By Meg Lacy (Doctoral Student, Palo Alto University)
As our Vietnam veteran population ages, many may become increasingly vulnerable for death by suicide. Despite the fact that the Vietnam war occurred approximately 40 years ago, the moral injuries sustained are still felt by many who served our country. It is not unusual for Vietnam Veterans to have coped with difficult times by staying busy at home or at work. As retirement looms, it is not unusual for Vietnam era veterans to experience additional age-related risks such as social isolation, a feeling of burdensomeness, and changes in health status.
These changes can coalesce to hamper coping strategies that previously worked to manage mental distress, such as depression and posttraumatic stress disorder. Alcohol and substance use increases the risk of suicide as the abuse of substances, particularly alcohol, is strongly associated with both suicide attempts and deaths. So what should friends and family watch out for and what could be done in response to warning signs?
In general, individuals most at risk of suicide are white older adult males who have health issues. As risk factors associated with veteran status converge on risk factors associated with later life , there are a few specific things friends and family should be aware of.
What’s going on in their life?
- A major change in routine including retirement or loss of a job
- The death of a spouse
- A new medical diagnosis
- A break up, separation or divorce
- Not having a stable place to live
- Inadequate family income
How are they behaving?
- Increase in drinking or drug use
- Sleeping considerably more or less
- A loss of interest in things they typically enjoy
- Social withdrawal
- Impulsivity – engaging in risky behavior (running red lights, driving recklessly, looking like they have a “death wish”)
- Becoming aggressive- examples of this are punching holes in walls, seeking revenge, getting into fights
- Anxiety- worrying excessively about things they cannot control
- Agitation and mood swings
- Putting affairs in order such as giving away prized possessions or making out a will
- Seeking out firearms access to pills
- Neglecting personal welfare including deteriorating physical appearance or hygiene
What are they saying?
- A sense of hopelessness:
- “I have no purpose”
- “I have no value”
- “Nothing is ever going to get better”
- Rage or anger: expressed toward people or things
- Expressed feelings of excessive guilt, shame or failure:
- “My family would be better off without me”
- Feelings of desperation:
- “There is no solution”
- “I just feel trapped”
What do they have access to?
Familiarity and access to a firearm makes suicide by firearm more likely. Any means by which a suicide can be attempted, including pills, is something that should be asked about. Veterans are more likely to own a gun and be comfortable using one making death by firearm a common means of suicide among this population.
How can you help?
Social support is one of the most effective protective factors against suicide (Cummings et al., 2015). However, many veterans have isolated themselves and their friends and family struggle to talk to them. Inviting them to an event, writing them a letter or participating in a shared activity (building something, fishing, walking, etc.) are great ways to get things started.
Talk about it. Suicide is an uncomfortable topic but its best to be direct. Ask overtly if they are planning on killing themselves or have had thoughts about killing themselves. Just because they say no doesn’t mean that they don’t still have suicidal intentions so be sure to have additional information to provide such as a suicide hotline number for veterans, apps they could utilize (PTSD Coach), or a therapist’s contact information.
If your loved one has a plan or tell you they are going to kill themselves, call 911. Its better to put their safety first. Demonstrating your support by seeking additional help is always best. If you can, include them in the process of seeking immediate help. Calling 911 or visiting the ER does not have to be a one-sided decision.
These by no means are the only risk factors, signs or solutions for suicidality. However, engagement with friends and family has shown to be extremely effective against suicide. Demonstrating your support with regular calls or visits is an important step toward safety for many veterans.
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Meg Lacy is a first year doctoral student at Palo Alto University. She is interested in researching early intervention to trauma in combat soldiers and amongst first responders. Additionally, she is interested in the veteran population and suicide prevention.
Image source: Flickr user Elvert Barnes via Creative Commons