1. Suicide Prevention Robert Tell, LCSW Suicide Prevention Coordinator Portland VA Medical Center

2. What’s the VA doing? Suicide prevention coordinators in each medical center 24-hour hotline Guide training Ongoing identification of patients at risk Ready access to Mental Health services Monitoring and follow-up to maintain continuous care

3. 1-800-273-TALK (8255) Partnering with SAMHSA and Lifeline VA employees 24 hours a day Veterans, family members, and friends can call Follow up provided by local suicide prevention coordinators

4. It’s everyone’s problem A third of suicides aren’t receiving care. We need to catch them wherever we can. Know the warning signs. Ask the questions. Refer for help.

5. Prevention is hard, but it’s worth it. Study of people prevented from jumping off of the Golden Gate Bridge. 94% are still alive or died of natural causes after 15 years. A comparison group of people admitted to SF Hospital had 89% still alive after 15 years.

6. Warning Signs Hopelessness Rage, anger, seeking revenge Acting recklessly or impulsively Feeling trapped Increased alcohol or drug use Withdrawing from friends, family and society. Anxiety, agitation, unable to sleep or sleeping all the time Physical illness (Pain, Nausea, untreatable discomfort) Dramatic changes in mood No reason for living, no sense of purpose in life. Talking about suicide!

7. Warning Signs: Talk 66% said something to a family member or friend Overt (active suicidal ideation) –“I want to kill myself” –“I am going to kill myself” Covert (passive suicidal ideation) –“I would be better off dead” –“Life has lost its meaning for me” –“Its just too much to put up with anymore” –“I can’t go on any longer” –“Nobody needs me anymore” –“Maybe a car will hit me”

8. Warning Signs: Action 80% give a clue –Buy a gun –Stockpile medications –Take a sudden interest, or lose interest in religion –Take risks –Have previous suicide attempt/s –Make amends: Thank You’s & Good-byes –Get affairs in order –Make a Will –Give away prized possessions –Have sudden unexplained recovery from severe depression –Spend Money or give gifts or charity that is out of character

9. Ask the Questions Are you currently having thoughts that you might be better off dead? Are you currently thinking about specific ways to hurt or kill yourself?

10. Get Help Multnomah (503) 988-4888 Hillsboro (503) 291-9111 Clackamas (503) 655-8401 Clark County (360) 696-9560 Washington County (503) 291-9111 National (800) 273-TALK

11. Means Restriction Guns! Bullets in a separate place Trigger locks Locked cabinet Each provides additive protection!

12. Portland VAMC Suicide Prevention Coordinator Robert Tell, LCSW Phone: 503-220-8262 x56198 E-mail: robert.tell@va.gov