MARY LOUISE KELLY, HOST:
We've known for a long time that veterans are at the greatest risk of killing themselves soon after they leave the military. There is another time of great risk. It's late in life, often decades after their service. Steve Walsh of member station KPBS in San Diego has more.
STEVE WALSH, BYLINE: Robert Neilson was drafted in 1961. He spent two years in the Army and was out before the big deployments to Vietnam. Neilson never saw combat, but he did suffer another trauma while in uniform - sexual assault.
ROBERT NEILSON: And the guilt wasn't strong enough to overpower the person. Plus, it was a high-ranking person
WALSH: Nielson, now 76-years-old, remembers back then standing on a subway platform watching a speeding train.
NEILSON: And I just figured if I'd just hold my hands up in the air, I could just let it suck me in. Somebody shouted, what are you doing? And that snapped me out of that trance. But I still didn't seek any help. I just figured, OK, I'll struggle through life.
WALSH: It would take Neilson another half-century to get help dealing with his military sexual trauma. Three years ago, Neilson found himself again contemplating suicide. This time he went to the San Diego VA.
NEILSON: That's what brought me into emergency room. That wasn't really the first time. Two months after I got out of the service, I attempted suicide.
WALSH: All sorts of service-related issues lay dormant only to crop up later in life, says Ron Stark. Stark founded Moving to Zero in San Diego, where he counsels fellow veterans who have contemplated suicide. More than a few are elderly.
RON STARK: You have a bad day at work, you can go home. You have a bad day on a submerged submarine, people die.
WALSH: Stark retired from the Navy in 1994 after serving aboard a submarine in the Arctic in the 1970s and again during Desert Storm. Like Nielson, he never saw combat. But he did suffer from depression most of his life. Stark remembers sitting by the roadside with a pistol, overwhelmed by feelings of inadequacy and contemplating taking his own life.
STARK: The military didn't make me who I was. There are so many things about the military that are traumatic just in its daily existence. Everything you do is mostly unsafe. You're constantly at hypervigilance.
WALSH: As veterans grow older, many take stock of their lives. Stark says for some older veterans, no accomplishment is enough.
STARK: We have things about stolen valor. And nobody wants to misrepresent themselves. So I was a Vietnam era, I was - I'm not a Vietnam veteran, OK? I was in Desert Storm, but I wasn't in combat. We're constantly talking about what we're not quite.
WALSH: So if you're not feeling 100 percent, maybe it's better to keep it to yourself in service and long after. Stark described suicidal feelings as a brief moment of blackness when all other options fade from view. Get passed that, and a veteran is likely to survive. Colin Depp, a psychologist with the San Diego VA, says one problem is researchers still don't know who will attempt suicide.
COLIN DEPP: We're not very far ahead in terms of understanding who's out there who's really likely to take their lives in the next hours, days, months.
WALSH: Instead, the VA has focused on identifying risk factors for veterans - isolation, previous suicidal thoughts, access to firearms. Older men are also more likely to reject treatment for mental health issues, another big risk factor. So the VA emphasizes getting potentially suicidal vets in the door where they can deploy a range of treatments.
DEPP: One clear message though is for those veterans - it's if they do come here, they do just as well with treatments for mental health problems, for depression, for PTSD.
WALSH: As part of his own treatment, Robert Neilson, the vet who was 73 before he sought help himself, is now writing letters of encouragement to fellow veterans who were just beginning treatment as part of a VA program. Pulling out one of the letters, Nielson explains how he can help a veteran that he'll never meet in person.
NEILSON: What does it mean for somebody to have faith in me? How about that? Let me open this one. I don't know you, but I have faith in you. You're going to make it.
WALSH: The letters are just one more nudge to keep veterans away from that dark moment when suicide feels like the only option. For NPR News, I'm Steve Walsh in San Diego.
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