Ralph H. Johnson VA Medical Center
According to the Center for Disease Control and Prevention (CDC, 2008), suicide is now the tenth leading cause of death in the United States for males and the numbers are rising for females. Both the Department of Veterans Affairs (VA) and Department of Defense (DoD) say Veterans are at a higher risk than civilians who have not served. Frequency, length and location of deployments, extreme stress, physical or sexual assault and service-related injuries are specific risks to Servicemembers.
Dr. Mark De Santis, Suicide Prevention Coordinator at Charleston VAMC and VISN 7 Lead SPC said Charleston began a psychosocial pilot program to better assess individual risk factors. The program flags a reminder in the patient’s record to ask psychosocial questions of the Veteran. In addition, a nine question Patient Health Questionnaire (PHQ9) is asked from the hospital at the Veteran’s first visit after being discharged from the hospital.
"Risk of suicide increases dramatically post discharge, so we ask them the nine questions at their very next appointment," explained De Santis.
Most facilities utilize the PHQ2 which asks only two questions. If positive then a PHQ9 is asked. Charleston is currently the only facility that uses the PHQ9 for every Veteran at his or her post discharge visit, according to De Santis.
"It’s unique to Charleston and our CBOC’s. We are working hard to define or establish noticeable trends to help us identify more patients at risk," De Santis said.
Warning signs and symptoms include threatening to hurt or kill self, looking for ways to kill self, seeking access to pills, weapons or other means, or talking or writing about death, dying or suicide. Other signs to look for are hopelessness, rage or anger or seeking revenge, acting reckless or engaging in risky activities, feeling trapped, or increasing drug or alcohol use.
Recently the VA stood up a new website for suicide prevention. For information on getting help or getting involved, visit http://www.suicidepreventionlifeline.org/. The Veterans Crisis Line, 1-800-273-TALK (8255) can be called 24 hours a day, seven days a week by the Veteran in need or his/her friends or family.