Warning signs for suicide: 

Warning signs are a person’s “red flags” that signal an increase in their risk for suicide. These can be thoughts, feelings, behaviors, and/or images. Warning signs may vary from person to person. In many cases, individuals will exhibit one or more warning signs at a time. Some warning signs include: 

• Thinking about or making plans to die by suicide 
• Engaging in self-destructive or risky behaviors 
• Saying final goodbyes to friends and family 
• Putting personal affairs in order (e.g., giving away possessions, making a will) 
• Feelings of hopelessness 
• Increased anger or agitation

Who is at elevated risk for suicide? 

Although risk factors do not cause a behavior or outcome to occur, they may be associated with an increased risk for the behavior or outcome. Ongoing research has identified various risk factors associated with suicide and these include, but are not limited to: 

• Chronic major mental illness or personality disorder 
• History of prior suicide attempt(s) 
• History of substance use disorders 
• Chronic pain 
• Chronic medical condition 
• Limited coping skills 
• Relationship conflict or distress 
• Unstable housing or employment problems 
• Limited ability to identify reasons for living

If you or someone you know exhibits warning signs for suicide, it is important to address the concerns immediately, intervene, and seek help from a healthcare professional. This professional will typically talk to the person about their warning signs and any suicidal thoughts they are having. They will also identify coping skills that can be used and review how to get additional support if needed. They might refer the person for behavioral health treatment, which will include talk therapy and may include medication or other treatments. Connecting yourself or someone you know who is showing warning signs for suicide with a healthcare professional can help save a life. 

If you or someone you know has thoughts of self-harm or suicide, you should reach out. Go to the nearest emergency room or walk into your behavioral health clinic for same day triage (based on locations and hours listed above). These are your best options. Any of these places have excellent resources, and usually include the availability of behavioral health professionals, to keep you safe and provide immediate care. Care is available at emergency rooms 24/7. If you go to an emergency room or your behavioral health clinic, you will be evaluated face-to-face by a caring, attentive clinician who is licensed to care for people struggling with suicidal thoughts. 

If you or someone needs help, and you cannot access in-person care at JBSA-Fort Sam Houston or your nearest emergency room, or you feel you are not ready to see a healthcare professional in-person, call the Suicide Prevention Lifeline: 1-800-273-8255 and press 1 for the Military Crisis Line or text 838255 to speak with a trained responder. 

Starting a conversation with your provider about behavioral health can mean the difference between a tragic outcome and a life saved. If you, or others close to you, have noticed changes in your behavior or moods, or if you have not felt like yourself lately, those are important observations to share with your provider. Just like physical health, behavioral health is essential to your overall well-being. 

You can get better! There is hope. There are lots of treatment options and getting help is the first step. You and your provider will work together to determine the best treatment plan for you. Your safety and improvement are the most important. A treatment goal is to reduce your thoughts of hurting yourself while planning for times when that happens. There are many different treatment options for preventing suicide such as therapies, decreasing or limiting access to lethal methods, and medications. 

What can I expect from treatment?

Treatment is focused on several things: 

• Your safety
• Your behavioral health goals
• Taking care of your behavioral health symptoms
• Enhancement of coping skills
• Education
• Therapy
• Medications, as needed 

Treatment is aimed to: 

• Improve your quality of life
• Reconnect you with what is important to you
• Restore your social function (e.g., activities, connections with others) 
• Address issues resulting from the physical or emotional pain (e.g., depression, poor sleep) 
• Increase your healthy lifestyle (e.g., reducing the use of tobacco and alcohol) 

In order to deploy, you must be both physically and mentally fit. It’s important to know that only a few behavioral health conditions or medications may affect deployability/medical readiness.

For more information regarding deployment/medical readiness concerns: Psychological Health Center of Excellence - Deployment Concerns

For both civilians and members of the military, information related to behavioral health care, treatment, and diagnosis are confidential except when there is: 

• Risk of harm to self/harm to others 
• Child abuse, neglect, or domestic violence 

The military has some additional limitations on confidentiality to ensure the proper execution of military missions.

For more information regarding behavioral health confidentiality concerns: Psychological Health Center of Excellence - Behavioral Health Confidentiality Concern

Brief Security Clearance Overview

• A security clearance is an approval process which allows an individual access to classified national security information. 
• Characteristics such as trustworthiness, reliability, and honesty are important factors in the process of obtaining a clearance. 
• Security clearances are reinvestigated typically every 5–10 years.

For more information regarding security clearance concerns: Psychological Health Center of Excellence - Behavioral Health Section Endorsement and Treatment-Seeking Concerns