Part of a fast-growing national and local effort to boost veteran suicide prevention resources, Forefront panelists were among many local voices in the systemic effort to create suicide-safer world for veterans and their loved ones.
For too many veterans, the transition to the civilian world is fraught with difficulties that put them at higher risk of suicide than the general public. This includes trauma, health issues, loss of identity, and a lack of benefits and crisis resources for those who have received an OTH (Other than Honorable) discharge.
The 5th Annual Mental Health Summit explored services available, through panel discussions regarding several key themes: Suicide prevention, family services and how to access care. With Forefront’s Safer Homes, Suicide Aware campaign launching on World Suicide Prevention Day, veteran-specific issues also figure prominently into the discussion.
Forefront advocate Jo Arlow spoke on the summit’s Family Services panel, sharing the experiences of her late Navy SEAL husband’s struggles prior to suicide.
“Five years ago, my husband was still alive. I didn’t know where to send referrals to get him help, and I didn’t have the words to describe what was wrong,” said Arlow. “More and more groups are using non-traditional approaches (to healing). If only I had known what I know now – that he could have had the support of peers, a community where we could call fellow vet, take the gun temporarily, and make bonds to reduce isolation.”
Training and education, a peer-to-peer support model, and temporary removal of lethal means are some elements of the Safer Homes, Suicide Aware campaign.
For families – who struggle with the “secondary trauma” of a loved one’s transition back to civilian life – framing the struggles with specific language is also key to finding pathways to healing. That includes understanding the nuances of moral injury – the profound spiritual and emotional impacts that occur when one’s actions (such as in combat) deviate from their personal moral code.
“PTSD and moral injury look similar, but are different,” Arlow said. “My husband had both. He was very much a warrior type, but his heart was broken by his moral injury.”
A 1960s-era veteran in the audience described how until recently, there was no term for PTSD: “People my age are walking around with PTSD, and they don’t even know,” also adding that symptoms were referred to as “suicide headaches.”
To prevent veteran suicide, change must happen at multiple levels
Forefront co-founder and faculty director Jennifer Stuber spoke on the Suicide Prevention breakout panels with Michelle Borsz of VA Puget Sound Health Care System, Jolee Darnell of Joint Base Lewis-McChord, and Tory Gildred of Zero Suicide Puget Sound and Coordinated Care.
In this panel, a similar approach emerged: Enlisting medical providers as foot soldiers in the fight against veteran suicide. Data shows that about half of all individuals who died by suicide had visited their doctor in the month before death.
This is the impetus behind Forefront’s launch next week of All Patients Safe – a six-hour training developed by and for medical providers. Washington is the only state to require all medical providers to take a one-time suicide prevention training – and the outcome of that will also impact early intervention of the state’s veterans struggling with suicidality.
“There’s a big focus on the Veterans population – some of the actors are Veterans themselves,” Stuber said.
That includes Peter Schmidt, the Behavioral Health Programs and PTSD program director of Washington State Department of Veterans Affairs – as well as Brett Bass, a Marine who is a range manager at West Coast Armory and Bellevue Gun Club.
“It’s time to integrate physical and mental health. We know that many veterans who are receiving services go to community-based care. It’s important that we’re meeting them at the front line,” said Stuber. “If we’re not engaging with them at the primary care level, we’re losing them.”
Understanding the link between firearm ownership and veteran suicide is another preventative pathway, she added. With half of all suicide deaths being by firearm, “for veterans thinking of suicide, access to firearms can be deadly and temporarily removing firearms can be life-saving.” So is boosting capacity for our state’s suicide prevention hotlines and crisis call centers, to ensure that calls from local vets are not dropped, left on hold, nor routed to another state.
Taking the “200,000-foot view of suicide prevention” includes involving community services in an integrated suicide prevention system, said Gildred – as opposed to the traditional mindset of viewing it as solely a behavioral health problem.
There are instances where a screening questionnaire helped non- behavioral health doctors to identify risk among their patients. “That’s the culture of zero. That’s why primary care is so critical: They can identify risk, and then do same-day treatment,” said Gildred.
Exciting initiatives, resources on the horizon for Washington veterans
From telehealth services to the upcoming launch of the nation’s first same-day opioid addiction treatment clinic, many local organizations and agencies are making innovative efforts to better serve those who have served our country.
Among all of us, we can agree: We’ve got to reach our vets early and often, to improve access to care, involve Veteran family members and loved ones as one unit; and to do this, we’ve got to work together on a systems level to better serve those who have served our country.
That system includes an ever-widening net of Safer Homes partners – including those who sell firearms.
“That’s why you need to know when to keep firearms locked up, and that’s why you need to know the (suicide intervention) steps. The Safer Homes, Suicide Aware campaign is changing that knowledge working collaboratively with Second Amendment Foundation in a friendly way,” Stuber said.
The summit’s sponsors include: National Alliance to End Veteran Suicide, Give an Hour, Washington Department of Veterans Affairs, Veterans Training Support Center, King County Veterans Program, and VA Puget Sound Healthcare System. It was funded by the King County Veterans and Human Services Levy through a contract with the Washington State Department of Veterans Affairs.