Suicide, the 10th leading cause of death, is a significant public health concern — and one that is taking the lives of our nation’s veterans at a growing rate. The Department of Veterans Affairs is committed to improving the health and well-being of veterans by addressing suicidal behaviors. And on this Veterans Day, it’s important to recognize that there are things all of us can do to help those at risk of suicide.

The rate of veteran suicide is approximately twice that of non-veterans, according to the VA. In 2014, veterans represented 8.5 percent of the national population but accounted for 18 percent of adult deaths by suicide.

The latest VA data show that from 2005 through 2015, roughly 20 veterans and service members died by suicide every day. Suicide rates increased substantially among younger veterans ages 18-34, yet remained relatively stable among their civilian peers.

The suicide rate among women veterans has increased much faster than it has among male veterans and female non-veterans. Rates of suicide are higher among both women and men who reported having experienced military sexual trauma than among those who did not.

Many factors contribute to the increased risk of suicide for veterans. They are exposed to brutal combat conditions and subjected to high stress, and they endure lengthy deployments in hostile environments, experience long-term medical and brain injuries and sometimes experience sexual or physical assault (both males and females). Many combat-deployed veterans struggle with other challenges, including divorce, post-traumatic stress disorder and re-adjustment to daily life. Once separated from the military, many feel isolated, with difficulty relating to people who do not have military experiences.

The four of us — including psychiatrist Jeffrey Barkin, M.D., board president of Tri-County Mental Health Services, and Executive Director Catherine Ryder — believe it is important to debunk the myths and understand the facts:

• Asking about suicide does not create suicidal thoughts.

• The immediate risk is often time-limited and can be prevented, despite someone’s perceived determination.

• Making one method of suicide less convenient may be enough to deter a person from suicide, offering time to intervene.

• Eighty-five to 90 percent of people who survive a suicide attempt do not die by suicide later.

Become familiar with SAVE, a VA initiative that encourages intervention through thoughtful care and compassion when encountering a veteran who may be suicidal:

• Signs of suicidal thinking (hopelessness, mood swings, “no reason to live,” increased substance use, withdrawal from family and friends).

• Ask questions (“Have you had thoughts about taking your life?”).

• Validate the veteran’s experience by talking about it nonjudgmentally, reassuring him/her that help is available.

• Encourage treatment and expedite help (don’t keep the behavior a secret; do not leave him/her alone; call 911).

Resources available to support veterans in crisis include:

• Resource Locator: Find local VA services by visiting www.veteranscrisisline.net/GetHelp/ResourceLocator.aspx.

• Make the Connection: Connect with other veterans at maketheconnection.net/.

• Coaching Into Care: A VA national telephone service at (888) 823-7458; www.mirecc.va.gov/coaching/.

Recent VA initiatives include “SAVE,” a 25-minute online suicide prevention training video, as well as veterans outreach services at Lewiston-based Tri-County Mental Health Services (tcmhs.org; 888-304-HOPE).

An expanded Veterans Crisis Line is available 24/7. Veterans can call 1-800-273-TALK (8255) and press 1 to reach responders trained in suicide prevention and crisis intervention. The line also includes an online chat service at VeteransCrisisLine.net with a texting option (text to 838255). The VA has modified its facilities’ phone systems to allow direct connection to the crisis line by pressing 7 when calling a VA medical center.

The VA is also employing preventive tactics. They’re setting up screening processes throughout the system to assist in the identification of veterans at risk for suicide. They’re using computer algorithms to determine which veterans may be at highest risk of suicide, allowing providers to intervene early.

They’re identifying veterans in the top 0.1 percent of risk (who have a 43-fold increased risk of death by suicide) before signs of suicide are evident. And they’re providing enhanced care to patients who have been identified as high risk, including missed appointment follow-ups, safety planning, follow-up visits and individualized treatment plans that directly address their suicidality.

Veterans have sacrificed so much for us — we can start to repay them by reaching out and helping veterans in crisis get on a path to mental health recovery.

Charles Bernacchio, a professor at the University of Southern Maine, is a board member of Tri-County Mental Health Services, and Tiffany Reagan is an Army veteran who attained the rank of captain and is pursuing her clinical professional counseling license at USM.

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