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VA Struggles To Unlock The Reasons Behind High Risk Of Suicide Among Older Veterans

The outside of the San Diego VA Medical Center is shown on Nov. 2, 2018.
Megan Wood
The outside of the San Diego VA Medical Center is shown on Nov. 2, 2018.
VA Struggles To Unlock The Reasons Behind High Risk Of Suicide Among Older Veterans
VA Struggles To Unlock The Reasons Behind High Risk Of Suicide Among Older Veterans GUEST:Steve Walsh, military reporter, KPBS News

The California Department of Public Health recently came out with a report on veterans suicide. It showed that in 2017 one hundred eleven San Diego County Veterans committed suicide in Los Angeles County a much bigger county. 93 veterans committed suicide. K PBS military reporter Steve Wallace joins us now. And Steve these numbers surprised me. Well they are incredibly high and you have to understand that not only is Los Angeles a larger county it also has a larger veteran population than San Diego. So San Diego being right at the top that is significant. Also San Diego County has a higher suicide rate. Los Angeles you have about 30 vets per 100000 veterans who have committed suicide in 2017. In San Diego County it is 45 veterans per 100000 veterans. Now the V.A. tracks this nationally. Their numbers say that it's just under 30 veterans a deeper 100000 nationally and that's already considered a crisis. Is there any indication of what's driving these numbers. Well when you talk about what's driving suicide the answers are always kind of unsatisfactory. Now the VA has been alarmed by the rising number of suicides among younger veterans. And San Diego does have a large population of Iraqi and Afghan vets. Now Steve you spoke to Cathy shot a retired Air Force officer who lost her son Tony an Iraq war vet after he killed himself. She now counsels the families of people who attempted suicide. Her son Tony committed suicide on Christmas Day 2013. Let's hear her story. Kathy shot Nuers son Tony was having trouble. He was living halfway across the country. He'd had a messy divorce. He was in the middle of a custody battle over his young son. And it wasn't going well. I know I talked to Tony all the time but I didn't hear the pain at that point. She says he went to the V.A. two days before Christmas. I said what's going on. He was small I'm just so sad. And I go buddy. How are things going to be OK. At most everything will be OK. He finally returned her call on Christmas 2013 and he sounded optimistic. I play that conversation and I have met many many times his very last words to me were mom don't ever forget how much I love you. I heard it but I didn't hear it shot emphasized how difficult it can be to tell when someone is about to kill themselves even if you know that person will at times. Military service can make people even harder to read nobody wants to go and admit I have a problem you know which we need to admit. I have a problem. I'm hoping that it's getting better but you know I think there's still this stigma that if you say you have a problem you're not fit for military yet. We all have problems. Shot now counsels others as part of the group Survivors of Suicide Loss. She casts around for some other reasons. Like so many veterans her son killed himself with his own firearm. He was constantly teaching others how to use guns safely and then he used the gun here in court. Do we have the Bambridge you know which we need to figure out a way to do something so it's not so accessible. And that was Kathy Shahd who lost her veteran's son to suicide. And joining me again in studio is PBS military reporter Steve Walsh. Jade how are dying by suicide in San Diego County. So there are a couple of things that Kathy mentioned that in in the tape that the Corado bridge now nine veterans of between 2013 and 2017 healed themselves by jumping off the court bridge but end lethal means that definitely is part of the puzzle. Though it's nothing compared to firearms of the four hundred and seventy four veterans who killed themselves in San Diego County over those same five years 262 of them use the gun. And that's really considered the most lethal means and has there been an increase in the number of veteran suicides over time. So the short answer is yes. I talked to a San Diego Medical Examiner Dr. Steven Kampmann. He says the number of veterans suicides have been trending up in San Diego. He's somewhat concerned. He doesn't know if this is just better accounting that we simply are tracking this more than we had in the past or if it is like it looks that there have been a number of veterans who have committed suicide in San Diego County. So like much of the focus on veterans suicides has been on Iraq and Afghanistan veterans. So how does the rate of suicide among younger veterans compare to that of older veterans younger veterans have a higher suicide rate. There's more of them in that category are committing suicide but overall I believe the numbers are over half of the suicides among veterans are people 55 and older. Interesting here's the story of one such elderly veteran Robert Nielsen. Robert Nielsen was drafted in 1961. He spent two years in the Army just before the Vietnam War. He was recently at the V.A. in San Diego as part of his treatment three years ago. The 76 year old came into the VA after contemplating suicide. A revoting divergence. That wasn't really the first time. Two months after I got out of the service I tempted back then. Nielsen remembers standing on a subway platform watching a speeding train. I just figured if I just hold my hands up I could just let it stop somebody shouted What are you doing at me. I did a trance but I still I still think I need help. I just get stuck for life. It was a military sexual trauma and it would take Nealson another 50 years to ask for help. The guilt was because I wasn't strong enough to overpower the person. Plus was all sorts of service related issues can lay dormant only to crop up later in life says Ron stark stark founded moving to zero in San Diego where he counsels fellow veterans who have contemplated suicide more than a few of them are elderly. Stark retired from the Navy in 1994 he served aboard a submarine in the Arctic in the 1970s and again during Desert Storm. Not a bad career but Starks says were some older veterans no accomplishment is ever enough. We have things about stolen valor and nobody wants to misrepresent themselves so I know. So I was a Vietnam era. I am not a Vietnam veteran. Okay I was in Desert Storm but I wasn't in combat. We're constantly talking about what we're not quite veterans struggling with suicide aren't always wrestling with memories of combat. Starks suffered from depression most of his life. He remembers sitting by the roadside with a pistol while he was still on active duty. The military didn't make me who I was but the military establishes lifelong habits both good and bad. You want to be someone people can rely on you know you have a bad day work working go home in a bad day on a submerged submarine. People die. So if you're not feeling 100 percent maybe it's better just to keep that to yourself. Stark describes suicidal feelings as a brief moment of blackness when all other options fade from view. Get past that and a veteran is likely to survive. The VA is focused on finding risk factors isolation previous suicidal thoughts access to firearms. Older men are also more likely to reject treatment for mental health issues. Another big risk factor Colin Depp a psychologist at the V.A. in San Diego says the problem is researchers don't know. Among the people who have those risk factors who will actually attempt suicide were not very far ahead in terms of understanding who is out there who is really likely to take their lives in the next hours days months in one V.A. program. Robert Neilson the vet who was 73 before he sought treatment for himself is now writing letters of encouragement to fellow veterans who were just beginning treatment pulling out one of those letters. Neilson explains how he can help a veteran that he'll never meet in person. He opened a month. I don't know you but I taken a pay cut. The letters are just one more nudge to keep veterans away from that dark moment when suicide feels like the only option. Joining me again in studio is PBS military reporter Steve Walsh. Steve are we only seeing this increase in suicides among veterans now. Now in fact this has become a national issue. The CDC just came out with their report earlier this year that saying that there's been an upward trend and almost a doubling of suicides in the nation from 1999 to 2016 making suicide the 10th leading cause of death. Now that was military reporter Steve Walsh. Steve thank you. Thanks. If you or someone around you is in suicidal crisis or emotional distress call the National Suicide Prevention Lifeline at 1 800 273 TALK or support information and resources. And you're listening to KPBS midday edition.

Much of the focus by the Veterans Health Administration has been on the growing number of younger veterans who commit suicide. However, statistics show that elderly veterans kill themselves in larger numbers than other people the same age.

Robert Neilson was drafted in 1961. He spent two years in the Army just before the Vietnam War. He was recently at the VA Hospital in San Diego as part of his treatment. Three years ago, the 76-year-old came into the VA after contemplating suicide.

“That’s what really brought me into the emergency room. That wasn’t really the first time,” Neilson said. “Two months after I got out of the service, I attempted suicide.”

After he got out of the Army, Neilson remembers going back home to New Jersey. He was standing on a subway platform watching a speeding train.

“And I figured if I just hold my hands in the air, I could just let (the train) suck me in,” Neilson said. “Somebody shouted, “What are you doing?” And that was enough to snap me out of the trance, but I still didn’t seek any help. I just figured, OK, I’ll just struggle through life.”

It would take another 50 years for Neilson to get help dealing with the trauma of a sexual assault he experienced in the military.

“And the guilt was, I wasn’t strong enough to overpower that person. Plus, it was a high-ranking person,” he said.

That was all he wanted to say about the incident that has haunted him most of his life.

All sorts of service-related issues can lie dormant only to crop up later in life, said Ron Stark. Stark founded Moving to Zero, a nonprofit group in San Diego, where he counsels fellow veterans who have contemplated suicide. More than a few are elderly.

Stark retired from the Navy in 1994. He served aboard a submarine in the Arctic in the 1970s and again during Desert Storm. For some older veterans, no accomplishment is ever enough, he said.

“We have things about stolen valor. Nobody wants to misrepresent themselves,” he said. “So I’m a Vietnam-era veteran. I’m not a Vietnam veteran. I was in Desert Storm, but I wasn’t in combat. We’re always talking about what we’re not quite.”

Veterans struggling with suicide aren’t always wrestling with memories of combat. Although he was never in combat, Stark suffered from depression most of his life. He remembers sitting by the roadside with a pistol and contemplated pulling the trigger.

“The military didn’t make me who I was,” he said.

But the military establishes life-long habits, both good and bad. A soldier strives to be someone people can rely on, especially in critical situations.

“You have a bad day at work and you go home. You have a bad day on a submerged submarine, then people die,” he said.

So if you’re not feeling 100 percent, maybe it’s better to keep it to yourself, he notes. Stark describes suicidal feelings as a brief moment of blackness when other options fade from view.

The VA National Suicide Data Report for 2005 to 2016, which came out in September, highlights the alarming rise in suicides among veterans age 18 to 34, who had the highest rate of suicide – 45 per 100,000 veterans. But those 55 and older still represent the largest number of suicides among veterans. Part of the reason for this is that the veteran population in the US tends to be older.

For veterans age 55 to 74 years old, the rate of suicide is 26 per 100,000, while nationally, the suicide rate in the same age group is 17.4 per 100,000. The rate ticks up even higher for veterans over 85 years old.

The Veterans Health Administration has focused on finding risk factors that could lead someone to kill themselves, such as isolation, previous suicidal thoughts and access to firearms. Older men are also more likely to reject treatment for mental health issues, which is another big risk factor.

The problem is that the VA still doesn’t know who will attempt suicide among the people who have those risk factors, said Colin Depp, a psychologist at San Diego VA who has researched suicide among older veterans.

“We’re not very far ahead in understanding who's out there, who's really likely to take their lives in the next hours, days, months,” he said.

The VA emphasizes getting potentially suicidal veterans in the door, where health-care workers deploy a range of treatments, he said.

As part of his own treatment, Neilson — who was 73 before he sought treatment himself — is now writing letters of encouragement to fellow veterans who are just beginning treatment, as part of a VA program.

Neilson pulled out one of the letters he wrote and explained how he can help a veteran he will never meet in person.

The letters are just one more nudge to keep veterans away from that dark moment when suicide feels like the only option.

VA Struggles To Unlock The Reasons Behind High Risk Of Suicide Among Older Veterans
Trauma from decades earlier linked to older veterans who take their own lives at a rate higher than their peers.

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