Tears well in his eyes, he stops talking. Silence hangs between us and I shift uneasily in my chair. I hesitate to reach for the Kleenex, as this is a delicate situation. I am a psychiatrist and my patient, a veteran. Home from Iraq for two years, but the passage of time has not healed his psychological wounds.
Through stifled tones he bravely tells me his story. About horrifying memories, so difficult to erase and now dangerously directing his life. The tears start to fall. It's difficult for him to open up, but necessary if I am to get an honest answer to my next question: "Have you had thoughts of killing yourself?"
Eighteen American veterans die as a result of suicide every day, a sobering statistic. The Dept. of Veterans Affairs has done much to try and prevent such tragedies, programs like a 24/7 suicide prevention hotline, specialized teams that keep close tabs on high-risk veterans, suicide education, outreach and research efforts are just some examples.
But suicide remains difficult to prevent, mostly because it is hard to predict who will take that fatal step. For example, we know that suicide runs in families, but there is no suicide gene that neatly predicts who in a family will take their own life. Also, we know that those suffering with mental illnesses, like bipolar disorder, are at much higher risk for suicide. But under what circumstances they might do so remains elusive. Finally, those thinking about taking their own life don't readily share this. So then, how do we get them the help they need at the crucial point in time that they need it?
The solution? One approach is to see suicide as a problem that is everybody's business -- family, friends, employers, educators and all caregivers. We can all get educated about warning signs, how to approach someone you are concerned about and how to get them help.