Ending Veteran Suicide
The first in a series of articles on solutions that save lives, in partnership with Mission Veteran Possible.
The best way to reduce the risk of suicide for an individual? It’s not a surprise. It just seems like an impossible task sometimes.
The task is: Help them feel better. Do something that works.
The best way to not kill yourself? It’s by not wanting to kill yourself. People who don’t want to kill themselves rarely die by suicide.
Forty-four veterans kill themselves every day. This is unconscionable. But knowing hope exists is a necessary first step to having hope.
Oral medications aren’t the answer, for the most part. Or, at least we don’t know how much of the answer they might be. The reason for this is that zero currently available oral antidepressant medications have been studied in randomized controlled trials to treat suicidal individuals.
That statement is not a typo, or a mistake. It is a shocking but accurate statement.
We have one randomized controlled trial of an oral psychiatric medication, the medication clozapine, in which it was used in individuals with schizophrenia or schizoaffective disorder. The study demonstrated a reduction in suicide attempts as a result of this medication, compared to an active control (olanzapine).
No currently available oral antidepressant medication has ever been studied as a treatment for people who are thinking about suicide. Because suicidal people are excluded from most studies in the first place.
Those black box warnings you hear about for teenagers? The ones that say “Call your doctor if you start having suicidal thoughts?”
The suicidal thoughts that those warnings refer to were happening in people who were enrolled in randomized controlled trials. Remember, by definition, these people weren’t suicidal when they enrolled in the trial.1
To sum it up, oral antidepressant medications have been studied in populations that did not include the suicidal veterans I want to address here.
So, I’m going to be writing about those treatments that we already have evidence for in cases such as this. Treatments that work for people who are struggling with suicidal thoughts. I am also going to be writing about emerging options that could reduce the risk of completed suicide for people struggling with thinking about it. I’ll discuss how these options apply in veteran populations.
Veterans deserve to be well, not suicidal. This means we need effective treatments. It also means we need to get the word out about what works.
I’m going to be writing about the fact that hope exists, even for those who are really struggling.
Veteran Suicide? Let’s Rethink This.
By the way, if this topic matters to you, use hashtag #EndVetSuicide on Twitter, LinkedIn, and other social media outlets, to amplify this message.
Thanks so much.
—O. Scott Muir, M.D.
Also, it’s worth noting that no children died by suicide as a result of suicidal thoughts during these trials. Many more children died by suicide after the FDA warning about suicidal ideation as a potential side effect of oral antidepressant medication. By getting doctors to worry about suicidal thoughts, we consigned more children to suicide. These worries led doctors and families to withhold effective treatment from their children.