September is Suicide Awareness Month. Veterans are most at-risk for attempting or achieving suicide.

September is Suicide Awareness Month. Veterans are most at-risk for attempting or achieving suicide.

Trained for — and often placed directly into — battle, it isn't hard to understand how many soldiers return traumatized. They have an exceptionally difficult, sometimes impossible, mission to survive — but not just on the battlefield, they must be able to cope after they get home. After being subjected to unthinkable horrors, a veteran could find settling back into a life of normalcy more challenging than dodging bullets.

The mission of Dr. Johnie Fredman, owner of Focus Mental Health Services, at 1127 N. Kickapoo, and his team of 30 therapists, has been to help local veterans, and others, work their way past the past and toward a productive and healthy life.

Fredman said, regarding veterans, the topic of suicide comes up in conversation about half the time, in his experience.

“That doesn't mean they are all suicidal,” he said, “but the issue does come up, and that's significant — they are at increased risk, so we thoroughly screen them.”

He said statistically veterans are at higher risk of suicide, so it's something he and his team have to be aware of and sensitive to.

“They've been exposed to death on several levels,” he said.

Veterans have been trained to kill in order to defend and protect the country, their families and their friends, he said.

“Whether it's being the boots on the ground, working in intelligence or combat, they are seeing death first-hand,” Fredman said. “Having experiences like that can change how they look at it — they have been forced to face their mortality.”

At some point many get used to it; the idea of death almost no longer frightens them, he said.

With that mindset, orchestrating their own death may not seem to be such a leap, given the pain and struggles they are facing.

Fredman said some may view it as a way to be in control of how they die, if they see no way of escape, rather than waiting for sickness, old age or some unforeseen tragedy to take them out.

As data shows, oftentimes a method veterans may choose to accomplish suicide is through firearms.

“In my experience, firearms are commonly used or considered,” he said.

Fredman said it isn't surprising or unusual, in fact, it can arguably seem the natural choice.

“These vets are extremely familiar with guns; they are trained with them, and they know they are effective,” he said.

They are not, however, the only popular method considered, he said. Hanging and intentional car accidents are other ways, Fredman explained.

“Pills are often a convenient and easily accessible method, as many veterans are heavily medicated,” he said.

The impact of veteran suicides has on the community is not an easy thing to measure.

“It's difficult to really nail down an accurate percentage of veteran suicides without a way to be certain of how many actually live in the area,” he said, “but it's definitely an issue.”

Reportedly, an estimated 20 veterans a day take their own lives, American Legion National Commander Bill Oxford said.

“One is too many. Prevention begins by first removing the stigma associated with those who ask for help,” he said. “We also must ensure that resources and access are plentiful and well-publicized to those who could use them.”

As a former law enforcement officer, Fredman said he related to and has a heart for veterans; he believes he can help them rediscover the value and purpose their lives hold.

“I want to help them recognize all the reasons they have to stay alive,” he said. “I really enjoy working with them.”

While Fredman has many tools and fellow counselors at his disposal, he said what he does just isn't enough.

“I can't keep them alive just being with them one hour a week,” he said.

It's got to be a community effort, he said; these vets need strong support systems.

Studies have shown that brief, low cost intervention and supportive, ongoing contact may be an important part of suicide prevention, especially for individuals after they have been discharged from hospitals or care services, according to suicidepreventionlifeline.org.

“Being around other veterans can be a great help — they understand what the other has been through,” Fredman said. “Often vets can't discuss events and experiences with family members — whether it's because information is classified, it's too difficult or disturbing, or they don't want to burden or traumatize loved ones.”

Comrades-in-arms, though, are another kind of family — one that relates well through shared encounters, he said. In fact, once a tour is over and soldiers are sent their separate ways to go home, it can be overwhelming.

“They can feel like they've been abandoned,” Fredman said. “They can feel like there's not much support for them now.”

And often, that is the case, he said.

Over the decades, the number of veterans has skyrocketed, yet services offered to them have not, Fredman said.

“The VA is overwhelmed and lack of care is a concern,” he said.

There really aren't many resources specifically aimed at the area's vets, he said.

“We've got to reach out and build partnerships within the community,” Fredman said.

Though a 24/7 hotline is helpful and certainly of use to some, Fredman said, in his experience, those 'Here's a number, call us' attempts may too many times fall on deaf ears.

“Someone who has reached the end of their rope generally has no mental energy or motivation to call a stranger,” he said. “We have to find a more proactive way.”

By the numbers

• 22 percent — Oklahoma has the second-highest prevalence of adults with mental illness, at 22 percent

• 2nd — Suicide is the second-leading cause of death for Oklahoma youth, ages 10 to 24

• 1 — The No. 1 need of Oklahoma 2-1-1 callers is help for mental health and addiction

• 16th — Oklahoma has the 16th-highest number of suicide deaths in the United States

• 1 (800) 273-8255 — National Suicide Prevention Lifeline (Heartline, Help for Oklahomans in Need, is based in Oklahoma City and answers calls to the lifeline for 76 of 77 Oklahoma counties); the number also is the same advertised as the Veterans Crisis Line

• 838255 — Free, confidential support also is offered via text messaging, at 838255, or chat online at VeteransCrisisLine.net, according to

Information compiled from heartlineoklahoma.org or VeteransCrisisLine.net.

Enroll in local ASIST workshop

Applied Suicide Intervention Skills Training (ASIST) is being offered from 8:30 a.m. to 4 p.m., Oct. 10-11, at the Absentee Shawnee Multi-Purpose Building, at 2029 S. Gordon Cooper Dr., in Shawnee. The ASIST workshop is for caregivers who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide. To enroll, call Jenifer Sloan, at (405) 878-4716 or Ann Passarella, at (405) 447-0300. For more information, visit http://www.livingworks.net/