With ranks of suicidal veterans swelling, hotline offers help
By MEG JONES | Milwaukee Journal Sentinel (Tribune News Service) | Published: March 12, 2015
Despondent over a breakup, the caller admitted he had relapsed into drug abuse and was afraid he'd lose his job as a long-haul trucker.
He no longer wanted to live.
From her office in the Milwaukee VA Medical Center, Karen Gage listened to him pour out his story as staffers at the Veterans Crisis Line pinged his cellphone in a frantic effort to learn his location. She reminded him that "we all change our minds. Suicides always start with a thought, and thoughts change."
The caller — a veteran from eastern Wisconsin — stayed on the line with Gage for three hours. When he was pinpointed in Tennessee, she gently talked him into driving to the closest VA hospital. As the man pulled in, Gage asked him to hand his phone to a suicide prevention coordinator just like herself.
Then she breathed a sigh of relief.
The VA estimates that 22 veterans commit suicide every day — men and women who served in peacetime and war, officers and enlisted personnel, all ages and from all military branches.
Many more, like the long-haul trucker, call the Veterans Crisis Line in New York. Hotline staffers ask veterans for permission to contact the VA hospital nearest their home. If they agree, they're referred to suicide prevention teams at those hospitals.
Their efforts have gained recognition in the film "Crisis Hotline: Veterans Press 1," which won the Academy Award last month for best short documentary. The movie is being screened Thursday at the Milwaukee VA Hospital.
Since the hotline started in 2007, calls and referrals have increased every year and now reach 22,000 annually.
Closer to home, the Milwaukee VA region — 14 counties in eastern and southeastern Wisconsin from Green Bay to Kenosha — handled 74 referrals in fiscal year 2009. The number increased to 106 the next year, 162 in 2011, 253 in 2012, 395 in 2013 and 516 last year. In the Madison VA region of 15 southern Wisconsin counties and five northern Illinois counties, the number of referrals from the crisis line has also increased dramatically — 41 in 2010, 82 in 2011, 88 in 2012, 121 in 2013 and 227 last year.
A few years ago, text and chat functions were added to the hotline and the number of contacts jumped.
"Maybe they feel better talking via chat or texts to say what they're feeling and thinking," said Gage.
Not all hotline callers are suicidal. Some are depressed or homeless or abusing alcohol or drugs and know they need help. Sometimes family members, friends or co-workers call the crisis line because they suspect something is wrong with a veteran. Some referrals come via Facebook. Staff members at the crisis line triage callers and determine who needs immediate help and who should be advised to go to their local VA for services in a day or two.
Local VA teams follow up, encouraging callers to come in and meet with mental health professionals to determine what kind of services they need. That can range from in-patient care to residential programs, therapy, drug and alcohol addiction treatment, and family counseling. Veterans can be enrolled in services on the spot, without a referral from a primary doctor.
Lists of problems
The reasons veterans become suicidal are complex and often, though not always, stem from their military experience. Some suffer from post-traumatic stress related to combat. Some suffer from post-traumatic stress because of sexual assaults while they served in the military. Some have trouble re-integrating into society after they return home or switch from their highly structured life in the military to an unfocused life in the civilian world. Some can't keep a job because of their addictions or pain from injuries or chronic medical problems. Some have trouble maintaining relationships. Some are alone and homeless.
"Most people have a list, sometimes a long one, of things wrong in their life," said Nancy Krug, suicide prevention coordinator at the William S. Middleton Memorial Veterans Hospital in Madison. "Often it's a combination of relationship problems. A common one is problems with sleep, substance abuse, anxiety, PTSD and depression."
While an array of issues can lead veterans to think about suicide, stressors often act as a trigger, like a breakup or a job loss — or a Hollywood blockbuster that opens a Pandora's box of emotions.
"With the movie 'American Sniper' we've had veterans that weren't even in the system come in," said Eileen Ahearn, a psychiatrist and medical director of mental health at the Madison VA. "For some of our veterans with PTSD, it's a difficult film to watch because it rekindles their PTSD symptoms. We've tried to discourage some of our veterans from seeing the movie."
Because of the warrior ethos, many don't want to seek help since that could be construed as a sign of weakness. Or they turn a blind eye to what they know is a problem.
"A lot of times they ignore it or don't do anything about it but then it begins to spill over into their jobs, their families, their relationships," said Jason Fischer, a clinical social worker at the Milwaukee VA who works with Iraq and Afghanistan veterans. "When I talk to veterans it's a sense of hopelessness, nothing is going right and they don't know where to turn."
When she's on the phone with a suicidal veteran, Krug asks them how long they have been thinking about ending their life and what previously stopped them from carrying out that impulse. Often they'll say it's because they didn't want to leave their dog or they got drunk or high and the feeling passed.
Ultimately, it's up to veterans to take control of their lives. VA staffers can admit them to in-patient care or provide temporary housing vouchers or enroll them in job training or myriad other steps, but it's up to veterans to go to therapy or find a job or attend family counseling. Usually when they do, they get better. But not always.
Neither Gage nor Krug have lost a veteran to suicide while on the phone. They know, however, that the veteran may take that step weeks, months, even years after the initial contact. When that happens, mental health teams invite family members to come in for counseling, and also gather to discuss the case and offer each other support.
"It's difficult for a team because we work with a lot with our veterans and we do take it hard. You have to put a lot of yourself into the job and it's hard to lose someone," said Ahearn.
The Veterans Crisis Line is (800) 273-8255. Chatting also is available at www.veteranscrisisline.net and by texting 838255.
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