'Suicide prevention must start before crisis intervention'

Suicide. It’s becoming America’s largest epidemic, cutting a swath of pain and suffering to young and old alike. It’s wreaking havoc on active duty military personnel, veterans and their families. It’s stealing hearts, futures and hope.

The American Legion hosted a Preventing Suicide: Educate, Inspire, Mobilize discussion in its Washington, D.C., office Sept. 12, in conjunction with National Suicide Prevention Week. A panel of speakers discussed this crisis with guests who must face the ghosts personally and professionally.

“We are in the midst of a crisis that is assaulting our veterans and active duty servicemembers where they are fighting battles here at home,” said George Mitchell, American Legion deputy director of health policy, in his opening remarks. “We are in the midst of a crisis that is devastating families and the communities across our nation.”

Preventing suicides is not an easy task. It is a task that can be complex, hard to detect and quixotic. Suicide can be an ongoing underlying fight, or a sudden decision that can leave survivors and those who have attempted suicide bewildered and confused.

Chief Warrant Officer Cliff Bauman attested to this personally during his remarks. He is a survivor of an attempted suicide.

Bauman was a first responder after the Sept. 11, 2001, attack on the Pentagon. He internalized his experiences on that fateful day – the impact to his senses, smell and touch – and those that followed. He knows today that post-traumatic stress disorder (PTSD) was stalking him. It started with alcohol, as well as with nightmares of what he saw and what he did.

Bauman said his work suffered, he denied he was dealing with a crisis, and he refused help. All classic symptoms of suicide. Compounding his crisis is that suicide was treated negatively by the military. It was different, a very different time for treating PTSD and a suicidal person.

Bauman’s life changed forever in 2002, when he attempted to end his life at his brother’s house in Kansas City, Mo. “I don’t quite know what triggered me that night,” Bauman said. “With a bottle of pills and drinks on the table, I wrote a suicide note. I wrote I was tired of the guilt of not finding anyone else alive, from the attack at the Pentagon, and I took over 20 Ambien pills and I laid on the couch.”

Bauman’s brother, a nurse at the Truman Medical Center nearby, had an unsettling feeling about his brother while at work and called the house. No answer. His brother rushed home and found Bauman near death.

Unfortunately, the story of Daniel Somers had to be told to the panel by his surviving parents.

Daniel served as a sergeant in the California Army National Guard and was married to his high school sweetheart. He was federalized for active duty in 2004, sent to Iraq and suffered from PTSD and a traumatic brain injury (TBI). His parents shared with the panel via teleconference how Daniel grasped for peace from the nightmares, guilt of war, frustrations with the system and hopelessness.

In 2013, Daniel ended his life by a single shot to his head in the parking lot of the Phoenix VA medical center.

“There was and remains a huge shortage of mental health providers not only in the VA but the community at large,” said Dr. Howard Somers, father of Daniel. “We still have the need to educate our community providers about military culture.”

At the time of Daniel’s death and even today, his parents believe the VA is reluctant to refer veterans suffering from PTSD and TBI to outside providers during a crisis situation. Furthermore, Howard said the VA did not share with them the knowledge of other programs available to those facing this type of crisis.

“VA was not in compliance with their own regulation to make a bed available to a veteran needing urgent treatment within the VA facility or the private community,” Howard said. “There is a huge need for a community support network … and that the VA should transition to centers of excellence for service-related injuries. As some people say, VA should do what VA does best.”

Dr. Mathew Miller is a psychologist and acting national director for suicide prevention at the VA. He pointed out the need for hope for those contemplating suicide, and for families either trying to help the suicidal veteran or have to deal with the aftermath of this devastating action.

“ The message we are attempting to convey is that suicide prevention must start before crisis intervention,” Miller said. He added that while the system is making great strides in improving reaction time, case referral and resources to assist veterans facing a crisis, suicide continues to be an elusive enemy and far more needs to be done.

“In each of the suicide reports of veterans over a given year, something stood out to me in the pages and it broke my heart. In several situations veterans who died by suicide had the Veterans Crisis Line phone number in their pants pocket,” Miller said.

More must be done “upstream,” Miller added. “The suicide prevention mission belongs to all of us. It is an eternal battle.”

Mathew Campbell is a combat veteran and Navy hospital corpsman who served two tours in Iraq. Within weeks of transitioning out of the military in 2008, Campbell said he lost the mission-minded purpose he was used to.

“It is our duty and our job to be there for one another,” said Campbell, a field based implementation team consultant with the VA’s Office of Patient Centered Care and Cultural Transformation. He believes reducing the number of suicides is a group effort. “I challenge you to pick up the phone, to text, to message them. To be that brother or sister.”

Miller shared some elevated risks that veterans face during times of transition, such as financial hardship, that can play a role in the minds of a suicidal individual. Identifying these factors and initiating outreach is an important step the VA, friends and family need to be aware of to help.

Bauman’s recovery from his suicide attempt has helped provide insight for him and he believes has changed the culture of suicide in the military. No longer is the discussion of depression, mental illness or TBI a PowerPoint presentation during a lengthy briefing. “What they’ve found out is that (telling personal stories) helps enhance the training,” Bauman said.

Dr. Heather Kelly, director of Military and Veterans Health Policy for the American Psychological Association, served as the discussion moderator. Kelly said that the VA has worked hard over the past 20 years to develop outside partnerships to address the veteran suicide crisis. She advised that there are programs available to help deal with this issue, but the money must be effectively spent.

“If you want to help, you need to be willing to evaluate your programs and make sure these precious resources get to those needing assistance,” Kelly said.

Howard Somers concluded the discussion with a reminder that “the upstream support is so important. If we can get people educated to what our servicemembers are experiencing and make them aware of some of the issues they might be suffering from and the resources available in and out of the VA, we might get better outcomes.”