Suicide, the 10th leading cause of death among all Americans, is taking the lives of our nation’s veterans at a growing rate. The Department of Veterans Affairs is committed to improving the health and well-being of veterans by addressing suicidal behaviors. And on this Veterans Day, it’s important to recognize that there are things all of us can do to help those at risk of suicide.

The rate of veteran suicide is about twice that of non-veterans. In 2014, veterans represented 8.5 percent of the national population but accounted for 18 percent of adult deaths by suicide.

The latest VA data show that from 2005 through 2015, roughly 20 veterans and service members died by suicide every day. Suicide rates rose substantially among veterans ages 18-34, yet remained relatively stable among their civilian peers. The suicide rate among women veterans has increased much faster than among male veterans and female non-veterans.

Many factors contribute to the increased risk of suicide for veterans. They are exposed to brutal combat conditions and they experience high stress, long deployments in hostile environments, long-term medical and brain injuries and sometimes experience sexual or physical assault (both males and females). Many combat-deployed veterans struggle with other challenges, including divorce, post-traumatic stress disorder and readjustment to daily life. Once separated from the military, many feel isolated.

The four of us – including Jeffrey Barkin, M.D., board president of Tri-County Mental Health Services, and Executive Director Catherine Ryder – believe it is important to understand the facts:

 Asking about suicide does not create suicidal thoughts.

 The immediate risk is often time-limited and can be prevented.

Making one method of suicide less convenient may be enough to deter a person from suicide, offering time to intervene.

Eighty-five to 90 percent of people who survive a suicide attempt do not die by suicide later.

The VA initiative SAVE encourages intervention through care and compassion when encountering a veteran who may be suicidal:

Signs of suicidal thinking (hopelessness, mood swings, increased substance use, withdrawal from family and friends).

 Ask questions (“Have you had thoughts about taking your life?”).

 Validate the veteran’s experience by talking about it nonjudgmentally, reassuring him/her that help is available.

Encourage treatment and expedite help (don’t keep the behavior a secret; do not leave him/her alone; call 911).

Resources available to support veterans in crisis include:

Find local VA services by visiting  veteranscrisisline.net/get-help/local-resources.

 Connect with other veterans at maketheconnection.net/.

Coaching Into Care: A VA national phone service at 888-823-7458; mirecc.va.gov/coaching/.

Other recent VA initiatives include “SAVE,” a 25-minute online suicide prevention training video, as well as veterans outreach services at Lewiston-based Tri-County Mental Health Services (tcmhs.org; 888-304-HOPE).

An expanded Veterans Crisis Line is available 24/7: Call 800-273-TALK (8255) and press 1. An online chat service at is available at VeteransCrisisLine.net, with a texting option (text to 838255). The VA allows direct connection to the crisis line by pressing 7 when calling a VA medical center.

The VA is also employing preventive tactics. They’re setting up screening processes to help identify veterans at risk of suicide, and using computer algorithms to determine which veterans may be at highest risk, allowing providers to intervene early.

They’re identifying veterans in the top 0.1 percent of risk (who have a 43-fold increased risk of death by suicide) before signs of suicide are evident. These veterans get missed-appointment follow-ups, safety planning, follow-up visits and treatment plans that directly address their suicidality.

Veterans have sacrificed so much for us – we can start to repay them by reaching out and helping veterans in crisis get on a path to mental health recovery.