VA suicide prevention doctor: Can suicides really be prevented?

Dr. Matt Miller, the director of suicide prevention for the VA, speaks before The American Legion at the Washington Hilton during the Washington Conference on March 9.

WASHINGTON — The director of suicide prevention for the U.S. Department of Veterans Affairs struggles with the notion that suicide is preventable.

“I have a love/hate relationship with that saying,” Matt Miller told a room of Legionnaires at the Washington Conference of The American Legion on Monday, March 9.

As the chief of mental health at Vance Air Force Base in Enid, Oklahoma, Miller spoke with the airmen about suicide prevention every six weeks. That included a good friend, a pilot named John, who, unfortunately, died by suicide using a firearm. The death made Miller feel like all of his efforts were for nothing.

He left the military, grew his hair our and holed himself up indoors.

One day, he watched “60 Minutes” on CBS. It had a segment on veteran suicide that was not encouraging.

“That was an eye-opener for me,” Miller said.

He thought he could either get up off of his ass and do something or he could wallow in questions and guilt.

“I figured the best way to honor John was to do something,” Miller said.

He applied to work for the VA and got a call from Saginaw, Michigan. Google, he said, wasn’t kind to Saginaw, but he and the staff there liked the place. He was the chief of mental health there.

“We called it Saginawesome.”

Now, preventing suicide is not just his day job. He said he felt John’s death was the result of an impulsive choice, and he shared with the Legionnaires the three fronts of the VA’s efforts to prevent suicide.

  1. A community-based coalition, where everyone is paying attention down to the county and city levels.
  2. A veteran-to-veteran coalition, where veterans are tending to buddies.
  3. Governor’s challenges to raise awareness and communication.

He said the time between the decision to die by suicide and the act of suicide ranges between five and 60 minutes. Efforts will focus on introducing a time and space between the two.

“Lethal means safety” is a term for limiting access to lethal means of self-harm, which has been a proven way to reduce suicides, Miller said.

That particularly regards firearms, without impinging the Second Amendment, Miller said, but practicing safety and security.

Veteran suicide by firearms in 2017 among male veterans was 70.5 percent. Among female veterans, it was 43.2 percent.

He said people tell him, “Matt, they will just find another way to do it.”

Miller said he said that is untrue and that 90 percent never attempt suicide after an intervention.

There were 6,139 veteran suicides in 2019, up from 6,010 in 2018.

The rate of suicide was 2.2 times higher among female veterans compared with the non-veteran population. The rate of suicide was 1.3 times higher among male veterans compared with the non-veteran population.

Male veterans ages 18-34 experienced the highest rates of suicide, while 55 and older experienced the highest count of suicide. (Counts and rates are different approaches, and, of course, there are more veterans over 55 than between 18 and 34.)

“Both need careful attention,” Miller said.

He noted veteran suicide is set against the larger context of suicide as a problem among the general population. Suicide, Miller said, is now the second leading cause of death in the United States.

Suicides in the United States in 2005 was 31,610. Suicides in 2017 was 45,390. That’s a 43.6 percent hike.

Veteran suicides in 2005 was 5,787. Veteran suicides in 2017 was 6,139. That’s up 6.1 percent.