Older men die by suicide at steep rates. Here's how the VA is trying to change that

It was a Friday greeting and George McCune had roused himself to make nan 2.4-mile travel from his Northridge location to nan Veterans Affairs field successful North Hills.

The 77-year-old was greeted location that March time by nan accustomed unit training for nan Golden Age Games: There was Roger, 82, who had piled up medals successful javelin, discus and changeable put. Bob, who had conscionable gotten his cochlear implant. Becky, 71, bent connected defeating her “nemesis” — a feline conscionable six days her inferior — successful pingpong.

McCune tin beryllium reclusive, he said. He has grappled pinch post-traumatic accent disorder, he said, though he was ne'er capable to get formally diagnosed. Silent meditation is much of his accustomed velocity than socializing.

Yet McCune routinely joins his teammates successful nan gym and connected nan track. He has yet to be nan Golden Age Games, a national competition for veterans 55 and older, but trains 5 days a week pinch nan Greater Los Angeles team. That Friday, he had circled nan way for 46 minutes, a extremity he chose for nan twelvemonth of his birth.

And “more than nan beingness worldly is nan intelligence stuff,” he said, “of getting maine to interact pinch people.”

Arnie Ossen, 92, prepares to time off nan VA’s North Hills installation aft a time of pingpong.

(Michael Blackshire / Los Angeles Times)

This mightiness not beryllium what you envision arsenic “mental health” care, fto unsocial “suicide prevention.” But astatine nan VA, getting older veterans specified arsenic McCune together to deed nan way is portion of a broader push to amended their lives — and perchance moreover to prevention them.

Older men successful nan United States person been astatine growing risk. When suicides reached a historic high for nan state successful 2022, nan sobering numbers were being driven up by their deaths. The starkest statistic were for men past their 75th birthdays, who were dying by termination astatine much than doubly nan complaint of men younger than 25.

The problem is “not caller but it is overlooked — regularly overlooked,” said Thomas Joiner, a Florida State University scientist who studies termination and has written astir nan intelligence wellness of older men.

The grim shape has persisted for years and is wholly different from that among U.S. women, for whom termination rates rise successful mediate age and past fall. Across nan lifespan, men are overmuch much apt than women to dice by suicide, moreover though slump is much much common among women.

In Los Angeles County, nan aesculapian examiner tallied much than 300 specified deaths successful 5 years among men 75 and older — much than six times nan number among women of nan aforesaid ages, according to a Times study of nan region figures.

Researchers person faulted a big of forces for nan steeper complaint of termination arsenic men scope their 70s and 80s. Joiner said men thin to suffer from worsening loneliness complete nan people of their lives successful a measurement that differs from women, pinch “friendship networks falling isolated complete nan decades.” Women look to beryllium amended astatine maintaining ties aft schoolhouse aliases activity extremity giving them a root of peers, he said.

Mike Dawson takes a thigh astir a way — backward — astatine nan VA’s North Hills facility.

(Michael Blackshire / Los Angeles Times)

That isolation some whittles down nan chances that personification will admit men are successful problem earlier a termination attempt, and makes it little apt that they will beryllium quickly rescued if they effort to extremity their lives, said Dr. Yeates Conwell, professor of psychiatry astatine nan University of Rochester Medical Center. Their beingness frailty arsenic older adults besides jeopardizes their chances of recovering from a termination attempt.

Diseases and different ailments specified arsenic proceeding nonaccomplishment tin besides worsen intelligence wellness arsenic men age. And past location are nan dangers of guns, which older men are more apt to own — and which make termination attempts much deadly. In L.A. County, astir two-thirds of termination deaths among aged men successful caller years progressive guns, acold much than among older women, according to a Times study of region aesculapian examiner data.

Despite nan troubling pattern, “we don’t surface for termination consequence very well, and we particularly don’t do it pinch older adults,” said Richard Frank, head of nan Center connected Health Policy astatine nan Brookings Institution. Suicide consequence screenings successful emergency rooms are done little often pinch seniors, he said, pinch “a large drop-off aft property 60.”

And for older adults, nan criteria for a intelligence wellness test often miss group successful need, Frank said. “They are hurting psychologically successful ways that are not cleanly captured by our diagnostic attack to intelligence illness.”

In general, “our knowing of really to intervene is conscionable emerging” successful nan past decade and a half, said Mike Hogan, a erstwhile New York authorities commissioner of intelligence health. Many termination prevention theories revolve astir “if we tin protect group against nan vulnerabilities that lead to it — alleged ‘upstream’ prevention.”

“That turns retired to beryllium very difficult to do,” Hogan said. Suicide prevention strategies person besides focused connected limiting entree to “lethal means,” specified arsenic installing barriers connected tall structures, but Hogan said that has besides been difficult erstwhile it comes to guns. Then location are targeted efforts to inquire group whether they are astatine risk.

An effective attack is “basically asking group if they’re having those thoughts and — if they are — to past helping them” return steps to guarantee safety, Hogan said. Yet specified methods are “not yet successful wide use.”

Too often, aesculapian providers “feel very uncomfortable asking” whether group person suicidal thoughts, said Julie Goldstein Grumet, head of nan Zero Suicide Institute astatine nan Education Development Center, which helps wellness systems adopt practices to forestall suicide. With older patients, physicians whitethorn deliberation “this is conscionable benignant of a earthy consequence of aging. ... It doesn’t person to be. You don’t person to consciousness much sad arsenic you age.”

Ray Emmons gets successful immoderate greeting stretches.

(Michael Blackshire / Los Angeles Times)

Among nan wellness systems that person grappled pinch nan situation is nan Veterans Health Administration, which falls nether nan VA. Suicide has been an urgent rumor for nan wellness strategy successful ray of nan alarming numbers among U.S. veterans, who person mislaid their lives to termination astatine higher rates than nan broader population.

Yet that isn’t nan lawsuit for nan oldest antheral veterans, according to Veterans Affairs figures. In 2021, aged antheral veterans had little rates of suicide, arsenic calculated by nan veterans system, than nan figures reported by nan National Center for Health Statistics for men ages 75 and older. And location was a promising downturn successful their termination complaint betwixt 2020 and 2021, particularly among those who had precocious utilized nan wellness system.

Matthew Miller, head of nan VA’s nationalist termination prevention program, said nan agency has worked to weave consequence appraisal for termination into its pain, slumber and oncology clinics, mindful that older patients whitethorn beryllium astatine higher consequence aft getting troubling news astir their health, particularly if a weapon is successful reach. It has besides done media outreach to impulse older veterans to securely store firearms and medications.

The VA has besides placed intelligence wellness professionals successful nan aforesaid accommodation wherever veterans get day-to-day care. Roughly three-fourths of older adults who dice by termination person seen a superior attraction expert successful nan twelvemonth earlier their death, researchers person found — a overmuch higher percent than had received intelligence wellness attraction — which has led to an accrued attraction connected regular attraction arsenic a way to thwart suicide.

Power stepping is 1 of nan competitions astatine nan Golden Age Games.

(Michael Blackshire / Los Angeles Times)

At nan West Los Angeles VA Medical Center, Dr. Lucinda Leung said a diligent mightiness travel successful complaining of slumber problems. “Most of my patients don’t say, ‘I’m depressed. Please mention maine to a psychiatrist,’” she said. (Older men are little apt than older women to authorities that they are lonely erstwhile asked directly, moreover successful cases erstwhile indirect questions propose akin levels of loneliness, researchers successful Britain person found.)

But observant questioning mightiness make clear that PTSD and nightmares are keeping that diligent awake, Leung said. If that happens, she tin locomotion nan personification down nan hallway to meet Dr. Suzie S. Chen, a objective scientist who tin measure that diligent nan aforesaid day.

“Many of my patients are reluctant to speak to a intelligence wellness master aliases moreover admit to having psychological symptoms,” Leung said. Being capable to instantly link personification to intelligence wellness attraction connected nan aforesaid tract helps it go “normalized.”

Chen agreed. “We’re not scary group — and intelligence wellness curen doesn’t person to beryllium a scary thing.”

Then location are programs that mightiness not look, astatine first glance, for illustration intelligence wellness care. Inside her agency connected nan Sepulveda Ambulatory Care Center campus, Paige Velasquez turned to nan camera connected her computer, greeted nan acquainted faces signing on, and guided a virtual group done a bid of exercises.

Recreation therapist Paige Velasquez helps VA members do online workouts. “Fun is therapeutic,” she says.

(Michael Blackshire / Los Angeles Times)

“Let’s thin to nan left. You should consciousness a bully agelong done this full correct broadside of your assemblage now,” Velasquez instructed from down her desk. “You guys emotion that today?”

As nan group took a break from nan exercises, she asked, “It’s Friday — anybody person plans for nan weekend?”

“Yeah — to make it to Monday,” 1 seasoned quipped.

The virtual groups meet Monday done Friday, connecting seniors who mightiness beryllium incapable to make it to nan San Fernando Valley field for an workout class. Velasquez, a recreation therapist, said that beyond nan beingness benefits, nan regular meetings tin easiness isolation for older veterans.

Behind nan machine surface aliases successful person, recreation is simply a benignant of “back doorway therapy,” Velasquez said. People think, “I’m golfing. That’s not therapy. Horseback riding — that’s not therapy. We’re conscionable having fun.”

“You are! But nosy is therapeutic.”

Hogan said nan “surprising power” of specified interventions is that “if group consciousness for illustration they person meaning and purpose, and they’re connected to different people, it is extraordinarily little apt that they’ll dice by suicide.”

When Roger Reitan retired, he recovered himself asking, “What americium I going to do pinch myself?” The Granada Hills resident had served successful nan Navy, past worked arsenic an accountant for much than 2 decades, commuting to downtown Los Angeles. Friendships seemed to wither aft his accounting profession ended, he said.

“I mislaid way of everybody,” Reitan said.

But now, “some of my champion friends are correct here.” The 82-year-old said he had competed for much than 2 decades successful nan Golden Age Games, proudly rattling disconnected nan galore sports he had mastered.

The Los Angeles squad has been preparing for nan August games, which will beryllium held this twelvemonth successful Salt Lake City. Nearly 2 twelve of its athletes are readying to attend. Ray Emmons, 76, said successful March that erstwhile he first went past twelvemonth — and won a bronze badge successful pingpong — he was enthralled to watch unsighted veterans playing bocce ball.

“I conscionable said, ‘This is for me,’” Emmons said.

But Velasquez said that for nan veterans she coaches, nan Golden Age Games is not conscionable “something to look guardant to erstwhile a year. It’s each week — training, seeing your friends, and making that connection.”

“That impacts intelligence wellness tremendously,” she said. “I’ve seen it.”

Pasqual Ramirez, 77, said successful March that training pinch nan squad had helped him suffer weight. He stopped relying connected insulin. Beyond nan beingness changes, joining nan group “made maine recognize that possibly I could unrecorded longer.”

“I utilized to beryllium angry astatine nan world,” Ramirez said. “In a measurement I felt fto down.”

There were times successful his life erstwhile he didn’t admit to having served successful Vietnam, aft protests collapsed retired complete nan war, he said. His woman tells him he still has nightmares, though he doesn’t retrieve them.

What helped easiness that anger was “this,” he said, gesturing astir an echoing gym wherever his teammates were playing pingpong. “The camaraderie pinch group that went done akin situations.”