Suicide hotline lets veterans -- and families -- dial for help

Washington -- The Veterans Suicide Prevention Hotline, in operation for about a year, is proving to be an important resource. It has received calls from more than 22,000 veterans, their families or friends, according to the sponsoring federal agencies.

While it has been recognized that veterans, particularly those returning from active duty in Iraq and Afghanistan, may benefit from mental health services, many are reluctant to connect with available resources.

A survey released last spring by the American Psychiatric Assn. indicated that six in 10 soldiers thought seeking help for a mental health concern would have at least some negative impact on their military careers. For this reason, an anonymous phone call can be a good entry point to connect with care, said Richard Harding, MD, president of the APA's American Psychiatric Foundation and professor and chair of the Neuropsychiatry and Behavioral Science Dept. at the University of South Carolina School of Medicine.

Posttraumatic stress disorder is common among veterans, said Daniel Potenza, MD, a psychiatrist with the Dept. of Veterans Affairs, who spoke last April at a symposium sponsored by the American Medical Association. Promising therapies for PTSD exist, including medications and psychological treatments. The community physician, he noted, can initiate treatment, perhaps offering patients a simple opening: "Tell me about it."

Physicians also can refer patients to the hotline, at 800-273-TALK (8255), said Janet Kemp, RN, PhD, coordinator of National Suicide Prevention at the VA. Hotline counselors can connect callers who provide identification directly to their local VA facilities for additional treatment. "We are able to track that to make sure the veterans who are referred don't drop through the cracks."

The national hotline is free and operates 24 hours a day, seven days a week. It is staffed by trained personnel who are social workers or psychologists or who have counseling degrees, Kemp said.

The telephone: A step toward help

The veterans' service is operated jointly by the VA and the Substance Abuse and Mental Health Services Administration. It is part of the larger National Suicide Prevention Lifeline, which receives 42,000 calls each month through a network of more than 130 crisis centers.

The automated initial greeting at the hotline directs callers to press "1" if they are a U.S. military veteran or are calling about a veteran. Those who select that option are connected to a VA-operated center in Canandaigua, N.Y.

SAMHSA has been promoting its suicide hotline for 3½ years, said Richard McKeon, PhD, MPH, a special adviser on suicide prevention at the agency. More than a half million cards with the hotline number have been distributed -- many to hospital emergency departments, he said.

Evaluation of the hotline has showed that callers experience a reduction in suicidal intent and hopelessness, McKeon said. The veterans portion is now being studied, Kemp said.

Vets in particular voice concerns about anxiety, depression, sleep problems and "readjustment issues." VA counselors have access to medical records, and, with a caller's permission, can check for ongoing treatment and medications, Kemp noted.

The APA survey conducted by Harris Interactive of nearly 200 military personnel found that about 75% reported their overall mental health as good or excellent. But nearly half also said they had difficulty sleeping at least twice a week. About a third reported having a lack of interest in daily activities at least twice a week.

The majority of spouses reported a lot or a little stress from handling domestic issues alone and from being single parents.

Dr. Harding praised the hotline, saying mental health problems often intensify after a veteran is home for a while. At the time of discharge, most are in a hurry to go home. "So they say, 'I'm fine.' They believe they are tough. They've been normal all their lives and they want to get home."

It's when the sleeplessness, anxiety and family problems materialize that they may need additional help. "If you have insomnia and everyone else around you is asleep and you are watching infomercials late at night with anxiety and desperation creeping up on you, being able to call someone can be lifesaving," he said.