Suicide, and an increase in adults committing it, is a growing concern among mental health professionals. Military veterans are among those who end their lives each day. A recently-released U.S. Department of Veterans Affairs report offers mixed trends over a 12-year period.
The VA's most recent annual report on veteran suicide prevention features data collected up to and including the year 2017. In 2017, 43,950 American adults took their own lives. Among them were 6,139 veterans. After adjusting for population differences in age and sex, the suicide rate for veterans was 1.5 times the rate of non-veteran adults.
Overall, annual suicides increased by 43.6 percent between 2005 and 2017. Among veterans, that increase was 6.1 percent. But there were upward and downward trends along the way. The deadliest year for veteran suicides within the report was 2014, with approximately 6,300 cases. The number fell to about 6,000 in 2016 but began ticking upward again in 2017.
The reasons why a veteran may commit suicide vary. But mental health professionals and counselors say there's a common theme among veterans battling a mental health problem. Many keep their pain hidden away.
"Veterans, of course, come up in a culture of strength. They come up in a culture of basically being a warrior," said Karl Shallowhorn, an education program coordinator at the Community Health Center of Buffalo who was recently elected chair of the Erie County Anti-Stigma Coalition. "We recognize that our veterans are, often times, indoctrinated in a way that they are shown they cannot demonstrate weakness."
And it's that belief that speaking out is a sign of weakness which keeps many veterans from getting needed help. There's a broader recognition and understanding of Post-Traumatic Stress Disorder now than several decades ago. Vietnam veterans, for example, also came home with traumas acquired from the battlefield.
"But it was also compounded by the whole issue of the country at that time being divided," said Max Donatelli, past chair of the Erie County Anti-Stigma Coalition and a Vietnam veteran who served as a mechanic with the United States Air Force. "There were a lot of protests going on, on college campuses. There were a lot of riots. There were a lot of not only anti-government but also anti-military."
Donatelli, Shallowhorn and other mental health advocates say it remains a challenge to eliminate the stigma related to mental illness, the negative and sometimes unfair images of those who are struggling with it. Donatelli says mental illness is more common than many may realize. He said one in every five people are living with or will one day face some form of mental illness, from depression to a condition more serious.
"It could be caused either genetically, or passed on from family member to family member, or it could be a person experiencing a trauma," Donatelli said. "Or, just everyday stress of life and, depending on the person's ability, to be able to cope with that."
Getting the person struggling with mental illness to speak out about one's case is the first step toward treatment. Getting veterans to talk, given their culture that seeking help is a sign of weakness, is even more difficult. Shallowhorn says the key is to convince them that speaking out and asking for help is not a sign of weakness but, rather, a sign of strength.
"Sometimes there's a feeling that 'they can't relate to me,' the professional, they only learn from the book," he said. "That may be the case but many clinicians are very skilled and able to help. Sometimes, I think the job of a clinician is to make the person they work with comfortable enough to open up, by engaging in what we call a good therapeutic relationship."
The VA's suicide prevention efforts include a new universal screening for suicidal intent, and in fiscal year 2018 provided more than 2.4 million same-day mental health appointments. It also provides online, text and phone lines for those in need of immediate help. The Veterans Crisis Line dispatched emergency services for callers in danger an average of 80 times per day in 2018.
Shallowhorn praises New York State for making mental health education a required part of the school curriculum since 2018, but says children of veterans also need their own support networks. He named one such program, Operation COM, or Children of the Military, a program offered by the Veterans One-Stop Center of Western New York.
Anyone who may be pondering suicide, or knows someone who is, is encouraged to contact the National Suicide Prevention Hotline at 1-800-273-8255 (TALK).