The suicide rate of Native American veterans has soared. What's being done in Wisconsin to help?

If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at 988 or text "Hopeline" to the National Crisis Text Line at 741-741. Contact 988 plus 1 for the Veterans Crisis Line.

When Melissa Doud, a tribal member of the Lac du Flambeau Nation, joined the U.S. Army more than 20 years ago, it was the first time she experienced a world beyond the reservation. It was a vastly different lifestyle, and it was structured in ways that allowed Doud to thrive.

Doud loved her time in the Army. But she knows that culture shock can be a double-whammy for Native Americans. First, there's the adjustment to Army life and all the traveling that comes with it. And returning to the reservation following Army life brings its own shockwaves.

"A lot of us do come from despaired communities, so I think that, once you join the military and find that style of life, sometimes when you come back home, you might be returning to that despaired community," said Doud, who serves as the tribal veteran liaison for the Wisconsin Department of Veterans Affairs. "I think it gets people depressed or down, like there's some missing pieces suddenly."

About 19% of Native Americans have served in the U.S. Armed Forces, in comparison with an average of 14% of all other ethnicities. They also have a greater rate of post-traumatic stress disorder than any other veterans group and, as of the latest report from the U.S. Department of Veteran Affairs released in May , the highest suicide rate.

That wasn't the case just a year earlier. White veterans and Asian, Native Hawaiian or Pacific Islander veterans both had higher suicide rates in 2020. But in 2021, the latest comprehensive reporting year, the rate of Native American veterans dying by suicide soared well past all other groups. For every 100,000 American Indian or Alaska Native veterans, 46.3 died by suicide in 2021.

By contrast, the two previously highest groups edged only slightly up between 2020 and 2021. For every 100,000 white veterans — the second-highest group — 36.3 died by suicide.

Doud isn't surprised by these statistics, because she knows what life can look like on reservations. The pull of substance use, whether alcohol or other controlled substances, is a significant factor. Doud counts herself among the fortunate — she always had a tight-knit family and a strong social network that put her at a distance from drugs and alcohol.

"But not everyone is quite so lucky," Doud said.

Native Americans already experience higher rates of suicide than the general population, and they also struggle more with opioid overdoses and death. Seeking or accessing help can be challenging.

Terrance Hayes, press secretary for the U.S. Department of Veterans Affairs, praised the Veterans Crisis Line, which any veteran can contact by dialing 988 plus 1. While Hayes could say it connected veterans in crisis with fellow veterans, he also said that Veterans Affairs didn't currently have counselors trained for specific cultures and nationalities.

Wisconsin's Native American veterans do have culturally specific options, Doud said. But it's about spreading awareness among tribal members — a not insignificant task.

High rates of service, and suicide

Dan King, an Oneida tribal member who is the commander for the Wisconsin Indian Veteran Association-Oneida Chapter, said one of the most common questions non-Natives ask him is why Native Americans serve at the highest rates for a country that disposed them of their land and treated them poorly for hundreds of years.

“It’s simple,” he said. “We lost the land once, and we’re not going to do it again.”

King said Native Americans have been taught since childhood to protect Turtle Island (North America).

Indigenous reservations also tend to be very rural, King said, and many youths are simply looking to get away into the world. An easily available option to accomplish that is to enlist in the military, especially since the military promises job training and a salary.

While people can also find jobs in the nearest city to reservations, King said many young Indigenous people still face discrimination there.

King said he's not surprised that the suicide rate among veterans is high, given the rate of service, the high suicide rate for Native Americans in general and a lack of mental health services on reservations.

In a stunning report from the CDC in 2021, American Indians and Alaska Natives had a suicide rate 91% greater than the general population . The rise in suicides among this population has steadily climbed between 2015 and 2022 by nearly 20%.

The rate of opioid overdose deaths is also three times higher in Wisconsin's tribal nations than the state's overall rate, which many tribes are hoping to combat with fentanyl prevention campaigns . And while gun suicides among veterans are by far the most common means of suicide, both at the state and national level, many experts who study why people die by suicide know the deadly combination of drugs, alcohol and access to firearms.

Heavy drinking, for example, is associated with a quarter of all gun suicide deaths , according to the Center for Gun Violence Solutions at Johns Hopkins University.

King said the number of veteran suicides may actually be higher, as some suicides may be incorrectly viewed as accidents by police. Victims’ families also may be unwilling to officially report a death as a suicide, he said.

Terrance Hayes, press secretary for the U.S. Department of Veterans Affairs, said the report uses data from the Centers for Disease Control and Prevention National Death Index, which relies on official reports from coroners and medical examiners to determine cause of death.

Those living on reservations, in rural areas face silence, lack of resources

For Indigenous communities, advocates say many of the challenges that lead to suicide and addiction come from generational trauma.

Indigenous peoples faced genocide, were forced onto reservations with little to no food, forced to assimilate and experienced institutional racism. The lingering effects of this include poorer health and poverty at much higher rates for tribal communities than much of the rest of the U.S. population.

Thousands of Indigenous children from Wisconsin also attended boarding schools, some voluntarily and many involuntarily, starting in the late 19th century, stretching well into the 20th century.

The schools stripped Native American children of their language, culture and customs. Youth were discouraged or forbidden from speaking their Native languages and forced to speak English. Their long hair, an important part of their identity and culture, was cut short. Their traditional clothing was replaced with uniforms. Many youths reported physical and sexual abuse.

While these horrific conditions at Indigenous boarding schools may be gone, their effects linger. And reservations face compounding problems.

Mental health concerns are shrouded in silence among rural residents . The combination of not trusting medical professionals, the rugged individualism that especially pervades rural men, and heightened stigma is a fact of life for many people living in less-populated and less-resourced areas.

It is of particular consequence for Wisconsin's Native Americans, of whom 22% live on reservations or other trust lands, according to the Wisconsin Department of Human Services .

King also said reservations lack the mental health services needed to treat those with depression, PTSD and suicidal ideations.

He said there have also been instances when Native veterans seeking mental help from a VA facility in a city were told to go back to the reservation for assistance from the Indian Health Service.

“We were promised VA benefits for being veterans, not for being tribal members,” King, a veteran of the Vietnam War, said.

Connecting Native veterans to help can be a challenge

Doud, for her part, knows the importance community can have. VA clinics in Wisconsin's 72 counties offer family resource centers with counselors, but there are also more traditional pathways to healing for the state's 11 federally recognized tribes.

One such resource for veterans is Camp Benesi , which means "Thunderbird" in Ojibwe. It functions as a free retreat for veterans and their families.

"Some of the tribes, I'm finding, didn't know about that," Doud said. "I'm trying to connect a lot of dots and build a web of network for tribes to help one another."

Some of the more culturally specific resources might look like gatherings, traditional healing centers, sweat lodges and meditation, Doud said. Her job is to help connect older tribal veteran service officers with newer officers, in the hopes that knowledge is shared and people can continue to find ways to help each other navigate resources.

In August, the Wisconsin Department of Veterans Affairs is hosting a veterans fair in Lac du Flambeau, Doud said. She's invited all tribal veterans service officers to set up tables and offer resources. Lac du Flambeau is a hub, Doud said, and feels centralized to Wisconsin's 11 tribes.

The challenge, Doud said, is that every tribe she's visited has a different area of concern. One tribe might struggle with mental health access, another might struggle with housing.

"We can't blanket solutions, but really engaging, and finding out what those issues are gives us a better opportunity to work on a plan to address some of those issues," Doud said.

Frank Vaisvilas is a former Report for America corps member who covers Native American issues in Wisconsin based at the Milwaukee Journal Sentinel. Contact him at fvaisvilas@gannett.com or 815-260-2262. Follow him on Twitter at @vaisvilas_frank .

Natalie Eilbert covers mental health issues for the Milwaukee Journal Sentinel. She welcomes story tips and feedback. You can reach her at neilbert@gannett.com or view her Twitter profile at @natalie_eilbert .

This article originally appeared on Milwaukee Journal Sentinel: The suicide rate of Native American veterans has soared. What's being done in Wisconsin to help?