Preventing suicide in US veterans

Clinical resources

Suicide Prevention Mobile App. This mobile phone app, hosted by the Substance Abuse and Mental Health Services Administration,²⁵ is a training tool to reduce veteran suicide. It is free for primary care providers. A five-step approach is used for suicide risk assessment, conversation starters, training and resources, behavioral and treatment locator services, and case studies.

The Durkeim Project. This research project was launched in 2013 by Patterns and Predictions and The Veterans Education and Research Association of Northern New England, with support from Facebook. It monitors suicidal behaviors in veterans and active duty military personnel on social media (Twitter, Facebook, LinkedIn) based on trigger words and phrases.²⁶ This is a voluntary, opt-in project that monitors a database of enrollees to help prevent suicide among veterans who are in crisis. This goal of this initiative is to provide clinicians with real-time assessments and the opportunity to intervene.

Veterans Crisis Line. Many suicide crisis lines are available throughout the country. The VA hosts the Veterans Crisis Line. Veterans can call 1-800-273-8255 or text to 838255 for free, confidential assistance.

Vet Center Program. Community-based counseling centers provide mental health and readjustment counseling to both veterans and active duty service members and their families (www.vetcenter.va.gov).

Veterans Choice Program. The Veterans Choice Program (VCP) was instituted by the VA to increase care, coverage, and access for veterans and to decrease wait times for veterans needing care.²⁷ Veterans must qualify for the program, but once approved, they can receive care within their community rather than wait for an appointment through traditional VA channels. To qualify for the VCP, a veteran must live a minimum of 40 miles away from the closest traditional VA center or have to wait 30 days or longer for an appointment. Providers who are interested in participating in the program can obtain more information on the VA website. The VCP can also improve veteran access to mental health services because patients requiring care can be seen by community mental health providers rather than be placed on a waiting list for an appointment with a VA mental health provider.

Provider education resources. Two useful websites for obtaining further clinical education include those of the Uniformed Services University and the VA.^28,29 The USU website has four 2-hour modules for civilian providers that give an overview of military culture, rank, treatment options, and resources. These modules can serve as a primer for providers who require an overview of military service and culture. On the VA website, a Community Provider Toolkit offers online training for providers and patient education handouts. The VA website also includes information about military culture and veteran-specific health care.

Conclusion

Veteran suicide remains a serious public health epidemic that can have lasting harmful effects on individuals, families, and communities. With this article, we hope to increase primary care provider awareness of veteran suicide risk by enhancing communication between patients and providers. Resources such as the Substance Abuse and Mental Health Services Administration free mobile app and the American Nursing Association “Have you ever served in the military?” program are excellent platforms for beginning discussions with all patients. After asking questions about military service, providers will likely be surprised by the number of current and former military personnel under their care.

Joy A. Dugan, MPH, PA-C, is an adjunct assistant professor, Touro University California Joint MSPAS/MPH Program, in Vallejo, Calif., and Gayle Cole, RN, MSN, CNM, is an associate professor, South College, in Knoxville, Tenn.

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From the November 01, 2017 Issue of Clinical Advisor