By Bernard A. Lubell—Medill News Service—nwitimes.com

David Cox remembers being deployed, looking at his loaded weapon and thinking of ending his life.

The Highland resident had suicidal thoughts during at least one of his six deployments to Iraq and Afghanistan and is thankful that one of his team members recognized his symptoms. Cox’s weapon was taken away before he was sent home.

Cox had grown accustomed to seeing horrible things. In his civilian life, he worked for 14 years as a trauma nurse specialist at Cook County’s John H. Stroger Jr. Hospital.

But in the Air National Guard, he was part of a three-member team that worked on the most critically wounded as the patients were transported to hospitals to receive treatment. He said the work he did while deployed was different than the work at the hospital, and it took its toll.

“You see things the human mind really isn’t supposed to see,” said Cox who was diagnosed with post-traumatic stress disorder and said he still struggles with suicidal thoughts sometimes.

More than 134,000 people made calls to the National Suicide Prevention Lifeline last year. Of those callers, 61 percent identified themselves as veterans, while 7 percent identified themselves as a friend or family of a veteran.

This means nearly three-fourths of calls made to the lifeline were related to veterans’ issues.

“What we don’t really know is the relationship between the people who are really going to kill themselves and the population who calls,” said Dr. Dean Krahn, chief of the mental health service line at the U.S. Department of Veterans Affairs center in Madison, Wis.

The Department of Defense and Veterans Affairs annual Suicide Prevention Conference is taking place this week through Thursday. Registration had to close, according to online notices, because of the number of people who signed up for the conference.

The lifeline was established in 2004, and the VA partnered with the lifeline in 2007 to provide those services for veterans. By dialing “1” after calling (800) 273-TALK, veterans are routed to a lifeline that caters to their specific needs.

While each veteran’s story is unique, there is a uniting thread: Combat changes you. Some veterans can cope; others cannot. Some consider suicide, and others attempt it.

Cox said while he was deployed he made a promise to himself to bring awareness to PTSD and what veterans go through when they return home. He works with organizations such as The Wounded Warrior Project with the hope of reaching at least one person. Cox said support from family members is a major influence on his life.

One doctor who works with veterans’ mental health issues at Hines VA Medical Hospital in suburban Chicago said the transition to civilian life is difficult.

“One thing that our servicemen and women are not always good at is reaching out for help when they come back,” said Thomas Nutter, assistant chief of mental health.

Some veterans end up taking their own lives. The VA reported nearly 11,000 suicide attempts and about 700 deaths in 2009.

Calls veterans make to the lifeline have been increasing by about 20,000 each year.

“Part of it is the education and the efforts of the VA,” Krahn said. “Part of it is probably a jump in suicide ideation, but I’m sure it’s not a 100 percent jump.”

Only half of veterans seek out VA services, which means that the numbers likely are higher, said Kristen McDonald, suicide prevention coordinator at the VA Healthcare Center in Palo Alto, Calif.

For the other half not seeking care through the VA, finding reliable data is difficult.

“What we’re finding is that veterans getting care from (the VA) are less likely to attempt suicide,” McDonald said.

There is preliminary evidence suggesting that veterans ages 18 to 29 who use VA health care services, compared to veterans who don’t, have decreased suicide rates, McDonald said. This decrease translates to about 250 lives per year.

In the same vein of outreach, the VA created an awareness campaign for mass transit lines in 2008 to help veterans and their families learn about the toll-free crisis lifeline. In late 2010, Chicago became one of 11 cities in which the campaign was expanded. Advertisements for the lifeline could be found on CTA buses and elevated train platforms around the city.

The Army’s Health Promotion Risk Reduction Suicide Prevention Report published in July details Army suicide prevention programs.

A holistic approach to mental health, including resiliency training and understanding risk factors are cornerstones of the report. The four pillars of the prevention program are educating participants, reducing stigma, providing resources and involving families.

The report also deals with the misconceptions associated with seeking help as a veteran or soldier.

The typical non-active duty suicide is committed by a young, white male junior enlisted soldier, the report shows.

“Certainly going to war can be difficult for your mental health,” said Krahn, at the VA in Madison. “Seventeen percent come back with post-traumatic stress disorder and others come back with (similar rates of) depression, and a chunk of both of those drink heavily.”

Gunshot wounds are the most frequent cause of death in these suicides, the report states.

“For veterans, your weapon is your security. It keeps you safe,” said Nutter, at Hines VA. “As a group, they are more likely to have weapons, and those with weapons in their homes are most likely to complete suicide.”

Nearly 700 soldiers committed suicide while in Vietnam, according to a spokesman for the 50th anniversary of the Vietnam War Commemoration Commission.

While no data is publicly available, estimates of suicides committed by Vietnam veterans, depending on the source, range from 2,000 to 300,000.

“The hardest part for everybody to deal with is that lots of people care a lot about this group of people who have risked their lives for us,” Krahn said. “So we all are sort of desperate for a single, simple answer, and it’s very unlikely that it’s a single, simple answer. And so I think one of the great risks is that instead of sticking with this project probably for months, years and decades, we’ll get into fights with each other about: ‘We invested in this why isn’t it fixed?’”

Times staff writer Kathleen Quilligan contributed to this story.

Original Article: http://www.nwitimes.com/news/local/illinois/chicago/article_8f89cb03-660b-5721-bdaa-850740660354.html