Suicide Risk Assessment in the VHA

The recent article in The Journal of Clinical Psychiatry “Suicide Risk Assessment Received Prior to Suicide Death by Veterans Health Administration Patients with a History of Depression” revealed several important findings. Among Veterans Health Administration (VHA) patients with a history of depression from 1999 to 2004, 74% of patients who died by suicide had received an assessment of suicidal ideation in the year prior to suicide,1 and this rate was achieved prior to the major initiatives that VHA has put in place over the last 7 years emphasizing suicide risk assessment and prevention. However, only 30% of patients with depression or a history of depression received such an assessment at a time that it might have been especially important—the last health care visit. Furthermore, of those assessed, 85% denied suicidal ideation when asked, and a similar proportion (>70%) denied suicidal ideation even when asked within 7 days of their impending suicide death. Read article here.

NFL Life Line: Confidential Support, Assistance, and Hope

If you are a member of the NFL family and are experiencing a personal or emotional crisis, you can talk to someone right now at (800) 506-0078. Trained, professional counselors are standing by 24 hours a day, 7 days a week, 365 days a year. It’s free, confidential support for the entire NFL family—current and former players, coaches, team and league staff, and their family members. It’s independent. The NFL Life Line is operated by the leading national providers of crisis counseling services and is entirely independent of NFL staff.

No confidential information about individual calls or callers is shared with the NFL, its teams, or any other organization. Read more here.

Dogs: A Medicine for Mental Health Problems?

A growing number of Americans are getting dogs for mental health needs, experts say. In the case of psychiatric service animals, they are trained specifically to help people with mental illnesses. Read article here.

PE Coach App

If you are a Soldier, Sailor, Airman, or Marine or Veteran experiencing difficulties due to a traumatic experience (for example, combat, deployment experience, or sexual assault), the PE Coach mobile application (app) may be part of the solution.

The app will guide you through the exercises assigned by your therapist and allows you to track and record your progress in treatment. In addition, the app provides you with techniques such as controlled breathing that will help you tolerate and decrease your distress. PE Coach will help you remember and track your upcoming therapy sessions. You and your therapist will be able to audio record your sessions directly onto your phone so that you can review them later as part of your treatment. Read article here.

Mental Illness: Questions to Ask Your Doctor

If you have been diagnosed with schizophrenia, bipolar disorder, or another mental illness, you may have many questions for your doctor. To help you organize your thoughts, here is a list of questions to think about asking:

• What is my illness?
• What are the symptoms?
• What might have caused my illness?
• How might this illness affect me over time?
• What other medical problems often go along with this illness?
• What are the risk factors for this illness?
• How can you tell I have this illness?
• How is this illness treated?
• What will the treatment do for me?
• Are there side effects from the treatment?
• What are my options if this treatment fails?
• What will happen if I do not do anything about my illness?
• What can I do to help myself?
• Where can I go for help?
• Where can I go to learn more about my illness?

Feel free to raise any other questions or concerns you may have about your illness with your doctor. The more you know about your illness, the better prepared you will be to deal with it.

Getting Help
Not sure where to go for more help? Talk to someone who has worked with mental illness, such as a doctor, social worker, or church counselor. Other types of people and places that can help include:

• Your health plan
• Community mental health centers
• Hospital psychiatry departments
• Social service agencies
• Private clinics
• Employee assistance programs
• Local medical and/or psychiatric societies
• State hospital outpatient clinics

If your doctor puts you on 1 or more medications for a mental illness, here are some questions you may want to ask your doctor:

• What is the name of the medication, and what is it supposed to do?
• What are my chances of getting better with this treatment?
• How and when do I take it?
• How will I know if the medication is working?
• How long will I have to take it?
• Can I take this medication if I am pregnant or planning to have a baby soon?
• What foods, drinks, other medications, or activities should I avoid while taking this medication?
• What are the side effects?
• What should I do if I have side effects?
• Will this medication affect my sleep, my sex life, or my appetite?
• How will this medication interact with other medications I’m already taking?
• What should I do if I miss a dose?
• Can I have beer, wine, or other alcoholic drinks?

Never stop taking a medication without your doctor’s help.

Before you get a prescription, make sure your doctor knows:

• Your medical history
• What other medications you are taking
• If you have ever taken medications for a mental illness in the past
• If you are pregnant or planning to have a baby
• Past problems with medications or food side effects
• Other health conditions you may have (such as diabetes, heart disease, allergies, etc)
• If you are on a special diet or take supplements
• If you smoke, drink alcohol, or do “street drugs” (such as cocaine, pot, etc)

Remember
It is very important to ask your doctor any questions you may have. The more you know about your mental illness and the medications you will be taking for it, the better prepared you will be to take care of yourself. You should always take medications exactly the way your doctor tells you to. Read article here.

PTSD App Gives Veterans a New Coping Tool

Veterans with post-traumatic stress disorder have a new mobile resource to help combat the anxiety disorder’s many challenges.

The Departments of Defense and Veterans Affairs (VA) have jointly developed the PTSD Coach, a free smartphone application. Dr. Sonja Batten, who works on national mental health policy for the VA, says the app was developed with veterans in mind. The app allows users to track and manage symptoms, find support and get reliable information about PSTD. A self-assessment mode has 17 questions — the same ones used in clinical settings — to gauge distress levels. Read article here.

White House Changes Condolence Letter Policy

On July 5, the White House reversed its longstanding policy of not sending condolence letters to the families of service members who die by suicide while deployed to Iraq, Afghanistan, and other combat zones. AFSP would like to commend President Obama on his decision. Read article here.

Contact the White House to urge the reversal of the White House Condolence Letter Policy!

On Wednesday, May 25th, Senator Barbara Boxer (D-CA), co-chair of the Senate Military Family Caucus, along with a bipartisan group of Senate colleagues, sent a letter to the President urging the reversal of a long-standing White House policy that withholds letters of condolence from families of servicemen and servicewomen who die by suicide. In the letter, the Senators highlight the incidence of suicide among troops serving in Afghanistan and Iraq, and reiterate that ending the policy “will provide comfort to the families struggling with the loss of a loved one, while also reducing the stigma that prevents too many men and women in uniform from seeking the mental health care they need,” (Senator Barbara Boxer). The letter is also signed by the following Senators:

Senator Ben Cardin (D-MD)
Senator Jay Rockefeller (D-WV)
Senator Jon Tester (D-MT)
Senator Mark Pryor (D-AR)
Senator Mark Udall (D-CO)
Senator Patrick Leahy (D-VT)
Senator Richard Blumenthal (D-CT)
Senator Richard Burr (R-NC)
Senator Richard Durbin (D-IL)
Senator Ron Wyden (D-OR)

With this latest Senate action, now is a great time for all of us to contact the White House in support of the above Senators and in support of military families across the country.

VIA EMAIL
The White House may be contacted via email 24 hours a day, 7 days a week by visiting http://www.whitehouse.gov/contact. After filling in the required information, under subject select “Afghanistan and Iraq” and post the following message:
I support the US Senators who recently wrote to you regarding the White House position on no condolence letters to military families who lose loved ones to suicide. Mr. President, please say no to the stigma associated with mental health issues and suicide. Please change this policy now!

VIA PHONE
The White House may be contacted via phone at 202-456-1111. When you call indicate that you want to leave a message for the President:
I support the US Senators who recently wrote to you regarding the White House position on no condolence letters to military families who lose loved ones to suicide. Mr. President, please say no to the stigma associated with mental health issues and suicide. Please change this policy now!

Please contact the White House with the above message this weekend through June 3rd, to not only show your support for your Senators but also to lend a voice to military families across the country.

How to Report Suicidal Content/Threats on Facebook

Facebook Help: How do I help someone who has posted suicidal content on the site?

If you have encountered a direct threat of suicide on Facebook, please immediately contact law enforcement.

You can submit reports of suicidal content to Facebook here.

For reports in the United States, we also recommend that you contact the National Suicide Prevention Lifeline (NSPL), a 24/7 hotline, at 800.273.TALK (8255). If possible, please encourage the user who posted the content to contact the Lifeline as well.

You can view a list of suicide prevention hotlines in other countries by visiting Befrienders Worldwide and choosing from the dropdown menu at the top of the page.

We encourage you to learn about how to identify and respond to warning signs of suicidal behavior online at the following address here.

National Suicide Prevention Lifeline (NSPL):

• NSPL wants people to report to Facebook first, as Facebook has the ability to provide identifying information and the process is faster if they can report all info to NSPL at that time.
• Facebook works with NSPL once the content is reported.
• If it is international, then Facebook works with the appropriate international organization.
• Facebook receives the notification, then provides NSPL with all information about the user. Unfortunately, NSPL cannot comment on the process from Facebook’s end, but believes that given Facebook’s sensitivity to suicide risk and knowing that their safety team works on the weekends, NSPL believes that the process is pretty quick and that it is the most efficient and quickest method for a user to receive help.

Parenting Through a Crisis

During a crisis act like a thermostat, not like a thermometer. This analogy means staying level when your child’s emotions are running wild. Instead, we often act like a thermometer, responding to the distress by heightening our own emotions in response. Read article here.