Preventing Suicide Among Servicemembers And Veterans

March 18, 2011 -- The calls come pouring in to the National Veterans Crisis Hotline in Canandaigua, N.Y. There have been some 400,000 since the center first opened in July, 2007 and many of those calls result in rescues, including one just this past weekend.

"A servicemember called the hotline and said he intended to hang himself. He did agree to let our counselor call his wife, she was able to figure out where he was…the local emergency responders caught him just as he kicked out the chair," said Dr. Janet Kemp, national director of the Suicide Prevention Hotline at the Department of Veterans Affairs.

There is no doubt that the wars in Iraq and Afghanistan have taken a staggering toll on America's military men and women. A stunning report issued last year showed that in 2009 more soldiers died from non-combat injuries – like suicide – than in war. The harsh reality is that too many soldiers are dying at their own hands, and the question is how best to prevent it.

Dr. Kemp and 1,100 other attendees are in Boston this week at a suicide prevention conference – a joint collaboration between the Veteran's Administration and the Department of Defense – to try to answer that question.

"We usually get about 11,000 calls a month and we would expect with the economy the way it is and more servicemembers coming home that our calls would increase but they haven't, they've flattened out…that led us to believe that we're not reaching everyone," said Kemp. "We know that Thursdays are our highest call volume days, but we don't know why. We know that late winter and early spring our calls increase but, again, we don't necessarily know exactly why," said Kemp.

Still, the calls continue.

A typical exchange goes something like this. A soldier picks up the phone and begins the conversation this way "I'm not sure this is the right place but…" at that point they indicate some level of mild distress; perhaps it's a simple relationship problem, or maybe a job-related issue and then as the call continues they might say "Oh, and by the way, I have been diagnosed with Post-Traumatic Stress Disorder (PTSD)" or "by the way, my wife just left me." Kemp refers to these as the "by the way" calls, when the real reason for the crisis only becomes apparent deep into the conversation.

Those kinds of dark feelings are familiar to Major Ed Pulido. In 2004, an IED exploded under an SUV Pulido was driving in Iraq. He suffered a broken arm, leg, and pelvis. Heavy pieces of shrapnel were lodged in his stomach. But the hard part came almost two months later when doctors told him they would have to amputate his left leg because of an infection. Not long after that Pulido found himself alone one night and struggling. "I had a very supportive family but I just kept thinking how am I going to take care of them like this? How am I going to keep it going?" said Pulido.

After hitting bottom, it took months for Pulido to claw his way out of despair. These days he is full of energy and eagerly shows off his titanium leg plastered with American flags. He has a simple message for other veterans: "It does get better and don't give up."

But for those who still struggle with mental health issues, the hotline is a key resource designed to address the specific needs of servicemembers. If a caller is enrolled in the VA healthcare system, their medical records can be instantly accessed by a counselor on the other end of the phone. And information from the hotline consultation gets dropped right into their medical file. All counselors are trained to understand the specific mental health risk factors involved in serving in the military – the difficulty of re-entry to civilian life for instance, the trauma of PTSD or the emotional difficulty of dealing with changed family or employment circumstances.

Recently a call came in to the center from a young man living on a houseboat in New York harbor. He called the crisis line on his cell phone. He said he wanted to pass along some messages to his loved one and then, said Dr. Kemp. His intention was to just head out of the harbor on his boat and not come back. "We were able to keep him on the phone for a bit and contact the New York Harbor Patrol. As he dropped the call for the last time, they were able to get his location and they did bring him back," said Kemp. Or there was the mother talking to her active duty son via Skype. He grabbed a gun and threatened to kill himself while she watched. "The mother was able to call us," said Kemp, "and we stayed on the phone while emergency personnel were dispatched to the scene." The mother actually watched the rescue on her computer, Kemp said.

The suicide prevention conference wraps up this week in Boston.

The number for the National Suicide Prevention Lifeline is 1-800-273-TALK (8255).