Approximately 16.8 veterans die by suicide daily. The U.S. Department of Veterans Affairs (VA) reported 6,146 veteran suicide deaths in 2020—a 57.3 percent higher suicide rate vis-à-vis non-veteran adults.
A new suicide hotline, created through the National Suicide Designation Act of 2020, was introduced last July to help individuals in suicide prevention and crisis circumstances quicker than its 10-digit predecessor.
The 988 Suicide & Crisis Lifeline, touted as the "911" for mental health, recently superseded its 1-800 precursor. Due to hold times, about 18 percent of the approximately 1 million callers to the National Suicide Prevention Lifeline in the first half of 2022 hung up prematurely. Now, despite the higher call volume, the average caller waits about a quarter of the time. Still, the 988 Lifeline leaves deported veterans behind.
Rodolfo (pseudonym), a repatriated U.S. veteran, is among the dozens of veterans I met through my research—deported veterans who risked their lives only to be denied life-saving health care and access to suicide prevention resources.
"If you're a veteran, you get health care," Rodolfo told me, agitated. "But if you're deported in Mexico, how the f—k are you going to come across and get your benefits or go see the doctor?"
About four decades ago, Rodolfo immigrated to the U.S. as a lawful permanent resident as an elementary school pupil. He graduated from high school, enlisted in the U.S. military, and was deployed twice. He fought "for the love of my country," until he earned his honorable discharge.
A traumatic brain injury and consequent post-traumatic stress disorder (PTSD) precipitated by being "blown up for a little bit" during combat, complicated Rodolfo's civilian life. He once overheard his mom ask, "'Was he upstairs acting like he was just shooting everybody up?' My dad was like, 'Yes. It's sad.'" His mom took him to the VA hospital to seek mental health treatment.
"But the waiting back then was 17 hours," Rodolfo remembered. "I just wanted to leave because I got anxiety." He resorted to self-medicating with alcohol and cocaine. Proud of his military service, a "big-time drug dealer friend" would give Rodolfo free drugs and money for the casino. Once, Rodolfo accompanied him to deliver cocaine, but it was a sting operation. Rodolfo spent almost eight years behind bars. Ironically, while incarcerated, he shared, "I got the right medication. I started seeing a psychologist."
After his incarceration and a 1.5-year battle in immigration court, he was deported to Mexico. There, he suffered multiple acute suicidal ideations. But outside of the U.S., he could not avail himself of the 988 Lifeline (or its 1-800 predecessor).
Sheer luck and pride saved his life when he obtained a gun, the most common method of suicide among veterans. "[I] went in the closet, and I put a bunch of blankets and stuff, so they can absorb the blood. I didn't want it to be messy. I'm about to just blow my sh-t off." But he worried, "What if the toilet has a rim around it?" He feared rescuers would "start smelling the body," find him, and opine, "This motherf—er was dirty!"
Rodolfo put the gun down, inspected the bathroom, and found the toilet "sparkling clean." He'd cleaned it regularly, "on [his] hands and knees with bleach." If a whiff of fresh air stopped him from pulling the trigger, the 988 Lifeline would have likely been helpful.
While we repatriate U.S. veterans, three 988 Lifeline enhancements are imperative.
First, deported U.S. veterans should have worldwide access to the 988 Lifeline. A White House priority for reducing military and veteran suicide entailed "increasing access to and delivery of effective care." Meanwhile, access to the 988 Lifeline's services is limited to "anyone in a U.S. state, territory, or tribe." In states like New Mexico, there is one crisis center staffing 988 inquiries. In Mexico, none exist.
Second, Veterans Crisis Line responders should be trained to work with deported and repatriated U.S. veterans. Besides his deportation, Rodolfo's age (the second leading cause of death for veterans under 45 is suicide), sex (suicide rates are higher among men), and ethnicity (Latinxs' suicide rate recently increased) magnify his suicidal ideation susceptibility. Therefore, 988 staff who understand the military culture around mental health care are essential.
Third, more veterans should staff deported and repatriated veterans' 988 calls. "When I'm in the dark," Rodolfo said, "the only time that I'm really able to laugh is with other combat veterans." Deported and repatriated veterans need access to 988 staffers who can establish rapport with them quickly.
Yes, there's mental health help in other countries, like Línea de la Vida in Mexico. However, U.S. veterans earned VA-based medical care in the U.S.
We have a moral obligation to prevent Rodolfo—and all deported and repatriated U.S. veterans, willing to die for this country—from dying by suicide.
Saúl Ramírez is a Climenko Fellow and lecturer on Law at Harvard Law School, Sociology Ph.D. candidate at Harvard University, PD Soros Fellow, and Public Voices Fellow of The OpEd Project. Follow him @SaulRamirezR.
The views expressed in this article are the writer's own.
If you or someone you know is considering suicide, please contact the 988 Suicide and Crisis Lifeline by dialing 988, text "988" to the Crisis Text Line at 741741 or go to 988lifeline.org.
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