BUTLER TWP — Almost everyone knows a person who has committed suicide or attempted it, says Peter Albert, the suicide prevention coordinator with VA Butler Healthcare.

That’s why preventing suicide among veterans is a major effort of the U.S. Department of Veterans Affairs and was one of the presentations Friday at the 4th annual Mental Health Summit hosted by VA Butler.

“(Suicide prevention) is really, truly an area of heavy focus for the VA,” said Ken Kalberer with VA Butler.

Albert discussed causes of suicides and resources to help veterans who might be at risk, citing numbers from a recent report from the federal VA office.

That July report showed there were 20 veteran suicides every day on average in 2014. That year, veterans made up 18 percent of all suicides nationally, despite being only 8.5 percent of the general population.

For veterans, suicide can be caused by a combination of troubles compounding into one jumbled situation that feels impossible to handle, Albert said.

“I say it’s almost like an onion, there’s all those different layers,” he said.

“There’s more than just one thing. I’ll see men and women who are having drinking and drug problems, they’ve lost relationships, they’re unemployed, their kids won’t talk to them — their spouses, their family. It’s a combination of all of those things.”

On top of that, post-traumatic stress disorder, anxiety and physical health issues such as insomnia can worsen the situation, he said.

That report also identified women and older veterans as being at a higher risk for suicide than other vets. In 2014, about 65 percent of all veterans who died from suicide were age 50 or older.

The risk for women veterans is 2.4 times higher than for civilian women, according to the report.

“The highest rates (for suicide) for veterans are in the 55 and older (demographic),” Albert said.

For women specifically, they may feel different from the typical veteran, further isolating them.

Albert said, “I think it’s kind of a unique group. When I first was hired here nine years ago, I would walk these halls, I would see elderly white men from a rural area. I wouldn’t see anyone else.

“Now, here, nine or 10 years later, as more women serve and now they’re retiring ... we see those folks too. They have kind of a unique set of problems.”

The VA works with veterans, identifying possible risk factors that may put them at a higher risk of committing suicide.

“When we’re talking with someone, we try to identify risk factors. Alcohol or drug use is a big one,” Albert said.

“I just know it puts them at a higher risk. A lot of times, people self-medicate to deal with that anxiety or depression. Then it becomes a problem.”

Other risk factors include a lack of sleep, mental health issues, financial problems or relationship stress.

Albert outlined five signs of suffering, which are ways to identify veterans who may need more support.

Those signs are:

n Personality changes, such as behavior that doesn’t fit the person’s values or acting “differently”

n Uncharacteristic anger, anxiety, agitation or moodiness

n Withdrawing or isolating themselves from others

n Engaging in risky behavior such as poor personal hygiene or self-destructive behavior like drug or alcohol use

n Seeming overcome by a sense of hopelessness or being overwhelmed.

For relatives who are trying to encourage their loved ones to seek help, the VA offers coaching to teach family members how to connect with a veteran or how to encourage them to seek help.

Family coaching, called Coaching Into Care, includes information about the programs available for veterans.

“Everyone has their own time,” Albert said, explaining that it may take someone weeks, months or years to realize they need support.

“Not too long ago, there was a reserve unit that came back, and they’d come back on a Saturday. Monday morning there were six or seven of them in our waiting room because they wanted to have the assessment.

“Other times, I’ll talk to a veteran whose been home for five years, 10 years. They just have their time when they seek their treatment.”

But Albert said the earlier the intervention, the better. The sooner a veteran is able and willing to get help, the less suffering he will face, and the easier it will be to offer productive help, Albert said.

Part of addressing suicide prevention is working to reduce the stigma of talking about mental health, Albert said. This is something the military is trying to improve, including having mental health personnel with soldiers at the foreign operating bases.

Another way to help is by taking a simple action such as inviting a veteran to dinner, letting him know that he has a support system, Albert said.

This message will be part of a new awareness campaign expected to start next month called, “Be There.”

Albert said, “Just by virtue of (saying) ‘Hey, how are you doing today?’ and having an honest conversation or inviting someone to dinner ... whatever, it goes a long way toward letting people not feel so isolated, and they have somebody to talk to.

“I hear that so many times, a veteran is like, ‘I didn’t have anybody to talk to.’”