Hotline Proves Valuable Tool in Preventing Vets' Suicides

It's tough enough being a military veteran with memories of war still racing around inside your head, but it can get bleaker when the current conflict charges into your living room through the television set.

When Thomas Berger, Ph.D., senior analyst of veterans' benefits and mental health issues for the Vietnam Veterans of America, heard that a documentary about an emergency room in Iraq was scheduled to appear, he called Janet Kemp, R.N., Ph.D., national suicide-prevention coordinator for the U.S. Department of Veterans Affairs. Kemp made sure that the VA Suicide Prevention Hotline had extra staff on hand on the nights the program was aired.

In its first 13 months of operation, through August, the Suicide Prevention Hotline fielded more than 69,000 calls, of which more than 32,000 identified themselves as veterans, their family members, or friends, Kemp told members of the House Veterans Affairs Subcommittee on Health in September. Another 789 calls came from active-duty military personnel who were eventually referred to Department of Defense sources of care. The other calls came from non-veterans or persons who did not disclose their status.

The two biggest groups of callers who stated their era of military service were veterans of the current conflicts or the Vietnam War.

The system referred 5,980 calls to suicide-prevention coordinators at VA medical facilities around the country. The call system led to 1,628“ rescues,” events in which a caller is in imminent crisis, and police or ambulance services are sent to the caller's address.

The hotline is based in upstate New York, near the Canandaigua Center of Excellence for Suicide Prevention. The VA call-in system uses the federal Substance Abuse and Mental Health Services Administration's National Suicide Prevention Lifeline at (800) 273-TALK, but prompts veterans to“ press 1” to reach one of six phone lines staffed around the clock by nurses, social workers, or psychologists who have been specially trained as responders, she said.

The VA is taking steps to increase awareness of the hotline, Kemp said in response to a question from subcommittee Chair Michael Michaud (D-Maine).

In June, VA Secretary James Peake over-turned a ban on paid advertising to support the hotline, but the VA is still developing a request for proposal for advertising services and measurements.

A pilot program in the Washington, D.C., area used advertisements in buses, subway stations, and subway cars to inform veterans about help available through the VA's suicide hotline.

The campaign led to doubling the number of calls from the region, and radio announcements have been effective in rural areas, Kent said. “But it will take a lot of different methods to reach a lot of different segments of the population.”

Call-center personnel in Canandaigua ask the callers for permission to look at their VA medical records and see if the caller is enrolled in the VA, she said.

Once or twice a day, all the lines are in use, so the call center can switch additional incoming calls to overflow call centers with staff trained to handle calls from veterans.

An average of 18 veterans commit suicide every day, noted Kemp. The Department of Veterans Affairs convened a panel on suicide prevention during the summer. Among other points, the panel recommended that the VA design a study to identify suicide risk among veterans, improve suicidality screening for veterans with depression or posttraumatic stress disorder, apply evidence-based research to the choice of treatments, and increase research about suicide prevention.

In his testimony to the subcommittee, Berger praised the VA's hotline—especially “in the absence of any yet implemented VA national suicide surveillance plan or program”—but said that the hotline could do more to track the daily number of calls, collect clinical information (such as prior suicide attempts) and combat status during the call, and employ a tracking system to follow up with callers.

In related news, the U.S. Army announced that 62 soldiers had committed suicide through August. The service was investigating 31 deaths as possible suicides. There were a total of 115 suicides in 2007 and 102 in 2006, according to data previously released by the Army.

Concerned about the rising numbers, the Army Surgeon General's office announced expansion of its suicide prevention programs, moving from education and awareness efforts to training soldiers and their families to“ actively intervene” when signs of suicide appear.

More information on the hotline is posted at<www.suicidepreventionlifeline.org/Veterans/Default.aspx>.▪