By Alyssa Knoll
Oscar G. Johnson VA Medical Center
Community VA Engagement and Partnership Coordinator
When we see someone struggling with life stressors, we sometimes look away because we don’t know what to say or do. We feel like we do not have the skills or resources to help.
The good news is that professional mental health training is not needed to help. You have what you need in your toolbox. Be present with an open mind, be ready to listen, be prepared to ask tough questions and use resources.
It's important to recognize when things aren’t going right for someone. Risk factors are concerning and potentially increase someone’s risk of suicide. Factors we need to takeinto account include:
- Rurality — isolation, lack of transportation and lack of access to health care
- Separation from service — period of high risk
- Significant changes in substance use
- Trauma experiences — life threatening, sexual, physical or verbal abuse
- Significant changes in mood —very stressed to relieved
- Lack of sleep
- Emotional distress
- Access to lethal means
- Job loss, relationship issues, financial problems or troubles at home
- Peri/menopause
- Social support
- Access to mental health care
- Connection with self, trusted
- circle or community
- Problem-solving skills
- Mission or purpose
- Physical health
- Access/use of secure storage
- Safe home
- Employment
- Social and emotional wellbeing
- Healthy hobbies
suicide, it is essential to approach the person with care and compassion. Watch for changes in behaviors. For some, this may be in their mood. People who exhibit high levels of stress for a long time might suddenly act relieved even though the stressors all remain. They may have made a decision that will end the stress.
For substance users it could look like an increase in use or gambling. Watch for someone who gives away sentimental items when this is out of the ordinary. The person may make suicidal statements that draw your attention. People who are suicidal may talk about it before acting on their thoughts. The statements may not be direct. They might talk about going away and not coming back for a while.
Some examples of statements are:
“It won’t matter after tomorrow, nothing will.”“It would be okay if I never woke up.”
“You won’t have to worry about me being a burden anymore.”
Some statements are more direct, and sound like, “If this pain doesn’t stop, I’m going to shoot myself.” No matter the context, it is good to practice asking people about these statements. “Maybe you are not serious, but I know pain can be hard to live with. When you say that, are you serious? Do you have a plan to kill yourself?”
This is where asking questions to understand and listen becomes essential. If someone exhibits risk factors, behaviors or is making suicidal statements and you are concerned, ask them directly if they are thinking of suicide. If they say yes, you need to persuade them to go to an emergency room where they can be assessed for safety.
If they are not willing to go, call 988, Press 1, so they can talk with a Veteran specific counselor. You can sit with them and talk with the counselor together if they are reluctant to call for themselves.
At this point it is better to have a mad friend than a friend who has died by suicide. If someone has suicidal thoughts and is looking for mental health support, you can call 988, Press 1 day or night to talk with a counselor. The Veteran Crisis Line will alert the Veteran’s local VA Suicide Prevention Coordinators that a call has been made. The Suicide Prevention Coordinator will reach out to the Veteran to be sure they get the follow-up support and services they need.
Other mental health resources include:
- VA Mental Health during regular business hours from 8:00 a.m. - 4:30 p.m.
- Oscar G. Johnson VAMC Mental Health at 906-774-3300, ext. 32541
- Escanaba Vet Center, 301 North 30 th Street, Escanaba MI 49829, or call 906-233-0244
- 211 for community mental health resources
It is possible to have all the risk factors and experience high levels of stress and not be suicidal. Each person is different in how they manage life stress. If the person you are with says they are not suicidal, the following questions by Brad Bonar, stand-up comedian, magician and creator of the 1 Degree of Separation program, may help to talk to them to understand their struggles better.
Brad’s five questions are:
1. What does your depression or other mental health concerns feel like?2. What do others do that make it worse?
3. What do others do that make it better?
4. What do you do that makes it worse?
5. What do you do that makes it better?
You can find his story at, 1 degree of Separation.
Another great tool to explore is the VA Safety Plan app. The Safety Plan app is for everyone and helps to identify personal coping strategies and sources of support, giving suicidal thoughts time to decrease and become more manageable. Having conversations about places, things, pets, health care providers and support systems can help find additional support ideas. And the app is free.
By understanding the risk and protective factors for suicide among Veterans and knowing how to approach the conversation, you can play a crucial role in providing support and potentially saving a life. Remember, asking the difficult question directly and with empathy can open the door to vital discussions and interventions. Suicide prevention doesn’t require special training, just listening, caring, compassion and connecting them to resources for safety.
To receive a 1-hour free Question Persuade and Refer suicide prevention training
(individual or group), call U.P. Together With Veterans representative Pam Basal at 906-360-3890 or email pbasal-c@gapsi.com.
For emergent suicidal crisis, get to your nearest emergency room or,
- Call 988 press 1 for the Veterans Crisis Line
- Call VA Mental Health from 8:00 a.m. - 4:30 p.m. at 906-774-3300, ext. 32541
- Call the Vet Center in Escanaba MI at 906-233-0244
- Call 211 for community mental health resources
.jpg)