Missouri launches website intended to reduce veteran suicides

John Morlock, seated at left, told members of the Missouri Veterans Interim Mental Health Committee on Aug. 31, 2022, that they are looking at a ghost because, after returning from his service in the U.S. Army, he attempted suicide. He said the doctors were better at keeping him alive than he was at dying, so after healing physically, he founded the Heroes Outreach Program for veterans or first responders to get together over coffee or a meal to talk and work through issues. (Julie Smith/News Tribune photo)

Missouri now has a website intended to reduce suicides among service members, veterans and their families.

The Missouri Governor's Challenge team -- a collection of leaders in community and state governments -- on Thursday launched the website, which provides general information on the team's projects and strategic priorities, the impact suicide is having on the military community, and resources for both members of the military community and for anyone wishing to support them. The website offers access to free online military culture and suicide prevention training through PsychArmor for health care providers, veterans, employers, military family members and others.

The site may be found at www.mogovchallenge.com.

Two years ago, Missouri organized the non-partisan state interagency team to embark on the process to collaborate, plan for and implement best practices in suicide prevention for service members, veterans and their families.

The Missouri Governor's Challenge team pulled from the National Strategy for Preventing Veteran Suicide 2018-2028, which provides a framework for identifying priorities. Priorities work together to promote wellness, increase protection, reduce risk and promote effective treatment and recovery, according to the new website.

The team focused on three priorities that it found are likely to prevent suicides in Missouri -- identifying at-risk service members, veterans and their families; promoting connectedness and care transitions; and reducing access to lethal means.

The three priorities overlap with other priorities within the national strategy, according to Jon Sabala, co-lead for the challenge.

And people who visit the website should spend time on the "What Can I Do" page, Sabala said. He pointed out there are links to sites on the page, where folks may sign up to start free online training in military culture. They may also view the challenge's Safety Plan video, which is a brief training intended to help people support someone they know who may be struggling with a suicidal crisis. Safety plans are intended to be brief interventions to help people experiencing self-harm and suicidal thoughts, according to the site. It is a set of coping strategies and resources people may use to decrease their risk of suicidal behaviors.

The first priority for preventing suicides is identifying who is at risk.

"Identifying Missourians who may be at risk for suicide is a key part of a comprehensive approach to suicide prevention," the site states.

All state and community organizations that provide supportive services for the military community should screen for suicide risk, it says. The team has created an "Ask the Question Toolkit" to assist Missouri agencies with implementing a 2021 law that requires them to collect data from individuals about military data. The kit includes a series of questions intended to help state employees "engage in conversation with military-connected Missourians."

Promoting connectedness, the second priority, can help service members, veterans and their families create a strong and healthy support network, which may help reduce suicides. Part of that includes improving care transitions as veterans move between different levels of treatment and services, according to the website. An upcoming initiative would enhance the Missouri Veterans Commissions Benefits and Resource Portal, promoting social events and creating opportunities for veterans to connect with others.

The third priority, lethal means safety, will encourage people to voluntarily reduce access to lethal means.

"When someone receives clinical treatment for suicidal thoughts or surviving a suicide attempt, that care often includes creating something called a Safety Plan," according to the website. "The Safety Plan is a set of coping strategies and resources the individual can use to decrease their risk of suicidal behavior."

The new site includes information about the 988 suicide and crisis hotline. The three-digit code replaced the National Suicide Prevention Lifeline and gave Missouri a chance to expand crisis services.

The Federal Communications Commission in 2020 designated 988 as the national three-digit code for individuals experiencing a mental health crisis to contact a counselor. Each state was also responsible for ensuring the number was available in each community at any given time.

Parson set aside $28.5 million last year to implement the program, which connects users with regional crisis call centers and crisis intervention teams. During his State of the State address in January, Parson praised the crisis line for being "very successful."

In Missouri, call centers received 24,079 calls to 988 between July and December 2022, according to Debra Walker, Missouri Department of Mental Health director of public and legislative affairs.

The top five issues identified during 988 calls over the period included:

1. General mental health needs or referral assistance.

2. Current suicidal ideation.

3. Experiencing an acute mental health crisis in which the individual's behavior put them at risk of hurting themselves or others, or prevented them from being able to care for themselves.

4. Substance use or misuse.

5. Interpersonal violence.

The DMH reported the top five resolutions for callers were:

1. Callers received information or referrals to community resources.

2. Their crisis was de-escalated or resolved.

3. Callers were connected with 911 dispatchers for further assistance from law enforcement.

4. Callers were referred to, or scheduled for, behavioral health treatment or service.

5. The caller's safety or crisis plan was completed.

Much of the line's success may be attributed to years of preparation, according to Casey Muckler, an MDH member of the team. Organizers of the three-digit number anticipated a large increase in call volumes when it replaced the Suicide Prevention Lifeline.

"We had a lot of planning done," Muckler said. "With 988, we had to make sure we had funding and staff in place to accept the increase in calls we would receive."

A lot of people, she said, were concerned that suicide prevention services were going to take second place to crisis intervention. But, the two services are tightly connected, and both during this first year have been successful.

Muckler said, "988 and the national momentum surrounding and enhancing crisis services have really improved suicide prevention as well."

A goal of the 988 line is to divert people experiencing a behavioral health crisis from hospitals or emergency rooms. Data showed 6,891 callers received referrals to mobile crisis teams. Mobile crisis teams may include behavioral health providers and/or peer specialists who can connect clients with resources or crisis access points.

Performance for emergency calls and responses is typically measured in response time percentage -- calls answered within the first 20 seconds. Missouri had a response rate of 91 percent in December, Muckler said. Missouri, she said, is ahead of the national expectation, which is that the rate be 90 percent or higher by July.

She said, "988 is working fairly well here in Missouri. We hope to keep maintaining that."

The announcement of the website comes just a few months after the Missouri House of Representatives Interim Committee on Veterans Mental Health and Suicide held a series of hearings. The committee, chaired by Rep. Dave Griffith, R-Jefferson City, received emotional testimony from veterans who have struggled with their mental health and attempted suicide. The committee also heard from family members of veterans and service members who died of suicide.

Although the interim committee had no role in establishment of the Governor's Challenge website, Griffith said he's pleased Parson recognizes the need for it.

"This website is really going to push out the information the Department of Mental Health has," Griffith said. "This is a step in the right direction. I think it's good that that happened."

Griffith added a goal for the committee was to raise awareness of the volume of veterans who die by suicide every day.

The website, www.mogovchallenge.com, states a report shows an average of nearly 17 veterans die by suicide each day. It states Missouri veterans die at a higher rate than the national rate. It also shows more than 76 percent of veteran suicides were done by use of firearms.

"One of my hopes was that (the interim committee) would have raised awareness. This certainly got attention of the governor," Griffith said.