Suicide Prevention Challenges Educate VHA Staff on How to Help Save a Veteran’s Life
By Janet Sprehe, DNP, APN-BC, CVRN, RN-BC
Program Director of Simulations/REdI
James A. Haley VA Hospital and Clinics
TAMPA, Fla. - According to 2018 statistics from the National Institute of Mental Health (NIMH), 20 Veterans end their lives each day by suicide. That’s why the James A. Haley VA Hospital in Tampa, Florida and the Puget Sound VA Healthcare System in Seattle have been conducting suicide simulation challenges with other VA facilities across the country since 2016. This effort is in cooperation with the VA strategic plan to help reduce suicide rates among Veterans. Suicide is a leading cause of death in the United states. In 2016, over 45,000 lives were lost to suicide, and suicide rates have increased over 30% in half the U.S. states since 1999 (CDC, 2018). This increase has been a major concern across VHA.
Besides the Tampa and Seattle facilities, other participating VA medical centers are in St. Louis; Portland, Oregon and Bay Pines, Florida. Two sites used standardized actors playing the roles of the patient at risk for suicide with the hospital staff. Cases were true cases that occurred in each facility, and the other participating sites observed the training via video teleconferencing and then rated the two challenges while also participating in the debriefing.
The debriefing from staff across the country has opened a tremendous avenue of sharing best practices with each other. Not only did the participants discuss policies and procedures, they also discussed how the suicide intervention team members located Veterans who were in the actual process of harming themselves and what VA police had to do to get to the victim. Involving specific community resources were also written into the scenarios.
For 2019, the scenarios involved a male spinal cord injury Veteran whose wife left him, took his dog, as well as his pain medications. The other scenario involved a young female Veteran who had a newborn and three children under the age of 5. In the scenario, her husband later got arrested for holding onto a police officer’s arm while trying to let the female Veteran escape from the hospital after she had claimed she wanted to harm herself.
Why do Veterans and citizens want to end their lives prematurely? Over 54% of people who commit suicide do not have any mental health condition. How can VA staff help our Veterans feel like the answer to their problems is ending life? Many factors contribute to suicide among those with and with out mental health conditions. For example, losing shelter or one’s home, job or finances, use of problematic substance use, relationship problems and decline in physical health are all key factors in victims who commit suicide. Our national heroes have been trained to be stoic and often do not let others, even their health care providers or close family, understand the pain they are in.
The videoteleconferencing event lasted for one and a half hours, and participants received 1.5 hours of continuing education credit. Many participants asked to do the simulation challenges more than twice a year. Other comments included, “this really opened my eyes to how the normal Veteran I see may have such thoughts, so I need to ask them more questions and assess what their plan is and how I can help them more,” and “I never realized the avenues of what one has to do when we see a Veteran who does admit they want to commit suicide.”
From the numerous suicide simulation challenges that have been presented, everyone seems to have learned something new from it. Whether it was how to approach someone at risk, how to better intervene, better ways to get the patient to open and share their feelings or ways to prevent Veterans from harming themselves; everyone realizes that each scenario presented represents an actual Veteran who wanted to end their life.