1. Suicide 101 Peter M. Gutierrez, Ph.D. VA VISN 19 MIRECC Department of Psychiatry University of Colorado Denver School of Medicine

2. National Vital Statistics Reports, 56(10) National Mortality Data - 2005 32,637 Suicide Deaths (11.0) 25,907 Male Suicide Deaths (17.7) 11 th Leading Cause of Death Rate for 25-34 y/o 12.4 Colorado 6 th Highest Rate (17.1)

3. National Vital Statistics Reports, 56(10) Estimated Attempts - 2005 No Official National Data Compiled 816,000 (25:1) One Attempt Every 39 Seconds 3 Female Attempts for Every Male

4. VA Suicide Data Sources VA relies on multiple sources of information to identify deaths that are potentially due to suicide –VA 's own Beneficiary Identification and Records Locator Subsystem –Records from the Social Security Administration –Data compiled by the National Center for Health Statistics in its National Death Index

5. National Death Index Matched to Service Members Separating 2002-2005 VA examined OEF/OIF service members who separated from service in that time period Male veterans 18-29 who used VA care died by suicide at a rate of 21.0/ 100,000, compared to veterans of that age who did not use VA for care (30.4)

6. NDI Findings Continued Male veterans aged 30-64 who used VA for care died of suicide at a rate of 17.5 compared to a rate of 22.8 for those who did not use VA for care (ns) only 3 women OEF/OIF veterans died of suicide through 2005, accurate rates within age groups cannot be calculated

7. VA Efforts to Track Suicide Attempts Suicide Prevention Coordinators now compiling data on suicide attempts, of which they are aware, at all 153 medical centers nationwide In place for past 22 months

8. * Indicates fewer than 3 deaths; "Veteran" indicates only that the person served in the US Armed Services

9. Lessons Learned from OEF/OIF Veterans Qualitative study of combat veterans Impacts of deployment Coping strategies developed in theater don't work as well at home Role of burdensomeness, failed belongingness, and habituation to painful stimuli Brenner et al., 2008

10. Gutierrez, Huggins & Brenner, 2008 Suicidality and Psychiatric Admission – VA TBI Survivors 22 Subjects Total Number of Admissions: 114 –Median Number of Admissions: 3 –Range of Admissions: 1-20

11. Gutierrez, Huggins & Brenner, 2008 Suicidal Ideation Assessed at Time of Admission

12. Gutierrez, Huggins & Brenner, 2008 Suicidal Ideation Present at Time of Admission

13. Gutierrez, Huggins & Brenner, 2008 Number of Admissions Secondary to a Suicide Attempt 11% of total admissions Number of attempts 1-5 Median - 2

14. Gutierrez, Huggins & Brenner, 2008 Attempt Method

15. National Suicide Crisis Line 1- 800-273-TALK Press 1 for Veteran Partnership with the Lifeline Program of the Substance Abuse and Mental Health Services Administration Went live July, 2007

16. Impact of VA Crisis Line - Nationally As of April ‘09, more than 120,000 calls have come to the hotline from veterans, family members, or friends 3060 rescues involving emergency services