Community-Based Interventions for Suicide Prevention and Caregivers

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Jessica Heise, LCSW, RYT | Chicago VA Medical Center

Community Engagement and Partnerships Coordinator | Suicide Prevention

Community-Based Interventions for Suicide Prevention &

Suicide Prevention for Caregivers

Jessica Heise, LCSW, RYT | Chicago VA Medical Center

Community Engagement and Partnerships Coordinator

Suicide Prevention

Suicide Prevention is Everyone’s Business

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Focused Priority Areas Across CBI-SP Unifying Model

Identify Service Members, Veterans, and their Families and Screen for Suicide Risk

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Promote Connectedness and Improve Care Transitions

Increase Lethal Means Safety and Safety Planning

Community-Based Interventions

Community-Based Interventions for Suicide Prevention (CBI-SP) serves as unifying model, from national to community levels, for all community-based efforts to end Veteran suicide.

• The Governor’s Challenge is a collaboration with VA and SAMHSA where state policy makers partner with local leaders to implement a comprehensive suicide prevention plan. 
• Together with Veterans is focused on Veteran-to-Veteran coalition building and Veteran leadership development for suicide prevention. 
• Community Engagement and Partnerships for Suicide Prevention (VISN Expansion) is focused on facilitating community coalition building for suicide prevention

Outreach and Education provides SAVE, VHA facility partnerships, events, etc. through local Suicide Prevention Coordinators (SPCs) and does not change their critical role.

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Outreach and Education

State Level

Governor’s Challenge

National Level

National VA Suicide Prevention Program

Community Engagement and Partnerships for Suicide

Prevention

Together With Veterans

Community

Level

Suicide �is often preventable.

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A Little Housekeeping Before We Start:

• Suicide is an intense topic for some people.
• If you need to take a break, or step out, please do so.
• Immediate Resources:
• National Suicide Prevention Lifeline: 1-800-273-8255 or 988
• Service members and Veterans should press 1 to connect with the Veterans Crisis Line.

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Average Number of Suicides Per Day

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Time From Decision to Action < 1 Hour

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Source: CDC WISQARS and US Dept. of Veterans Affairs

https://www.mirecc.va.gov/lethalmeanssafety/facts/

Source: Simon, T.R., Swann, A.C., Powell, K.E., Potter, L.B., Kresnow, M., and O’Carroll, P.W. Characteristics of Impulsive Suicide Attempts and Attempters. SLTB. 2001; 32(supp):49-59.

Space Between Thought and Trigger

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Risk and Protective Factors

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Risk

Protective

• Prior suicide attempt
• Mental health issues
• Substance abuse
• Access to lethal means
• Recent loss
• Legal or financial challenges
• Relationship issues
• Unemployment
• Homelessness
• Chronic/terminal medical issues

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• Access to mental health care
• Sense of connectedness
• Problem-solving skills
• Sense of spirituality
• Mission or purpose
• Physical health
• Employment
• Social and emotional well-being

Goal: Minimize risk factors and boost protective factors

Signs of Suicidal Thinking

Learn to recognize these warning signs:

• Hopelessness, feeling like there is no way out
• Anxiety, agitation, sleeplessness, or mood swings
• Feeling like there is no reason to live
• Rage or anger
• Engaging in risky activities without thinking
• Increasing alcohol or drug use
• Withdrawing from family and friends

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Asking the Question

Know how to ask

the most important question of all…

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Asking the Question

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Asking the Question

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Validate the Veteran’s Experience

• Talk openly about suicide. Be willing to listen and allow the Veteran to express his or her feelings.
• Recognize that the situation is serious.
• Do not pass judgment.
• Reassure the Veteran that help is

available.

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Encourage Treatment and Expedite Getting Help

• What should I do if I think someone is suicidal?
• Don’t keep the Veteran’s suicidal behavior a secret.
• Do not leave him or her alone.
• Try to get the person to seek immediate help from his or her doctor or the nearest hospital emergency room.
• Call 911.
• Reassure the Veteran that help is available.
• Call the Veterans Crisis Line at 1-800-273-8255 or 988 and Press 1.

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Suicide Prevention for Caregivers

VA Suicide Prevention Toolkit for Caregivers�www.caregiver.va.gov/pdfs/VA-Suicide-Prevention-Toolkit-for-Caregivers.pdf�

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Caregivers of Veterans

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• Nearly 1 in 5 American adults, an estimated 47.9 million people, reported being a family or informal caregiver for an adult older than 18 years of age in 2019 (AARP, 2020).

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• Caregivers of Veterans make up 14% of those caregivers, or roughly 6.7 million people (AARP, 2020).

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• Caregivers of Veterans report providing care for most of the day every day, as well as high levels of financial strain, loneliness, feelings of burden, and depressive symptoms (Shepard-Banigan et al., 2020).

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Caregiving and Suicide Risk

The relationship between caregiving, suicidal behavior, and suicide is complex. Few studies have directly compared caregivers to non-caregivers, and some studies have reported contradictory results: 

• While one study reported that caregivers were twice as likely as non-caregivers to report thinking about suicide (Stansfeld et al., 2014), another study found no difference in the rate of suicidal thoughts between caregivers and non-caregivers (Joling et al., 2019).

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• A large study of caregivers and volunteers (n=1,018,000) from Northern Ireland found that while caregivers reported worse mental health than all non-caregivers, both caregivers and volunteers had a reduced risk for death by suicide compared to those who neither engaged in caregiving nor in volunteering (Rosato et al., 2019).

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Caregiving and Suicide Risk (continued)

Suicide risk among caregivers may be related to the specific circumstances of caregiving, rather than to caregiving status overall:

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• A study of the relationship between suicidal ideation and measures of physical social, and emotional well-being to identify three phenotypes reflecting high, medium, and low levels of caregiver distress.

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• Caregivers with the high and medium-distress phenotypes were more likely to care for a Veteran or Service member with depression, PTSD, and suicidal ideation, while caregivers with the low-distress phenotype were more likely to care for someone with a physical health condition.

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• Caregivers with the high-distress phenotype were 27.65 times more likely to report prior suicidal ideation than those with the low-distress phenotype; those with the medium-distress phenotype were 5.40 times more likely to report prior suicidal ideation than those with the low-distress phenotype.

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VA Mental Health Resources

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Free, Confidential Support 24/7/365

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• Veterans
• Service members
• Family members
• Friends
• Coworkers

Don't wait. Reach out.��Life has its challenges. As a Veteran you don't have to solve them alone.

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Use this site to get support that is designed specifically for you. If you’re a family member or a friend, you can also find resources that are designed specifically for the Veteran in your life.

Get Support & Resources

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https://mobile.va.gov/Appstore/mental-health

Scan the QR Code for VA

Mental Health Apps

https://veteranscrisisline.net

Scan the QR Code for Veteran’s Crisis Line

Make the Connection

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Stay Connected

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U.S. Department of Veterans Affairs

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Veterans Health Administration

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Make the Connection

@deptvetaffairs

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@veteransmtc

@deptvetaffairs

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@veteranshealth