In March, NYLAG hosted a screening of Crisis Hotline: Veterans Press 1, a film that frames the anguish of veteran psychiatric disabilities and suicide through the eyes of a dedicated team of first responders taking calls from veterans and family members in crisis. The film won an Academy Award in 2015 for Best Documentary Short. After the screening, a panel including the filmmaker and mental health practitioners and suicide researchers discussed how mental health affects the lives of NYLAG clients.

crisis hotlineThe packed-house screening was arranged for and coordinated by attorneys Keith Hoffmann, Nina Pejoves Gorman and Samantha Kubek, all with NYLAG’s LegalHealth Division. Hoffmann and Kubek work directly with veterans dealing with a range of health issues, including psychiatric disabilities like post-traumatic stress and depression. Pejoves Gorman is in charge of clinics at Memorial Sloan Kettering Cancer Center and Metropolitan Jewish Hospice Services that provide legal assistance to patients fighting cancer and struggling with legal issues that impact their health.

Since 2001, more veterans have died by their own hand than in combat in Iraq and Afghanistan. According to the most current analysis (2014) by the U.S. Department of Veterans Affairs, on average 20 veterans die every day from suicide. While only 1% of Americans has served in the military, former service members account for 18% of all suicides in the U.S.

Crisis Hotline: Veterans Press 1 is set at a nationwide suicide hotline for active duty and veteran soldiers in Canandaigua, New York. The film focuses on the workers and supervisors, many of them veterans themselves, as they take phone calls from soldiers, veterans and their families. To protect the privacy of callers, their voices are not heard. Instead, the camera is on the responders as they ask questions, listen intently, and tap notes onto keyboards.

In one of the film’s many tense moments a responder, Maureen, is on the phone with a veteran who is sitting in his truck with a loaded gun after leaving a suicide note with his mother. Maureen probes his situation, learns that he watched his best friend die in combat, and asks him what he thinks his friend would want him to do. We don’t hear his response, but we see her smile. Soon after, the connection is lost. Maureen calls his mother repeatedly and finally learns that he has arrived home safely. As a supervisor says at another point in the film, “This is a good ending to this day.”

An award-winning film about veterans was the evening’s main attraction, but the topic of suicide and suicide prevention is an important one for NYLAG staff members across the agency. Most of the attorneys in the audience work with clients dealing with stressors including poverty, isolation and mistreatment that can lead to depression and thoughts of suicide.

“Veterans struggle with mental health challenges and suicide at a higher rate than other communities, but these concerns aren’t limited to veterans. Everyone at NYLAG has encountered clients who are having feelings of hopelessness and despair,” said Hoffmann. “All of us can benefit from having a better understanding of the signs and symptoms of depression and other psychiatric disabilities, and be better prepared to help our clients find the help they need.”

Maureen crisis hotlineThe panel discussion, moderated by Pejoves Gorman, featured Dana Perry, a filmmaker who produced and directed Crisis Hotline: Veterans Press 1.  She was joined by Jill Harkavy-Friedman, PHD, Vice President of Research at the American Foundation for Suicide Prevention and Marianne Goodman, M.D., a Professor of Psychiatry at The Mount Sinai School of Medicine, who has been working with veterans and researching veteran suicide for the past 15 years.

Perry talked about her personal experience in making the film and her high regard for the responders she met and worked with, who consistently drew on reserves of calm and strength to diffuse potentially life-threatening situations, and help colleagues struggling with their own emotions. She also talked briefly about the bipolar illness and suicide of her 15 year-old son, Evan and how that loss informed her determination to bring Crisis Hotline to the screen.

In discussing the disproportionately higher suicide rate among veterans than the general population, Goodman pointed to a number of factors that play a role, including a person’s background and family history, traumas experienced while serving (including sexual abuse), the stressors of reentering civilian life, and access to and expertise in using guns. More than 80% of the suicides among veterans involve firearms. In addition, she cited a VA report indicating that those veterans who use VA services are far less likely to commit suicide than those who do not.

Harkavy-Friedman’s remarks shifted the focus to mental health and suicide prevention more broadly, and to advice for attorneys who have clients who express suicidal thoughts. She recommends talking in private to someone who displays suicidal ideation, showing understanding, compassion and respect — and taking their concerns seriously.

“Sometimes suicidal thoughts are occasional and fleeting, but sometimes it is a like a balloon building and building and building up pressure. So it is important to be direct: ”˜I care about you. Are you thinking of taking your own life?’ Just eliminating the secret they are carrying around can be a huge relief and give you the chance to help them find a mental health provider and get the help they need.”

For more information about suicide prevention, go to the American Foundation of Suicide Prevention.