription from the VA and subsequently unintentionally overdosed, unintentional overdoses occurred mostly among older veterans and generally in veterans without comorbid substance use disorders. Fifty-four percent of decedents had an active prescription on the day of their death, and 62 percent had an active prescription within thirty days of their death. Twenty percent of decedents did not have an active opioid prescription within one full year prior death.

Sonya Gabrielian, Elizabeth Bromley, Alison B. Hamilton, Van T. Vu, Adrian Alexandrino Jr., Ella Koosis, and Alexander S. Young
Based on semi-structured interviews and cognitive tests with 20 veterans who had retained VA housing for more than one year (“stayers”) and 20 veterans who had lost housing in less than one year (“exiters”), stayers exhibited more complex problem-solving skills than exiters. However, cognition was poor in both groups. 
Practitioner Publications
US Department of Veterans Affairs
This handout describes the direct and indirect warning signs of suicidal behavior in servicemembers and veterans, gives five simple steps to supporting and getting help for a loved one contemplating suicide, and lists helpful contact numbers and website links for resources.

US Department of Veterans Affairs
This booklet helps community members and leaders work to prevent veteran and servicemember suicides in their areas. The toolkit discusses public-private partnerships, suicide screening questions for veterans and servicemembers, myths and realities about suicide, safety plans, and more.

The American Institute of Stress
Learn about a range of issues including veteran suicides, PTSD and trauma-focused treatment, the unique challenges facing military families, stress management techniques for servicemembers and veterans, and how sports and hobbies can benefit these populations. 
Multimedia Resources
(Webinars, Podcasts, Online Resources)
US Department of Veterans Affairs, National Center for PTSD
One of the PTSD Consultation Program’s 2019 Lecture Series, this online lecture seeks to train clinicians working with the servicemember and veteran populations to deal with the challenges of TBI. Continuing education credits are offered for those who complete the training.

Children and Family Futures
This scheduled webinar analyzes the challenges of keeping families together and serving them in federal treatment courts. Special attention will be given to preparing the treatment court team to work with in-home families and overcome common challenges and barriers.

Home Base Veteran and Family Care
This multi-week course helps clinicians and military parents understand the mental health concerns of military children. The panel of experts talk about risks for substance abuse, how to deal with depression and anxiety disorders, and methods of dealing with aggressive behavior. 
This act allows certain medical professionals to prescribe hyperbaric oxygen therapy to veterans suffering TBI and PTSD. Based on clinical trials, it is thought to aid recovery of TBI and PTSD in veterans and civilians.
In the News
Events Calendar

September 3, 2019 - Salem, OR
September 4, 2019 - Savannah, GA
September 5, 2019 - Indianapolis, IN
September 5-6, 2019 - Great Falls, MT
September 6, 2019 - Asheville, NC
September 6, 2019 - Bad Axe, MI
September 6, 2019 - Boston, MA
September 6-8, 2019 - Des Moines, IA
September 6, 2019 - Kalamazoo, MI
September 6, 2019 - Montgomery, AL
September 6, 2019 - Oklahoma City, OK
September 7, 2019 - Philadelphia, PA
September 7, 2019 - Princeton, MN
September 7, 2019 - Quincy, CA
September 10, 2019 - Akron, OH
September 11, 2019 - Portland, OR
September 11, 2019 - Wichita, KS
September 13, 2019 - El Paso, TX
September 13, 2019 - Hardin County, KY
September 13, 2019 - New Castle, PA
September 13, 2019 - Portsmouth, OH
September 13-14, 2019 - Prescott, AZ
September 13, 2019 - Welch, WV
September 14-16, 2019 - Compton, CA
September 14, 2019 - Laveen, AZ
September 14, 2019 - St. Augustine, FL
September 14, 2019 - Wenatchee, WA
September 18, 2019 - Huntington, WV
September 18-19, 2019 - Lakeport, CA
September 18, 2019 - Nashville, TN
September 19, 2019 - Atlanta, GA
September 19, 2019 - Billings, MT
September 19-21, 2019 - Fresno, CA
September 19-21, 2019 - Rock Island, IL
September 20-23, 2019 - Antioch, CA
September 20, 2019 - Benton Harbor, MI
September 20-22, 2019 - Cumberland, RI
September 20, 2019 - Dayton, OH
September 20, 2019 - Dover, DE
September 20, 2019 - Lincoln, NE
September 20, 2019 - Muncie, IN
September 20, 2019 - Pensacola, FL
September 20, 2019 - Reno, NV
September 20, 2019 - Ridgecrest, CA
September 20, 2019 - Rocky Hill, CT
September 21, 2019 - Colville, WA
September 21, 2019 - Freeport, IL
September 21, 2019 - Milwaukee, WI
September 21, 2019 - New Brighton, PA
September 21, 2019 - San Carlos, AZ
September 21, 2019 - Tulsa, OK
September 25, 2019 - Bemidji, MN
September 25, 2019 - Bend, OR
September 25, 2019 - Roseburg, OR
September 26, 2019 - Evansville, IN
September 26, 2019 - Grand Rapids, MN
September 26, 2019 - Manchester, NH
September 26, 2019 - Panama City, FL
September 27, 2019 - Beaumont, TX
September 27, 2019 - Cherry Hill, NJ
September 27, 2019 - Chillicothe, OH
September 27, 2019 - Eugene, OR
September 27, 2019 - Lafayette, LA
September 27, 2019 - Las Cruces, NM
September 27, 2019 - Logan, WV
September 27, 2019 - Myrtle Beach, SC
September 27, 2019 - Riverside, CA
September 27, 2019 - Springfield, MA
September 28, 2019 - Bremerton, WA
September 28, 2019 - Hollywood, CA
September 28, 2019 - Moses Lake, WA
September 28, 2019 - Placerville, CA
September 28, 2019 - Rothschild, WI
September 28, 2019 - Vancouver, WA
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