My Hero Crate has made it our mission to improve the lives of veterans. Our method is to build military care packages for every branch of the armed forces and to ship them anywhere in the world, wherever your hero is living. We also support nonprofit, veteran-focused organizations because we put our money where our mouth is.

We are not experts in mental health or military suicides. We aren’t trained psychiatrists with an in-depth knowledge of how the brain works. But we do care a whole lot. And that’s why this month, National Suicide Prevention Month, we wanted to share with you some of the research we found about helping military veterans access the care they need, should they ever experience suicidal ideation. If this blog post helps even one veteran and the people that care about them get through a difficult time, then writing it will have been worth it. 

It is more than unfortunate that United States military veteran suicide has been a phenomenon for decades; the very first suicide prevention center opened in 1958 because of the prolific number of veteran suicides. In the years since, the U.S. and Veterans Affairs have taken steps to reduce rates of suicide by establishing additional mental health resources and legislation. It is difficult, however, to fix the root cause of the problem.

According to a report published by the VA in 2016, an average of 20 veterans die from suicide each day. Further analysis of the VA study shows that the rate varies by age group. Sixty-nine percent of suicides involved veterans 50 and older, whereas 31 percent involved younger veterans. Ninety-seven percent of victims were male.

The cause? It’s not precise, but the majority of veterans who commit suicide reportedly struggled with post-traumatic stress disorder (PTSD), depression, and combat-related guilt. Transitioning back to civilian life can also be quite difficult, especially after years in the military. 

The National Center for Veterans Studies at the University of Utah and the VA both say there are risk factors that increase the likelihood of military veterans experiencing suicidal ideation:

• -Feelings of depression or hopelessness
• -PTSD and/or a history of trauma
• -Access to firearms
• -Combat experience and combat-related guilt (although combat doesn’t always play a primary role in suicidal ideation); severe combat conditions
• -Lengthy or frequent deployments, or longer times at war
• -Location of deployment
• -Branch of military
• -Lower level of education
• -Divorce soon after the end of deployment
• -Sustaining life-altering injuries
• -Brain/head trauma
• -Witnessing traumatic events, such as their fellow soldiers being killed 
• -Military structure and re-acclimating to civilian life

It’s difficult to predict when someone may be considering suicide, especially if they tend to hide their emotions. However, there is a set of common warning signs you can watch for as you interact with your hero at home, over the phone, or via mail.

• -They make statements about suicide, such as “I wish I were dead,” or, more specifically, “I’m going to kill myself.” 
• -They withdraw from social contact, including their friends and other family members.
• -They seem preoccupied with death and dying, or violence.
• -Their personalities may change, or they may have severe mood swings.
• -They participate in risky behaviors, including using drugs, abusing alcohol, or driving recklessly.
• -They express that they feel trapped or hopeless.
• -They say goodbye to people as though they’ll never see them again.
• -They change their normal routine, including when and how often they eat or sleep.
• -They give away their belongings or “get their affairs in order.”
• -They have acquired means to commit suicide, including purchasing a gun, accessing pills, etc. 

Don’t worry that if you ask your hero about suicidal thoughts or feelings, you push them into actually doing it. Giving them a chance to express their feelings can actually reduce their risk of acting on them. To do so, you can start your one-on-one conversation by asking some sensitive questions, like:

• -How are you coping with what has happened in your life?
• -How are you feeling about everything that has happened with you?

You should also ask some direct questions, like:

• -Are you thinking about hurting yourself? 
• -Are you thinking about suicide?
• -Are you thinking about dying?

Your questions can continue to delve into more detail, like:

• -Have you ever thought about suicide before?
• -Have you ever tried to hurt yourself before?
• -Have you thought about how or when you’d do it?
• -Do you have access to weapons, or other things you could use to hurt yourself?

Most suicidologists agree that committing suicide isn’t a decision. In an essay by Gerben Meynen, a professor of forensic psychiatry at Utrecht University in the Netherlands, he argues that “having a mental disorder takes away a person’s ability to choose alternatives.”

In fact, until the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), “loss of freedom” was listed as a component of mental illness. This description has now been updated to an “impairment in one or more important areas of functioning,” which is said to include “one or more losses of freedom.” 

It makes sense, then, that talking about suicide in a way that insinuates it is your hero’s choice would not be productive, and would instead shame them for their struggle. Never refer to committing suicide as selfish, stupid, cowardly or weak, a choice, or a sin, regardless of your personal beliefs.

You should also avoid “making it about you.” It is likely your hero has already thought about the repercussions of suicide and how it may affect their loved ones, but still views it as the only escape from their feelings.

If your hero is considering suicide, you can help them get the resources they need. You can encourage them to call the National Suicide Prevention Lifeline at 1-800-273-8255, and offer to sit with them as they make the call. To access responders with experience helping veterans, your hero should press “1” at the prompt. If they prefer to text with a responder at the Lifeline, they can send a message to 838255.

Help them locate the phone number for their doctor at the VA to get access to the VA Mental Health program and VA Suicide Prevention program. There are so many non-profit organizations dedicated to veterans’ mental health — just like the ones we donate to with the proceeds from each of our military care packages. You can learn more about them at veteranscrisisline.net. 

Be supportive. Express your love for them, and your concern. 

Your personal military hero is also ours. It is our sincere hope that you and your veteran will learn to stave off the thoughts of suicide while living your best possible lives together.