Several years ago an awareness campaign began to address the high number of deaths by suicide that our veterans were experiencing. I remember joining one of the challenges created by an awareness campaign. I did 22 pushups a day for 22 days and posted videos of my efforts to bring awareness to the tragedy of losing our veterans to suicide.

Has this campaign made any difference? I would say the answer to that is yes a difference (actually several) have been made. First, it built an awareness around a problem that existed. People began to ask, “Why are we losing so many veterans to suicide?”

This question is important and the answer is multifaceted. The transition from miltary life to civilian life is complicated and full of challenges even when the veteran has been honorably discharged and was never deployed to serve in a combat zone; and when the additional challenges of combat experience and/or conditions that led for the veteran to receive a discharge that was classified other than honorable those challenges increase and the related risk for suicide increases as well.

There is some good news, the rate of death by suicide is no longer 22 per day. According to the Veterans Adminstration 2022 Annual Report, in 2020 we lost 6,146 veterans to suicide which equates out to approximately 17 veterans dying by suicide daily. While this is better than 22, this number is still far too high and there are measures we can take to reduce this even further. In honor of the original awareness campaign of 22 for 22, let’s look at 22 ways to reduce veteran death by suicide.

1. S.A.V.E. Training is a suicide prevention training you can take to learn steps to assist a veteran who is in crisis. The acronym SAVE can help you remember the steps to take —

2. Cognitive Behavioral Therapy (CBT) can help a veteran understand the relationship between their thoughts, feelings and behaviors. Once that understanding is better understood, they can work to learn new patterns of thinking that can increase positive feelings.

3. Safety Planning Intervention can help by creating a plan which reduces the risk of death by suicide while also allowing the veteran to feel in control of their choices. This involves providing resources and coping skills that can keep them safe when they are having suicidal thoughts.

4. Solutions Focused Therapy (SFT) can help veterans identify ways to address the problems that are causing them stress. With solutions available both the stress and the related suicide risk decrease.

5. Dialectical Behavioral Therapy (DBT) can help veterans learn skills to improve their ability to manage strong emotions and relationships. These skills include distress tolerance, mindfulness and interpersonal skills.

6. Make the Connection is a self-help program that veterans can utilize that will help them realize they are not alone through the stories of others. Make the Connection also provides education about signs and symptoms they may be experiencing and has links that allow them to connect to treatment resources.

7. My Recovery Plan is a self-help program that veterans can access online that allows them to build their own plan for staying well. My Recovery Plan is broken down into sections based upon what the veteran is working on. The plan covers everything from everyday wellness maintenance through managing crisis. Ther is a specific safety plan and for the veteran who may be new to working on this sort of plan, there is a page that provides examples and instructions for tools they can use.

8. Moving Forward is another self-help training that veterans can access online. This program helps them understand their own problem solving style and assists them in developing better problem solving skills which can reduce the stress they are experiencing.

9. Psychological First Aid (PFA) is a course that anyone can take that helps you build skills to assist anyone who is experiencing a crisis. Psychological First Aid is offered in many communities but if you are not able to access an in person class in your area, you can still take this training online. It’s offered by Johns Hopkins through the Coursera platform. https://www.coursera.org/learn/psychological-first-aid

10. Mindfulness Coach is an app available on both Android and iOS platforms. Mindfulness Coach assists veterans with learning and using mindfulness skills. Mindfulness is about turning attention to what’s happening in the moment and increasing this skill has been shown to assist with increasing feelings of relaxation and decreasing the affects of stressors. https://mobile.va.gov/app/mindfulness-coach

11. PTSD Coach is an app available on Android, iOS and an online platform. This app helps veterans manage the symptoms of PTSD through various coping skills they can learn and practice in the app. Skills this app focuses on include relaxation, mindfulness, positive self-talk, anger management and how to access support. https://mobile.va.gov/app/ptsd-coach

12. Firearms Locks can reduce the risk of death by suicide by incresing the time it takes to fire the weapon. The increase of time between impulse and action can be life saving because the impulse is often of short duration. Guns have a high level of lethality and are the means used in many deaths by suicide among veterans. Gun locks are available for free at many police stations and Veterans Administration Medical Centers.

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13. Medication Storage and Opioid Overdose Reversal — when a veteran may be at risk for suicide using a lockbox for medications such as opioids can reduce the risk of an intentional overdose. If these medications are utilized for medical conditions by the veteran or their family or if the veteran has any history of addiciton then also knowing how to use Naloxone (Narcan) and having that available can prevent a death by suicide. You can obtain both training in overdose reversal and Narcan through many community agencies. If you are having trouble accessing these in your community you can access the training online and have Naloxone mailed to you by Next Distro.

14. QPR Gatekeeper Training is a suicide prevention training that is designed so that anyone is able to help someone who is having suicidal thoughts. The training takes you through the steps of Asking the Question, Persuading to get Help and Referring to Help. You may be able to find a local in person training. Sometimes those trainings are free. Or you can take this training online.

15. Headspace and Timing is an online community for those who wish to learn more about Veteran menal health. The community was started by a Veteran who is now a mental health counselor. The goal is to both have meaningful conversations about Veteran mental health and to also inspire Veterans to use the skills they gained in the military to care for themselves and to make positive impacts on their community.

16. Give an Hour is a network of licensed therapists who have volunteered to provide mental health services to Veterans and those who support them at no cost. Give an Hour does not have limits based upon deployment into combat nor length of service.

17. VetsPrevail offers a program which blends coaching, lessons that teach you tools from Cognitive Behavioral Therapy (CBT) and online support groups. The program is set up in a way that allows you to be anonymous while you are receiving the assitance.

18. Vet Centers provide counseling and services that assist the newly discharged veteran with readjusting into their new civilian role. They offer individual, group and marriage and family counseling. They also refer individuals to other veteran services that may be needed.

19. Military Sexual Trauma Counseling is available to any veteran who experienced sexual trauma while serving regardless of gender or or era they served. Counesling is offered as individual, group, or marital/family counseling. Veterans who access Miltiary Sexual Trauma Counseling may also be referred to other veteran supports such as Substance Use Treatment as needed.

20. Be willing to provide an ear and listen when a Veteran is dealing with their emotions about transitioning to civilian life or dealing with memories they have of things they experienced while serving. Allowing people to talk about how they feel and share their experience is powerful in helping them deal with those emotions and *just* the act of listening without judgement is suicide prevention.

21. Suicide Prevention Coordinators are available at Veterans Assistance Medical Centers. The job of the Suiicide Prevention Coordinator is to provide resources to those who need them, train individuals in suicide prevention which is a responsibility to all and connect Veterans who need services to those services.

22. Veterans Crisis Support Line — calling 988 and then selecting option 1 for Veteran Services connects you to experts who can assist with the crisis at hand. Those Crisis Counselors can talk with the individual who is having suicidal thoughts or they can assist someone who is trying to support an individual considering suicide.