More Americans die from suicide than from car accidents or combat, according to the U.S. Centers for Disease Control and other sources. That includes an average of 22 veterans who take their lives each day.

Jan Kemp is determined to do all she can to reduce those numbers in her role as VA's national program director for suicide prevention and community engagement. VA's Veterans Crisis Line has fielded more than 890,000 calls and logged 30,000 lifesaving rescues since 2007.  In 2009, it added an online chat service followed by a text service in 2011 that provides veterans with another way to confidentially connect to mental health counselors 24 hours, seven days a week, 365 days a year.    In addition, there's the PTSD coaching app for smartphones, and “Make the Connection" website with videos of American Legion members and other veterans speaking about the benefits of seeking help. "Selling the story of hope is important," Kemp says. "Getting help does make a difference."

The American Legion provided valuable input leading to VA's rebranding its suicide hotline as the Veterans Crisis Line which encourage veterans in need to reach out. The Legion also provided input on Make the Connection, VA’s campaign to reduce the stigma associated with mental health treatment.

The American Legion Magazine recently spoke with Kemp about the suicide problem and the role veterans can play in addressing it. 

Who's most at risk for suicide? 
Veterans at risk for suicide look a lot like Americans at risk for suicide. They have experienced loss or trauma, have issues with substance abuse, or are at periods in their life when things are changing for them, such as retirement. Veterans may have more risk factors. They have experienced combat trauma. Often they have also had some difficulty with readjusting back to civilian life. 

More than half of servicemembers who kill themselves never deployed. Why are they taking their own lives? 
We don't know for sure. But even if you don't actually go fight the battle, you feel the stress of war. For our younger veterans, very early adulthood also is a vulnerable time for figuring out who they are and what they're about.

What VA suicide prevention efforts are working?
We're seeing good results with veterans who are engaged in care. So if we're able to identify someone as being at high risk, we have a whole package of care that we provide for them, including safety planning. We flag their records so people know they're in danger. We send out mailings to them and have frequent contacts with them. And that appears to really be making an incredible difference. 

What can American Legion members do?
You are the ones who are out in the community, and we rely on you to be our eyes and our ears for people in trouble. And it's through efforts like the ones that the Legion has made that we've really been able to educate friends and family. Over the past year, the number of friends and families who have called the crisis line on behalf of a veteran has climbed.

Is a veteran more receptive to hearing "you need to get help" from another veteran?
It's important for veterans to hear the message from someone who has experienced some of the same things they have experienced. They need to know that there's life on the other side of this trouble that they're in. And I think that's where Legion members have really stepped to the plate. They aren't afraid to say, "You know, I came back and I had a tough time, and it was hard, but look at me today. I have made a life that's worth living."

What can families do to help a veteran in crisis?
Encourage them to get help. Go with them for services and be supportive. Let their veterans know that while they can't understand and won't understand, they would like to, and that they still love them and care about what happens to them and their families. Sometimes contact with people who love you and care about you and are not going to go away makes an incredible difference. 

Is it appropriate for family members to ask a veteran if he or she is contemplating suicide? 
It's a very appropriate thing to do, and a good way to word it is to say something like, "You know, I've heard of other veterans or other soldiers who have felt so badly about something that they've killed themselves or they've thought about suicide. Is that something you are thinking about? Is there anything that I can do to help you?"

Does asking about it reduce the number of suicides?
It does. A lot of times, people will answer "yes" if someone comes right out and asks the question. They have unconsciously been waiting for someone to ask. Of course, there are people who are going to say no. And there's nothing you can do about that. But more often than not, they're going to say something like "sometimes" or "maybe" or "I think about it once in a while." It's easy then to say, "Let's get you some help."

So don't take no for an answer?
Don't give up. Maybe a week later, say, "You know, you're still not acting right." Or "You still look very depressed to me. And I'm still worried about you. Can I ask you again? Are you thinking about killing yourself?" And sometimes it's OK to say, "Well even if you're not suicidal, you don't deserve to be this unhappy. So we can get help for that." People don't need to be imminently suicidal to get mental health services. Certainly the ultimate goal is to improve the quality of people's lives.

– Ken Olsen