Suicide in Veterans: What to do if you get a call? Do we know?

I wrote this personal story last year as to be released in periodicals across the nation. I publish this here because this is still issue needs to be addressed; what do you do if you receive a suicide call from an active duty member or a veteran?

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I just returned from a PTSD suicide call where I left a home covered in blood and having to throw my sweatshirt away. It started when I received a text message from a once friend who said he needed help because he was suicidal and needed PTSD assistance.

I feel the need to write this because after going through the ordeal I’m about to relay, I still do not understand how to navigate the broken system for PTSD and veteran suicide help effectively.

What I realized through all of this however, is that 1) It‘s a good thing I’m not actually a veteran social worker because the trauma and poor system would be too much for me to handle and 2) It reaffirmed that we need a better system for PTSD/reintegration from war

 Flashback 4 years ago, I met Gabe and his dear wife Erica. They quickly became two of my closest friends in California. Gabe was a prior Marine and then a contractor that was literally blown up multiple times overseas. Severe physical ailments along with PTSD were evident, but his wife, who was also in the service, loved him dearly and continued to have hope that she could get him the help he needed. His VA claim had been lost for years and he still didn’t have a status determination from the VA to get the help he needed for physical or mental ailments. Despite being proactive, the lost claim fell on deaf ears. This Marine was as sweet as could be, but suffered from night terrors and violence in his sleep. He had obvious PTSD symptoms that he kept under control with fitness and other means while Erica tried to get his VA paperwork pushed through. Six to seven years after Gabe got out of the Marines, his VA claim was finally taken care of, but by then he had destroyed himself and his marriage. He lost all of the positive people and things in his life.

 Trying to help in my own way, I worked hard to get Gabe a job at Amazon and ensure his VA claim had made it to the proper place---mainly because I knew inside he was capable and just needed a chance at life and the workforce; he greatly lacked purpose and a sense of belonging. He felt like he was never good enough….so I thought with a good job and some potential VA benefits he would get there. Unfortunately, he started using alcohol to quiet his voices and then marijuana…which then led to other drugs. His wife Erica deployed to Bagram for 6 months and I promised I would keep an eye on Gabe in the event he was volatile. Gabe struggled greatly while Erica was away. Sadly, it was his codependence on Erica, and lack of her presence while on her deployment, that pushed him over the edge to a degree that led me to contact resources to help him. When those resources arrived, Gab he lied and said he was fine, then resuming his course to further self-destruction.  He would only work with a team that understood his military background and what he had been through. When Erica arrived home from deployment, Gabe was supposed to pick her up, but was nowhere to be found. I will never forget that thunderstruck [GD1] phone call from Erica.

 Erica and Gabe eventually divorced as Gab self-destructed and resisted getting help he needed--mainly because he felt rejected by the system. I was one of the only people he would talk to besides Erica—and one of the only people that really understood him. But once the divorce loomed large—he drew in further and further, him unwilling to get help and me unable to get any rehab facility to assist him. I was fighting too many other battles to take that one on myself. His self-destruction carried on in reckless behavior, and he became even more disconnected.

 Now, a year after the divorce with Erica and relocated to the east coast, I received a text from Gabe saying he was suicidal and needed help, “like suicidal help” the text said, “I don’t know who else to call.” I called him immediately to find out he took a bottle of pills as well as other drugs to not wake up-----but ended up sleep walking into oncoming traffic where he was hit by a car. When he got hold of me, he had just been released from the hospital even though they knew he tried to kill himself. The small town didn’t see a need to keep an “addict” supervised. I told him to hang tight and that I was on my way. He said if I called the police and they entered without me being there that he would kill himself right then. I promised him I would be there first.

I hopped in the car and called the Department of Defense Military One Source resource that  connected me to the suicide prevention hotline, to which I conveyedthe situation. They pushed me through to dispatch in the Modesto, CA area, and they proceeded to say that they were heading to the house. I told them I was an hour out and that I needed to keep Gabe on the phone and not have them show up without me. Much like in a hostage situation or a situation with children involved, there needed to be finesse in a suicide prevention process They showed up before me anyway.

Gabe called irate and said I needed to hurry because he didn’t want them there. When I got there, the police had already left because he lied and told them he was fine. I reluctantly knocked on the door alone. Gabe was covered in blood from having smashed his head through the back door window and breaking plates and punching other objects. His hands were covered in blood and the walls were covered in blood. The place wreaked of alcohol, drugs and smoke. There were needles, and pill bottles.

Gabe had poorly done staples in his head and scabs covering him. He saw me and his 6’5” frame picked me up and held me and told me he loved me and trusted me and to not leave him anymore. That he missed “us.”

He said he knew I would come. We sat on the couch with his Bull Mastiff that had been keeping him feeling as though “someone” cared and talked about what was going on. I had been texting his ex-wife and his other one-time  best friend Steve the entire time. Steve was on his way to retrieve the dog so we could make sure he was taken care of. Gabe was extremely concerned about the dog—because it is all he claimed to have. I told Gabe him I loved him, his ex loved him, he had friends that loved him. He cried and repeatedly asked why he was this way and why nobody wanted to help him? I kept itching myself because I was getting more and more dirty the longer I sat in the filthy home with blood stained walls.

 I called the police to help me get him to a facility, and yet they wouldn’t come because they had already been there. I remembered the guns in Gabe’s house and became scared and called the police again and lied to say he had an overdose right then because there was no other way to get them out there. I didn’t know what else to do. Gabe blurted that if I left,  he would kill himself.  I still got in my car because I became worried for my life (although I didn’t want to) and put an extra layer of metal between me and his front door. When the police arrived they chastised me for a false call and said they probably couldn’t retain him. Gabe told them that he wouldn’t harm himself. I looked at Gabe (who kept wanting to continually hug me) and said “you yourself told me that you would kill yourself if I left. Right?” He agreed but then told the cops he was joking.  I could make eye contact with Gabe and tell him it would be okay…but then he would get distracted and angry. I kept calling his ex-wife and Steve…asking what other resources they could think of. The local VA had also turned us away without onsite help.

I called my co-author, Dr Ross, and asked for help. I called psych armor. I tried everything I could think of to try to get someone to assist. The cops finally agreed to provide an escort to the nearby mental health facility who verified his PTSD and then sent him on his way alone….yet again.

 Luckily enough resources finally were pulled in, but Gabe still spent the night alone, unsupervised because he ran away after the local facility let him go (after approximately 30 minutes).  Eight years after returning from war and being a mess,  Gabe was not in a facility for treatment or getting any help. He last words as I hopped in the car to hand-off to Steve to get the dog, etce were “ Why is it so hard to get Gabe the kind of help he needs?” I said “I know Gabe----we will get you there.” He texted saying “I need to be with people that understand me.”

 So my question—was why is there not a single place to call when I needed immediate help for someone that is READY to take treatment? Who wants help? What does someone do that is not as well connected or resourceful as I am? How do we change this? How do we get help to veterans like this that have legitimately severe PTSD? How do we do better cross-checks when they return? Who should I have called that could have helped me when I showed up on scene with a 6’5” man covered in blood with guns……knowing he had PTSD and WANTED help? It shouldn’t be so hard…should it?

What are the steps that need to be taken when I get the call again? When someone else gets the call? Five different numbers on scene---and nobody would come to my rescue. After 16 years of war, our country still does not have a reliable solution for this known and growing problem. What will it take to prevent these ongoing casualties of America’s wars?

This experience spurred me to dive deeper into our Nation’s issues by reaching out to contacts across the board. While I still do not have a resolution for reintegrating our heroes with PTSD, I was able to connect with the suicide prevention lead for the Department of Veteran Affairs to come up with an action plan if you are to receive the call. If you are faced with an issue, your steps should be

1)     Listen and engage directly with the individual

2)     Ask directly based on what was said about whether they were considering suicide

3)     Get someone there with the Veteran as quickly as possible

4)     Once on scene, insist on going to ED or MH crisis unit for evaluation, make sure that you are allowed to provide input to providers (as many times particularly Veterans will minimize) and (unfortunately) really advocate, push and push as a nuisance until you feel that the Veteran (or any patient) gets what they need.

5)     If you can get them to the VA there should be staff who can really assist them with what they need.

Below a link to the VA website which has a contact information for Suicide Prevention Coordinators at all the facilities.

https://www.veteranscrisisline.net

 [GD1]Not sure this is the right word choice to convey the emotion you’re trying to describe, but consider it a placeholder