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Better data gathering to prevent suicide: expanding a national reporting system will enable stakeholders to craft better suicide prevention programs.

In Iowa, 22-year-old reservist Joshua Omvig died by suicide after suffering from untreated post-traumatic stress disorder (PTSD) following his 11-month tour of duty in Iraq. In Massachusetts, 23-year-old Jeffrey Lucey, another Iraq veteran suffering from deep depression and PTSD, died by suicide less than a month after being discharged from a military veteran's hospital. And in Kentucky, 28-year-old Spc. Jeremy Seeley committed suicide after returning from Iraq.

Unfortunately, these are not isolated stories. More than 30% of military men and women who accessed Veterans Affairs care between September 2001 and September 2005 received mental health and/or psychosocial diagnoses. The challenges posed by the war in Iraq are unlikely to be resolved in the immediate future, making it all the more important to provide quality mental health education, outreach, and services to returning veterans and their families.

Veterans make up about 11% of the U.S. population, yet they account for 19% of deaths by suicide, according to data from the 17 states using the National Violent Death Reporting System (NVDRS). Thus, about one in five suicides involves a veteran. That's why the Suicide Prevention Action Network (SPAN USA), a grassroots advocacy group working to advance public policies to prevent suicide, is dedicated to ensuring that our veterans receive the quality mental healthcare they need and deserve. An important component in developing effective programs and public policies is having comprehensive data about the circumstances surrounding suicides to inform policy makers, public health officials, and other stakeholders. NVDRS compiles critical data about homicides and suicides into a central database, and its full implementation in all 50 states must be a priority as we work to prevent suicide among veterans.

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The Cost of Suicide

More than 31,000 people complete suicide each year in the United States, and approximately 1.4 million attempt suicide. On average, 89 people take their own lives every day. By comparison, fewer than 20,000 die from homicide.

Most individuals who complete suicide suffer from depression, addiction, or other diagnosable mental illnesses, but two-thirds of those who die by suicide are not receiving treatment at the time of their death. Suicides cost the United States $13 billion in lost earnings each year, and suicide attempts requiring hospitalization cost the United States $3.8 billion per year. The emotional costs to countless families and communities are incalculable.

Despite the enormous toll suicide takes on our society, there is no comprehensive national system to track violent deaths in the general public or among veterans. But NVDRS can help: It can be used to develop effective prevention policies and programs.

How NVDRS Can Help

Housed at the Centers for Disease Control and Prevention, NVDRS is a comprehensive, linked reporting system that collects and centralizes information on homicides and suicides from a variety of sources, such as medical examiners and coroners, law enforcement, hospitals, public health officials, and crime labs. Information from NVDRS provides a better understanding of the circumstances surrounding violent deaths and helps officials and organizations develop and implement effective prevention policies and programs.

Before NVDRS was created in 2002, federal and state public health and law enforcement officials collected valuable information about violent deaths but didn't combine it into one comprehensive reporting system. Instead, data were held in a variety of different systems, and policy makers lacked the clear picture necessary to develop effective violence prevention policies.

NVDRS now is able to capture data critical to identifying patterns and developing strategies to save lives. With a more complete picture of why violent deaths, such as veterans' suicides, occur, the Department of Veterans Affairs, veterans' service organizations, the military, law enforcement, advocates, and public health officials can work together more effectively to identify those at risk and intervene with the necessary preventive services.

Yet NVDRS is funded and operating in only 17 states (figure). Another eight states and the District of Columbia previously applied to become NVDRS sites, were approved for participation by the CDC, but were unable to join due to funding shortfalls. Several additional states and Puerto Rico have expressed interest in joining NVDRS once new funding becomes available. The CDC would like to expand the program to all 50 states.

Fortunately, many states with a high number of veterans participate in NVDRS, including Virginia, North Carolina, South Carolina, and California. But other states with large veteran populations, including Texas, Ohio, and New York, are NVDRS-approved but not funded.

Without NVDRS data from every state, significant changes in a state's rate of suicide might not be detected. For example, in North Carolina researchers examining NVDRS data found that 24% of the people who completed suicide in 2005 were veterans--a 3% increase from the year before. In Virginia, NVDRS data showed that one in four suicide victims had served in the military; among male victims older than 65, more than 60% were veterans, demonstrating the need for the state to extend suicide prevention efforts to veterans' hospitals and service providers.

Two-thirds of the country still lack NVDRS coverage, leaving all but 17 states without the ability to learn about trends in their state and share vital data that provide a clear direction for violence prevention policies. Because each state has a unique population, NVDRS should be expanded to specifically inform each state about its particular trends as suicide prevention policies are crafted.

SPAN USA, along with other members of the National Violence Prevention Network, is advocating Congress to provide no less than $10 million for this vital program. The information collected through NVDRS is critical to developing and evaluating suicide prevention programs and policies among veterans. And given the proper funding, the CDC can expand NVDRS to all 50 states and better inform the policies proposed and implemented to help prevent suicide among veterans.

Conclusion

Omvig, Lucey, and Seeley all displayed symptoms of PTSD before their deaths. Omvig's aunt said her nephew refused psychiatric care, worried that it would hurt his chances of becoming a police officer. Lucey's father, Kevin, described how his son was haunted by killing two unarmed Iraqis, and how his drinking and isolation escalated. Seeley's grandfather told a reporter he believes his grandson still might be alive if the military had stepped in to help.

These are not atypical stories of veterans suffering from PTSD. And with the Department of Veterans Affairs estimating that 12 to 20% of those who served in Iraq suffer from PTSD, comprehensive data to inform the military, policy makers, and healthcare professionals are imperative. Tying the data together, through NVDRS, is critical to further prevent suicide among veterans.

Jerry Reed is the Executive Director of the Suicide Prevention Action Network USA. For more on NVDRS, visit www.preventviolence.net.
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Title Annotation:ADVOCACY
Author:Reed, Jerry
Publication:Behavioral Healthcare
Date:Jul 1, 2007
Words:1112
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