New study finds US veteran suicides higher in West, rural areas

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Military veterans are nearly twice as likely to commit suicide in the rural areas of the Western U.S., according to data released by the Department of Veterans Affairs.

One of the main factors contributing to this issue may be access to healthcare, according to Phoenix VA Hospital Director Rima Nelson. Healthcare facilities are much more spread out in the West, leaving veterans with fewer options. Studies have also found that the suicide rate for veterans who receive treatment from the VA have a much lower suicide rate.

“It’s very important that we reach out to as many of our veterans as we can,” said Nelson. “We know we cannot do that alone. We really need the help of our community partners.”

If you are a veteran, family member or friend of a veteran who is at risk, don’t hesitate to call the Veteran Crisis Hotline 800-273-8255, or chat online at

Ted Simons: Up next on Arizona Horizon, why is the western part of the country seeing more in the way of veterans committing suicide?

Ted Simons: a recent report by the VA shows the suicide rate is highest in the western part of the country and rural areas. Rima Nelson is the director of the Phoenix VA, she's here to tell us more . Highest in the west, what is that all about?

Rima Nelson: We are not sure. Maybe it's access to healthcare. In the west, the facilities are more spread out. The east. That's one thought behind that. What we do know is that veterans that receive healthcare in the VA, do not commit suicide at the same rate as the veterans that won't get care within the VA. It's important to reach out to as many veterans as we can. We can't do that alone. We need the help of our community partners.

Ted Simons: Mexico, Utah and Montana nearly double the national average. Is it because they are so far away? Are they not getting the care they need? Is there disconnect there?

Rima Nelson: If you look at the VA facility in the states and where they are located. In the east where they are a lot closer together, again, that's maybe one reason that the veterans are not getting the care that they need in a timely manner.

Ted Simons: I notice in the rural areas, if you have to drive 70 or more miles to a facility, the suicide rate increases.

Rima Nelson: It does. I want to talk about a network we have here in Arizona called “Be Connected.” What we are doing in Arizona is partnering with our community partners including the Arizona coalition of military females, VA, triwest and Arizona department of Veteran Services. We have come together to pool our resources and make sure whether veterans of Arizona live in the rural areas, veterans have access to services. We are able to do this together. This is a pilot project we are starting here. We have launched it. We had a mental health summit last week. We are trying to get the information out and engage as many community partners as we can to reach all of our veterans.

Ted Simons: As far as reaching the veterans, states like Kentucky, west Virginia, Oklahoma, they have higher rates as well, high le directed to opioid use.

Rima Nelson: Opioid use and abuse is not only an issue veterans are taking on but in the state of Arizona due to the alarming number of deaths due to opioid overdose. We have a robust pain clinic to look at modalities to treat pain besides just opioids. We are continuing to educate our vets because it is a problem, a concern.

Ted Simons: Something else interesting in the study, women veterans two and a half times more likely to commit suicide. What's going on?

Rima Nelson: They go through a lot. It's important to understand as a community, you don't need to be a healthcare provider to prevent suicide. Suicide is preventable. It's important to educate ourselves and the public that there are signs of suicide. If our colleague or coworker starts withdrawing. They are no longer caring for themselves, giving away things that are important to them. If they are disengaging, those are signs that something is going on. It's important that we talk about it and acknowledge that the person is going through something not right. We make sure to connect them to resources they need.

Ted Simons: In the limited care access, opioid, gun ownership, all of this crypts to the fact that 65% of cases, those above 50 years of age, you have to be careful that folks don't withdraw.

Rima Nelson: That's important. That's true. Reaching out and being connected. In the be connected effort going on right now, it's important to get to those folks such as a hotel clerk or a bartender or clergy member so that they are aware, and they are aware of signs and symptoms so they reach out with someone struggling with suicide. That's what the be connected effort is about.

Ted Simons: The impact of vets with injuries. It's more important to treat such injuries. Does that make sense for you?

Rima Nelson: It does. It's our highest clinical priority. We have focused during the month of September outreach. We held a resource fair recently, and a mental health summit in phoenix to get the word out and show we must talk about this. We must get the education out. We must educate the public on what signs and symptoms are.

Ted Simons: Be connected. That's a new project. How do you find out more about that?

Rima Nelson: Go to, There are all kinds of resources on the website that anybody can look up. If that you call into the VA crisis line, you can also be -- put in contact with folks that can offer information. The VA crisis line is not just for veterans in crisis, but family members who want more information on signs and symptoms and what they can do.

Ted Simons: Quickly, the phone number?

Rima Nelson: 1-800-273-8255.

Ted Simons: Be connected

Rima Nelson: Correct.

Ted Simons: Congratulations and thank you for joining us.

Rima Nelson: Thank you for having me. Thank you.

Ted Simons: The Susan G. Komen breast-cancer nonprofit has closed its doors in Arizona after the organization saw dwindling donations and participation, but there's a local nonprofit stepping in to fill the void. The group is called, "Don't be a chump! Check for a lump!" and here to tell us more is Holly Rose, founder and CEO of "don't be a chump! Check for a lump!"

Ted Simons: That's quite a name of the organization.

Holly Rose: It's our call to action. That was kind of -- I went through breast cancer eight years ago. That's how I found breast cancer, someone posted on Facebook to do a self-exam. I was 38. I did a self-exam and found a lump that turned out to be breast cancer, but early stages.

Ted Simons: Everything is okay?

Holly Rose: I celebrated eight years yesterday.

Ted Simons: Congratulations on that. It makes a difference. That name is a call to action. It's hard to forget. You need something with a hook to it.

Holly Rose: When I was going through breast cancer, every woman in the community would come up to me saying I have not done a self-exam forever. I'm two years over for my mammogram. These are attorneys and CEOs, very smart women. I thought if my community isn't doing it, what about the general population? Women, don't be a chump, check for a lump.

Ted Simons: So you started an organization. How did that happen?

Holly Rose: A little bit of god pushing me on the path and amazing community helping me get through treatment. I had nine month of treatment and the community bringing me weeks of meals, taking our kids, doing our laundry. Afterwards I said, I have to give back. Why don't I do what someone did for me and remind women.

Ted Simons: Was it difficult getting everything going?

Holly Rose: We started organically, a reminder on Facebook. Do your self exam. As I educated myself because I didn't want to sit in that chemo chair again and I wanted to be around for my husband and daughters, 90% of breast cancer is preventable. There is so much we can do to prevent cancer. We built up from there a comprehensive program.

Ted Simons: You work with hospitals, doctors, the whole nine yards?

Holly Rose: We sponsor Arizona Oncology, plastic surgery, fabulous doctors in the community. When I work with nonprofits, it think it's beautiful to collaborate and share the resources out there.

Ted Simons: You have a wig out program?

Going through breast cancer, across the board, one of the most devastating emotional losses is losing your hair. You think it's a matter of vanity, but it's so much more than that. It's your ID as a woman, daughter, mother, whatever it is for you. For me as a mother, my youngest daughter wouldn't hug me without my hair. I'm sure to a nine-year-old it was the face of cancer trying to take her mommy. I could go into a wig shop and purchase a wig that looked like mommy. Unfortunately, it's not covered by insurance and it's expensive. You can walk into a normal wig shop and pick out a wig up to $250 and we'll pay the bill.

Ted Simons: That's great news. You have a peak out 5k coming up, isn't it?

Holly Rose: Yes, October 1st. Rally a team. Come support. We are trying to help fill in the void. Komen -- what I don't think the public realized, they provided a lot of resources for our community, our women. They provided 50,000 mammograms, diagnostic testing and treatment for women. Now with Komen leaving and all of the funds they raised, who is going to fill that gap? I know I can as a nonprofit, I can offer the pink experience and raise funds.

Ted Simons: Is this the first pink out 5k?

Holly Rose: This is the first. We are looking to rally the community, support Komen. We are a natural progression. 50% we devote to education and our wigs and 50% back into mammograms and treatments.

Ted Simons: You mentioned Susan G. Komen and the foundation. What happened to them?

Holly Rose: Well, I haven't spoken with Komen personally, so I can't speak for them in the breast cancer community. I can definitely say there were political choices made, personal poor choices made, and their numbers started to decline and they didn't promote well what they did for our community. I heard lots of negative. They do a lot of positive.

Ted Simons: The idea of no longer giving grants to planned parenthood. You have to watch yourself out there, don't you?

Holly Rose: They became political and as soon as they pulled their funding from planned parenthood, they lost 50% of their supporters. Planned parent is a resource for women. You take the politics out of that, they were providing mammograms for women. They pulled it. They did lose a huge chunk of supporters.

Ted Simons: That would be a lesson for your group to watch out for politics.

Holly Rose: We are here to help women. I want to empower and assist women.

Ted Simons: You have sponsors, grants, supporters. Is everything lining up so far?

Holly Rose: Yes, yes. For seven years, I was a one-woman operation. I now have staff and mentors jumping in to help us strategically. We are picking up and moving along.

Ted Simons: When you look back when you had breast cancer and you had so many people helping you, did it surprise you so many people were there for you?

Holly Rose: Oh, gosh. Yes. It's little gifts that surprise you the most. From an unexpected stranger that comes to the door with a four-course meal that you have never met. It's beautiful.

Ted Simons: Sounds like you will continue that beauty with "Don't be a chump! Check for a lump!"

Holly Rose: Go to check for a on our event page pink out 5k.

Ted Simons: Thanks for being here. Congratulations.

Holly Rose: Thank you.

Ted Simons: Tuesday on Arizona Horizon, now that the economy appears to be doing better, what will happen to interest rates? And a conversation about the future with award-winning and best-selling science fiction writer, Kim Stanley Robinson. That's Tuesday on "Arizona Horizon."

That is it for now. I'm Ted Simons. Thank you for joining us. You have a great evening. ºº

Rima Nelson: Director, Phoenix VA Hospital

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