August 2018
Suicide Prevention among Military Veterans and Personnel
Message from the Editor

With suicide among our nation’s uniformed services on the rise, the US Department of Veterans Affairs (VA) has deemed veteran suicide “a national public health issue that requires a concerted, national approach.” This needed approach must include the efforts of family, the community, and healthcare professionals (VA and non-VA). Specifically, I believe that the veterans treatment court (VTC) is an important component of this comprehensive prevention approach.

Like many, I have had personal experience with suicide and its risk among some of those close to me who have served. Additionally, in my years working with VTCs across the country, I have witnessed (personally and in the data) the risk of suicide among VTC participants. I have seen VTC teams suffer the loss of participants to death by suicide as the impact extends beyond families to the larger community, including the VTC team members, participants, peer mentors, and program partners.

Because of their mission, VTCs (team members, participants, mentors) and their partners should be aware of the risk of suicidal behavior and become educated on evidence-based prevention strategies. VTCs work directly with a population of veterans experiencing behavioral and mental health issues, and the VTC team and its partners often deal with participants in crisis. Research has shown that particular substance use/misuse and mental health issues can significantly increase the risk and likelihood of suicidal behavior. Further, those helping these individuals may experience a greater risk of burnout, mental health issues, and suicidal behavior, and many team members themselves are veterans.

Therefore, this month’s Veterans Justice and Mental Health (VJMH) newsletter aims to raise awareness of the risk of suicide among military veterans and service members and disseminate evidence-based prevention efforts to our readership, which includes VTC team members, participants, mentors, and partners. Our team (thank you, Lizzie!) identified the topic as particularly fitting for this edition as September is National Suicide Prevention Awareness Month with September 10 being World Suicide Prevention Day.

Explore the resources below to learn more about this national public health crisis and what you can do to make a difference because you can! Suicide is often preventable. Most people who die by suicide have communicated some intent. Remember, the intent to die can override rational thinking, and asking directly about suicide is a prevention activity.

Dr. Julie Baldwin
Associate Director of Research
Justice Programs Office, American University
In the US, military veterans experience higher risk and rates of suicidal behavior than the adult civilian population. The risk of suicide among veterans is 22 percent higher than that of civilian adults, and the rate of suicide is twice as high among veterans as compared to non-veteran adults. Although veterans comprise 8.5 percent of the US population, they account for 18 percent of suicide decedents. Suicide risk for male veterans is 19 percent higher than male civilians, and the suicide risk for female veterans is 2.5 times that of civilian females. Risk of suicide increases if deployment occurs during the first year of service or shortly after a previous deployment or if military sexual trauma is experienced.

The resources below in this month’s Spotlight center on suicide prevention among the military veterans and service members. These sources can help educate you and others on the threat and prevention of suicide among these groups. Explore them and the numerous materials compiled in the rest of this month’s newsletter to help you become part of the solution.

US Department of Veterans Affairs

US Department of Veterans Affairs

US Department of Veterans Affairs

The Real Warriors Campaign
Current Fact Sheets and Data Sheets
US Department of Veterans Affairs
The middle of this webpage contains a drop-down list of states for users to click on to obtain state-specific veteran suicide data sheets.

US Department of Veterans Affairs Office of Mental Health and Suicide Prevention
This fact sheet provides general trends found in the most recent analysis of veteran suicide rates from 2005 to 2015 conducted by the VA. It also shares information about new efforts being undertaken by the VA to prevent suicide.

US Department of Veterans Affairs Office of Mental Health and Suicide Prevention
This fact sheet outlines statistics on suicide among women veterans (the fastest-growing veteran group) and resources for suicide prevention.
Research Articles and Full Reports
US Department of Veterans Affairs Office of Mental Health and Suicide Prevention
Updated in June 2018, the full report reviews the study and results of data through 2015.

James Griffith and Craig Bryan
This article raises awareness about the rising rate of suicide among military personnel and discusses current prevention strategies. The authors examine the effectiveness of these current prevention methods, review their efficacy, and offer suggestions for future policies and practices.

Nathaniel Mohatt, Melodi Billera, Nathaan Demers, Lindsey Monteith, and Nazanin Bahraini
This article looks at the differences in veteran suicide rates between rural and urban communities. Specifically, rural veterans have a higher risk of dying by suicide than those living in urban areas. The authors offer a list of 70 practitioner and community resources for veterans’ suicide prevention and note a dearth of literature and resources focused on rural veterans.

Jack Tsai, Louis Trevisan, Minda Huang, and Robert H. Pietrzak
The study discovered that veterans with a history of homelessness are more than 5 times more likely to have attempted suicide the past two years than veterans who have never been homeless. The discussion focuses on the importance of continued funding for veterans’ homelessness outreach as a method of preventing suicide.

Marek Kopacz, Hugh Crean, Crystal Park, and Rani Hoff
The study examined the relationships between self-reported suicidal behavior and demographics, military history, depressive symptomatology, and positive and negative religious coping in a sample of 772 recent-era veterans. Female veterans, veterans experiencing depression, and veterans struggling to readapt to society were at greater risk. While negative religious coping increased suicide risk, no significant relationships were found with positive religious coping. 

Kirsten H. Dillon, Katherine C. Cunningham, Julia M. Neal, Sarah M. Wilson, Eric A. Dedert, Eric B. Elbogen, Patrick S. Calhoun, Jean C. Beckham, and VA Mid-Atlantic MIRECC
The cross-sectional study used self-report interview and survey responses from more than 3,000 veterans regarding their combat experience, posttraumatic stress disorder (PTSD), depression, and suicidality. Combat exposure was indirectly related to suicidal behavior. Specifically, combat exposure was significantly associated to PTSD-depressive symptomology, and PTSD-depressive symptomology was significantly related to suicidal behavior.

Elisardo Becoña

This article looks back at a 1975 Vietnam Veteran Study that examined opiate use in returning Vietnam soldiers. The author uses the study’s findings to argue that the biopsychosocial model of addiction is more appropriate than the brain disease model. Specific importance is placed on the 1975 study’s findings that many servicemembers who used heroin in Vietnam did not continue use after returning home.
Practitioner Publications
US Department of Veterans Affairs
This 39-page report outlines the direction the VA plans to take for suicide prevention from 2018 through 2028. Specific attention is given to improving communication and awareness, enhancing preventative services, improving medical resources and training, and increasing the level of research done on current interventions.
Substance Abuse and Mental Health Services Administration
Newly revised in 2018, this booklet outlines steps and precautions for family members to take after a loved one has attempted suicide. It covers what information the ER can use to better treat your relative, preventive strategies such as removing lethal means (weapons and/or medications) from the home, and establishing a plan for moving forward.
Multimedia Resources
(Webinars, Podcasts, Online Resources)
Objective Zero Foundation
This free smartphone application connects veterans, military members, and their families to peer support and mental health professionals via voice, video, and text message. The app also offers free access to wellness resources, such as yoga and meditation sessions, and a catalogue of mental health resources. 

National Center for Telehealth & Technology
A free smartphone application for behavioral health improvement in coping, relaxation, distraction, and positive thinking. Patients and providers can work together to personalize the content for specific needs.

September 13 12:00– 1:30 p.m. EDT
Center for Deployment Psychology
In this free webinar, a panel of experts will address why veterans with other-than-honorable discharges are at a higher risk for suicide and what communities can do in terms of prevention. This session is aimed at helping viewers gain a better understanding of the barriers these veterans face.

September 27 12:00–1:30 p.m. EDT
Center for Deployment Psychology
This free webinar advocates for reducing access to lethal means (e.g., firearms, medications) as a method of suicide prevention. The session also explains motivational interviewing techniques and creating safety plans.

The Council of State Governments Justice Center
This recorded webinar gives an overview of veterans involved in the justice system. It examines related statistics, describes components of Veterans Health Administration’s Veterans Justice Programs, examines the needs of veterans in contact with the criminal justice system, and presents new developments in the field.

Massachusetts General Hospital Psychiatry Academy
Massachusetts General Hospital Psychiatry Academy offers free courses and sessions for mental health professionals for improving care to the extended military community in collaboration with Home Base, a partnership between the Red Sox Foundation and Massachusetts General Hospital.
This act expands the VA’s ability to remit payments to day health facilities on behalf of veterans with service-connected disabilities.
Wisconsin has become the first state to issue alerts for missing veterans who are known to be suffering from service-connected physical and/or mental health conditions. Through this legislation, lawmakers hope to reduce the number of veterans’ suicides. The alerts are issued much like Amber Alerts and have been termed “Green Alerts.”
US H 3562 – Effective 6/1/2018
Allows for veterans with service-connected disabilities engaged in the VA’s Vocational Rehabilitation and Employment (VR&E) program to request that adaptations be made to their residence, if necessary.
Revises provisions relating to the voluntary preference for Veterans by private employers, revises the definition of member of the National Guard. 
Requires a person who commits certain offenses under the code of military justice to register as a sex offender or child kidnapper, relates to the Servicemembers Civil Relief Act, relates to contracts made by servicemembers, relates to nonjudicial punishment of members of the organized militia, relates to offenses subject to court-martial proceedings and criminal prosecution, relates to the Department of Public Safety. 
In the News
Event Calendar
Make Plans! Upcoming Events Notice

October 12-14: Groton, MA Women Veterans Retreat

September Events

Every Weekend in September: Across the Country - Out of the Darkness Community Walks

September 1: Forman, ND  Carry the Fallen Ruck March
September 5-6: Austin, TX 2018 Military Social Work Conference
September 8: White Bear Lake, MN  Carry the Fallen Ruck March
September 9-14: Iowa City, IA National Disabled Veterans Tee Tournament
September 13-16: Vernal, UT  Green River Rafting through the Gates of Lodore
September 14-16: Groton, MA Talk and Veterans Mindfulness Meditation Day
September 15: Bonners Ferry, ID  Carry the Fallen Ruck March
September 15: Ewa Beach, HI 13th Annual Patriot Run
September 16-22: National Wellness Week
September 16-21: San Diego, CA  National Veterans Summer Sports Clinic
September 17: Summerville, SC Women Veterans Healing and Well-being Group
September 20: Seattle, WA Minority Veterans of American Day
September 28-30: Lincoln, CA Women Veterans Alliance Unconference

September 5, 2018 - Radcliff, KY
September 6, 2018 - Billings, MT
September 6, 2018 - Indianapolis, IN
September 6, 2018 - Waterloo, IA
September 7, 2018 - Asheville, NC
September 7, 2018 - Bad Axe, MI
September 7, 2018 - Boston, MA
September 7, 2018 - Cedar Rapids, IA
September 7, 2018 - Dayton, OH
September 7, 2018 - Lumberton, NC
September 7, 2018 - Macon, GA
September 7, 2018 - Montgomery, AL
September 7, 2018 - Oklahoma City, OK
September 8, 2018 - Philadelphia, PA
September 8, 2018 - St. Augustine, FL
September 11, 2018 - Akron, OH
September 11, 2018 - Portland, OR
September 11, 2018 - Wichita, KS
September 13 - 16, 2018 - Pleasanton, CA
September 13 - 15, 2018 - Rock Island, IL
September 14, 2018 - Angola, IN
September 14, 2018 - Benton Harbor, MI
September 14 - 16, 2018 - Cumberland, RI
September 14 - 16, 2018 - Des Moines, IA
September 14, 2018 - El Paso, TX
September 14, 2018 - Evansville, IN
September 14, 2018 - Monticello, NY
September 14, 2018 - New Bern, NC
September 14, 2018 - Pensacola, FL
September 14, 2018 - Welch, WV
September 15, 2018 - Bapchule, AZ
September 15, 2018 - Hollywood, CA
September 15, 2018 - Vancouver, WA
September 18, 2018 - Huntington, WV
September 19, 2018 - Atlanta, GA
September 19, 2018 - Bend, OR
September 19 - 21, 2018 - Fresno, CA
September 19 - 20, 2018 - Lakeport, CA
September 19, 2018 - Midland, TX
September 20, 2018 - Canton, OH
September 20, 2018 - Medford, OR
September 20, 2018 - Morris Plains, NJ
September 20, 2018 - Nashua, NH
September 20, 2018 - Roseburg, OR
September 21, 2018 - Brownsville, TX
September 21, 2018 - Cherry Hill, NJ
September 21, 2018 - Dover, DE
September 21, 2018 - Durham, NC
September 21, 2018 - Jackson, MS
September 21, 2018 - Kalamazoo, MI
September 21, 2018 - Muncie, IN
September 21, 2018 - Myrtle Beach, SC
September 21, 2018 - Reno, NV
September 21, 2018 - Ridgecrest, CA
September 21, 2018 - Rocky Hill, CT
September 21, 2018 - Sioux Falls, SD
September 22 - 24, 2018 - Compton, CA
September 22 - 24, 2018 - Milwaukee, WI
September 22, 2018 - Pittsburgh, PA
September 22, 2018 - San Carlos, AZ
September 25, 2018 - Marion, IL
September 25, 2018 - Winona, MN
September 26, 2018 - Bemidji, MN
September 26 - 27, 2018 - Detroit, MI
September 26, 2018 - Mishawaka, IN
September 26, 2018 - Muskegon, MI
September 26, 2018 - Northport, NY
September 27, 2018 - Franklin, NC
September 27, 2018 - Grand Rapids, MN
September 27 - 28, 2018 - Great Falls, MT
September 27, 2018 - Honolulu, HI
September 27, 2018 - Panama City, FL
September 28, 2018 - Alexandria, LA
September 28, 2018 - Beaumont, TX
September 28, 2018 - Chillicothe, OH
September 28, 2018 - Greensboro, NC
September 28 - 30, 2018 - Logan, WV
September 28 - 30, 2018 - Monterey, CA
September 28 - 29, 2018 - Prescott, AZ
September 28, 2018 - Riverside, CA
September 29, 2018 - Bremerton, WA
September 29, 2018 - Greenville, MS
September 29, 2018 - Mercer, PA
September 29, 2018 - Moses Lake, WA
September 29, 2018 - Pueblo, CO
September 29, 2018 - Tulsa, OK
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Our mission is to inform policy, practice, and scholarship through the distribution of current veterans treatment court-related resources.   
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