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Suicide is the act of taking one's own life. In many countries, suicide is a crime, and people who attempt suicide are charged heavily in the court of law. Suicide is caused mainly by psychological stress, primarily due to social, economic, and health challenges (Baek, Park, Ahn, Roh, Heo, Fava & Jeon, 2015). However, if suicidal thoughts are detected early, the healthcare workers can develop a framework through therapy to prevent the affected person from committing suicide. Therefore, suicide is a preventable health issue through early interventions such as counseling and guidance sections. Suicide not only increases the mortality rate but has a lasting effect on a spouse, family, and friends. Some family friends may acquire psychological disorders and severe heart attacks when they note that one of their loved ones has committed suicide.

Based on the information provided by the United States Departments of Veterans Affairs (VA) 2018, more than 511 veterans in the Texas United States committed suicides (Lawrence, 2018). Veteran suicides in the entire United States were 40,075 among the non-veterans and 6,435 among the veterans. Since there is more non=veteran than veterans, the suicide rate among the veterans is twice to the non=veteran. The same analysis indicates that the suicide rate among non-veteran was 17.2 per 100,000, and the rate of suicide among veterans was 32 per 100,000 (Centers for Disease Control, 2017). Suicide is a healthcare issue, and it has become a healthcare pandemic, particularly among veterans. Since suicide is a healthcare problem International Association for Suicide Prevention (IASP) set aside one day per year to create awareness of the pandemic.

The effect of suicide creates sadness and devastating to families, friends, and spouses after one has committed suicide. The act to severe mental illness since it leads to serious emotional consequences. Suicide requires immediate address because it is among the top ten causes of death in the United States. The United States indicates that the total cases of suicide lead to more than $44.6 billion loss in terms of work and lost medical cost. Through the Utilization of Program Implementation and Evaluation of Health Promotion under Helping through Encouragement and Reaching out (H.E.R.O) this assignment will investigate the root cause and prevention strategy to eradicate veterans suicides in Texas, United States.

Program Rationale

The table shows that suicide has been on the rise since 2005, particularly among young veterans between eighteen to thirty-four years. Therefore, it is a healthcare challenge that mainly affects the veterans and members of public service. Through Helping through Encouragement and Reaching out (H.E.R.O) the healthcare workers in the United States and particularly in Texas have the opportunity to change the rising trend by ascertaining the risk, evaluation, support, intervention, and treatment for most psychological challenges among the veterans. The community is among the key personnel in the program since they spend a lot of time with the veterans in society.

Veteran suicide is a crisis in the United States and, more particularly, in Texas. Based on federal law, a veteran is an honorable and an active public servant in the army force working under the United States and regulations. Suicide is not only common to veterans since statistics show that more than 15 million people have attempted suicide over the last twenty-five years in the United States. Veterans suicide is the process where an honourably member of the army force takes their life using their own hands. The fact that most veterans use firearms to take their lives raises a question on the veteran training and the rules and regulations monitoring the use of weapons in the United States.

The first program rationale is to identify the root cause of suicide among the veterans in Texas. Based on the information provided by the Craig Bryan of the University of National Center for Veterans, the veterans are also vulnerable to suicidal thoughts due to feeling hopelessness, depression, access to firearms, history of trauma, Post-traumatic stress disorders, and significant stress in the workplace. Based on researches that were conducted in 2017 is that the veterans with cases of drug abuse are twice more likely to commit suicide than veterans that do not abuse drugs. Mental illness is among the most common factors linked to a high rate of suicide among veterans. Mental illness is more connected to drug abuse. The most common mental disorder includes depression and PTSD. On the other hand, abuse of drugs is more likely to be experienced by individuals suffering from TBI and trauma.

The second rationale will evaluate the most vulnerable population to assess their needs and develop strategies to reduce the psychological need among the most susceptible veterans of age and gender. Based on the assignment, more veterans commit suicide through the use of firearms compared to women. Based on 2018 statistics, fifty percent of female veterans commit suicide through firearms compared to seventy percent of male veterans who commit suicides. Male veterans have more vulnerable to committing suicide as compared to their female counterparts. The cases of suicide occur after veterans have been deployed to an operation. For instance, there was high suicide among the veterans after returning from deployment to Iran and Afghanistan.

During veterans' deployment to an operation, some of their peers are killed or injured, thus increasing psychological stress and depression. Some of the veterans turn to drugs to control sad moments they encounter during an operation. Therefore, healthcare professionals have a duty to monitor veterans' mental health after returning to an operation. Those veterans that seem psychologically stressed should be exposed to therapy and guidance, and counselling to reduce the effect of suicidal thoughts.

The third program rationale should provide support after the veterans receive support, particularly from the member families. The family members should cooperate with the medical professionals to communicate any unusual behavior from their members who are veterans. Veterans from an operation should be exempted nor duties and responsibilities until they are emotionally stable. The veterans should be assisted in obtaining other options for dealing with their suicidal thoughts through self-help, charities, and National Health Service. Additionally, the veterans should not be reprimanded or blamed when they don't perform as expected since the process may reduce their self-esteem, thus increasing the suicidal thoughts among them.

The third rationale is medical intervention to understand the root cause of suicide thoughts and psychological distress. The first stage in this ratio is a diagnosis which includes in-depth questioning, tests, and physical examinations to ascertain the actual cause of suicidal thoughts and best treatments. The healthcare professionals should assess the medical health conditions through the assessments since unstable mental conditions highly contribute to most suicide thoughts. Psychiatrists professionals are best placed to conduct a cognitive assessment of male veterans. The assessment of physical health conditions is critical since advanced physical injuries among veterans may increase the risk of committing suicide in most cases.

The other critical assessment is the level of drug misuse and alcohol intake among the male veterans. Statistics show that people with suicidal thoughts are more likely to increase their level of drug consumptions. The healthcare professional will be keen to understand the level of drug abuse and whether the veteran has been struggling to reduce the level of drug abuse. Additionally, the family members should be advised not to buy drugs over the counter for veterans since some drugs can increase suicidal thoughts. Therefore, through oral questions and laboratory testing, the healthcare professional should determine whether the culprit has taken medicine over the counter, which will increase the level of suicidal thinking.

The last rationale is a treatment that depends on the behavior and thoughts specific to a particular situation. The treatment will also depend on the level of suicide risk. Although some people with suicidal thoughts don't speak about their challenges, it becomes difficult for families and societies to refer an individual to a doctor professional. However, through the community-based programs, the community member can note somebody with suicidal thoughts through a drastic change of behavior that has not to be normal to the person. There are higher chances of committing suicide, mainly when there are multiple attempts. Veterans' men are four times to commit suicide than their counterparts' females. Medical professionals are likely to rescue female veterans since they have higher chances of expressing their suicidal thoughts than men.

Based on the information provided by VA, it is the role of the family, healthcare workers, and the general society to support the well-being and health of veterans in the United States. The significant support is the timely provision of the health status and access to high healthcare status within the shortest time possible. The VA has a responsibility to assess the needs of the veterans and any service that will make their life smooth and meaningful.

Suicides among the veterans in Texas are a critical healthcare issue that requires urgent interventions. The research papers focus on preventive measures among male veterans in Texas, United States. The program will focus on Helping through Encouragement and Reaching Out (HERO) that effectively monitors various healthcare issues that have been a crisis in most of the first world countries. The program is effective since it combines the analysis of planning, implementation, and evaluation to reduce suicide among the veteran male population. The program not only focuses on the healthcare issue it is also commonly used across the industries. I chose the program since it has a chronological framework to minimize and even eradicate suicide among veterans.

First, the program will determine the real cause of suicide among the veterans in the United States and, more specifically, Texas. Through the first phase, the program will also determine the consequences and risk of determining the cause of suicides among the veterans. Since the case of veterans suicides is on the upwards trend, the paper will utilize the PROCEDE-PROCEED program for H.E.R.O. It will also assist in developing education programs for veterans and non-veterans members on how proactive determine people with suicidal thoughts. The ability of the Texas people to proactively determine people with suicidal thoughts will assist the medical health professionals in intervening in the situation and exposing the affected through therapy, guidance, and counseling.

The program will also create policies that will ensure the needs of the veterans are met. For instance, significant researches blame the Department of the Veterans Affairs for their unfairness in treating the veterans in the United States. Many veterans feel that they are unfairly treated, particularly when they return from an operation. Through the guidance of the PROCEDE-PROCEED program for H.E.R.O, the policy-making will enable the Texas City to draft policy that will create significant reforms in the VA. For instance, a veteran named Olen Hancock, who was sixty-eight years old, shot himself in front of the Department of VA after a long depression and desperation due to a long-term chronic illness that he acquired while in the course of his duty. Another touching case involved Steven Pressley and twenty-eight young veterans who shot himself on the chest neat VA parking lot.

Suicide near the Department of VA is an indication that veterans face a lot of mental challenges. Still, they don't have anyone to air their grievances, particularly physical and mental challenges. Between 2017 October and 2018 November, approximately 20 veterans committed suicide near VA offices. A marine veteran named Marine Justice Miller was suffering from a post-trauma stress disorder. After struggling with suicidal thoughts, he was admitted to the hospital, but he committed suicide near VA offices after four days of discharge. Therefore the policymakers will be critical to ascertain why veterans are committing suicides near VA offices.

However there are other crucial that made us choose this model. (1) It is hypothetically base and combines a series of phases in the planning, implementation, and evaluation to acquire the quality of life to the target population; (2) “It is the most widely known model in program planning” (Green & Kreuter, 2005); (3) This planning model starts with consequences and determines its cause; once the cause is known, an intervention will design to reach the desired outcomes; (4) “PRECEDE is helping to predisposing, reinforcing, and enabling constructs in education; PROCEED helps in policymaking, controlling and structural constructs in educational development” (Green & Kreuter, 2005, p. 9).

"In phase 1 is called the social assessment, the model seeks to state the quality of life of the target population to know problems and priorities of those population so that team can identify the desired outcomes" (Green & Kreuter, 2005). It analyzes the situation and allows the employee and employer the assessing the needs for achieving the quality of life. In phase 2, epidemiological assessment, we use data to determine the risk factors or causes of health in the population's genetics, behavioral patterns, and environment and rank the health goals and problems identified in phase 1. we use this phase to plan the health program.

Phase 3, educational and ecological assessment, helps identify and classify the many factors into three categories: predisposing, reinforcing, and enabling. These three categories help provide social benefits such as appreciation, relief of discomfort or pain, or tangible rewards like avoidance of cost to get quality of life in the target population in the H.E.R.O program. In phase 4, the intervention alignment, we aim to compare the strategies and interventions from the previous phase and bring needed changes to the policies. Administrative and policy assessment helps determine what resources are available to carry out the health promotion intervention, what time the invention can conduct, there are financial resources to buy needed stuff for an employee or not, what organization and administration will support the H.E.R.O program.

After identifying the intervention, we determine the availability of program resources; in phase 5, we begin the implementation, and in Phase 6,7 and 8, we evaluate the program's composition based on the objectives that we create during the assessment phase (Green & Kreuter, 2005). We focus on the availability of educational components for the employee, evaluate the changes of behavior in employees, reduce the incident, and focus on increasing productivity. PRECEDE PROCEED explains how the planning model relates to our topic to meet our goals to reduce the suicide rate in middle-aged veterans and our audience who will help us make our intervention successful.

Since suicide among veterans has become a pandemic in the United States, the Helping through Encouragement and Reaching out (H.E.R.O) program aims to reduce suicide among male veterans.

The main goals are to offer training to the members of society and encourage their awareness and how they can proactively note the suicidal thoughts among male veterans. The other goal is to provide early intervention in monitoring both the physical and mental illness among male veterans. The other goal is the make deliberate policies with the VA department to ensure the key stakeholders in the department address the needs of the male veterans.

Objectives

· Process objectives

The Texas Veterans Commission (TVC) provides the necessary awareness of suicide among the male veterans both to the public and the affected. The Veterans Commission works under strict regulations to ensure that the state and the federal government meet the male veterans' physical and mental needs. The commission also examines mental health and substance use and how they contribute to suicidal thoughts. Therefore the most effective process will require the TVS to conduct research and provide the list of male veterans who required medical intervention to prevent suicidal thinking.

· Impact objective

The public member will also be involved in the process to assist the commission in revealing some of the weald behavior noted among the veterans that suggest that they might be mentally ill (Kimbrel, Meyer, DeBeer, Gulliver & Morissette, 2018). Before the commission and the member of the non-veterans community able to identify veterans with suicidal thoughts, they must be aware that the challenge is there and given the training to note abnormal behavior. Various risk factors can suggest that a veteran is likely to commit suicide. Although suicide is not confined to a specific ethnicity, gender or race, the healthcare challenge is four times likely to affect male veterans than female veterans. The first risk factor is uncontrolled drug abuse behavior that may lead to depression and other mental disorders.

· Outcome Objective

The commission and the society member should be keen to report any prior attempt of murdering the male veterans. The other risks factor is mental illnesses, where some veterans have been reported to rape and engage in the serial murdering of the public without justifiable reasons. The other risk factor among male veterans is sexual, physical, emotional, and family violence. Research also has indicated that some of the veterans' males vulnerable to attacks include members from a family with a suicide history. The commission and the member of the general society should be keen to observe veterans' behavior. Veterans from an operation either from within the United States or outside the country are more vulnerable to suicidal thoughts.

Losing colleagues on the battlefield leads to depressions and other mental illnesses to veterans if the condition is not monitored early enough. The last stage is to take male veterans with suicidal thoughts to the relevant medical professional. Based on the literature review, various scholars (Carroll, Kearney & Miller, 2020) indicate that suicide in the United States needs to prevent through collaborations of all the stakeholders. The article suggests that the VA should use the emerging technology to provide sufficient data sheets to ensure that the Center for Disease Control and Prevention (CDC) and Department of Defense (DoD) cooperate in encouraging the mentally ill veterans to access the necessary treatment time.

Implementation Plan

An implementation plan will constitute the facts about veterans in Texas, United States. The research shows that Texas is among the states with the most significant number of veterans in the United States. Statistics show that the state accommodates more than one million and six hundred thousand members of the veterans in the army force majority being men. The first implementation plan is to enforcement personnel that will enforce the relevant and already established policies under Donald Trump's administration to prevent suicide.

There should be reforms in the top management of the VA in the entire United States to pave the way for more credible, reliable, and integrity personnel to enforce rules that prevent suicide among male veterans. Department of VA has failed their duties as they watch more than twenty-two veterans that lost their life due to desperation and mental illnesses that should be enforced monitored by the department (Norr, Smolenski & Reger, 2018). The VA department's role is to ensure that to facilitate cooperation between the private and public sectors in collaborating and strengthening activities that prioritize research activities through coordinated suicide prevention efforts to reduce suicide among the male veterans.

Therefore the implementation stage will ensure that the policy under the US Air Force Suicide Prevention Program (AFSPP) that aims at preventing suicide has been followed. Research on AFSPP indicates that adherence to the program has reduced the suicide rate since its implementation. However, the post-traumatic disorder that causes most of the suicide cases is less addressed through the program. The first implementation plan will focus on male veterans with post-traumatic disorders. Veterans suffering from post-traumatic disorder should be exempt from their duties until the medical professional confirms that the affected individuals are stable to resume their duties.

The United States should ensure that AFSPP is fully implemented by providing additional resources to the VA department for efficient management. The other plan will include evaluating the physical and mental health stability among male veterans every year. There should also be measures of veteran-reported symptoms and facilitate the recovery process if the signs evoke suicidal thoughts and depression.

Department of VA should focus on enlightening the public member about the number of medical facilities available, mainly in Texas. The Veterans Health Administration (VHA) will also play a critical role in ensuring community-based education aims to reveal the number of public health facilities in Texas that deal with suicidal thoughts among veterans. There are more than 1255 veterans' healthcare facilities in Texas. Including 1074 outpatient care facilities and 170 medical centers. Based on the current statistics, more than forty-one percent of veterans are diagnosed with substance use conditions or mental illness. More than seventy-five percent of the veterans' suicides result from the use of firearms.

Health education strategies should educate every member of the society since each person can play a critical role in reducing suicide among male veterans. The first strategy will be education focusing on access to the economic and financial needs that may contribute to suicidal thoughts. Healthcare with other relevant authorities should ensure that the veterans are taught how to strengthen financial security and house stabilization policies. Additionally, the non-veterans members should be trained to guide the veterans to access medication by safer suicide care through systems change.

The health education plan should create suicide awareness where there is a public mob, particularly during church and political gatherings. The health education strategies should also focus on utilizing the emerging technology platforms such as social media and the media such as television and the radio. The health education strategies should also focus on advising the veterans to reduce excessive alcohol and other lethal substances.

The program to prevent suicide among male veterans will be stage by creating awareness and education programs. The program will incorporate the senior managers from Veterans Health Administration (VHA), Veterans Affairs (VA), the Center for Disease Control and Prevention (CDC), Department of Defense (DoD), and the Texas Veterans Commission (TVS) (Granello, 2016). The initial campaign will be conducted (VHA) department in Texas. The initial campaign will require the veteran and non-veterans to participate in seminars that will take two months every weekend from 1:00 PM to 6: PM on Saturday since the program involves every member of the local government authority. Billboards and posters should be availed in major towns and cities in Texas.

The Billboards and posters should be availed within the first four weeks prior to the education program. The center for preventing suicide among male veterans will occur in DeBakey Veterans Affairs Medical Center, which is situated in Houston, Texas. The education program will promote education for the non-veterans and veterans communities to prevent suicide among the male veterans. The posters and billboards will be posted in secondary schools, army forces centers, markets, major towns, bars, and churches to capture the attention of many people as possible. The general education program will take two months for the non-veterans and one more month for the targeted population.

The campaign will also be monitored by a special workforce in social media, specifically targeting the young generation. A social media campaign is essential since more of the youths between the age of eighteen to thirty fives spend an average of twelve hours on major social media platforms such as Facebook and Twitter. The total education training program will take 40 hours for the non-veterans and 60 hours for the male veterans since they are the targeted group. Each category will be assigned 2.4 hours for the program. VHA will be assigned the role of equipping the members of the society on how to note that a male veteran is psychologically affected and require medical intervention.

The VA personnel will also be assigned 2.4 hours to discuss the policies of AFSPP and how the male veterans should ensure the policies are well implemented to ensure their colleagues with suicidal thoughts are assisted through the VA department. Most of the suicide committed by the veterans occurs outside the VA office, which indicates frustration the department has been exposing to the veterans. The veterans should be educated on their rights and the framework to air their grievances if the VA departments cannot address the physical and mental needs of the veterans. The (CDC) will be assigned 2.4 hours to address the need for male veterans to avoid the abuse of drugs since they may compromise the veterans' mental health. The drug that leads to suicidal thoughts includes excessive use of alcohol, cocaine, and heroin.

Department of Defense (DoD) is will also be assigned 2.4 hours to address challenges of the workplace that could lead to suicidal thoughts. DoD should ensure that the veterans are exposed to guidance and counseling after an operation. Most veterans need psychological support, mainly when some of their colleagues are killed during an operation. DoD will play a critical role and have to get the special training before addressing the male veterans during the education training. The last key stakeholders will include the Texas Veterans Commission (TVC), which offers individualized services to veterans and ensures they dwell in a good environment with their families. The education based on the TVC will enable the family member to note the challenges of the veterans when they are on leave.

Various resources are required for the implementation of the prevention of suicide among male veterans. The main resources include education material that includes handouts, books particularly discussing the effects of drug abuse, posters, and billboards. The other critical resource includes human resources that will consist of 10 personnel per every category from VHA, VA, CDC, DoD and TVC. The program managers will also hire two buses to ferry people from various parts across Texas to the medical facility. The other essential resources will include four laptops for personnel conducting the training.

Since the training requires integrating the emerging technology, two projectors and ten amplifier speakers will also be required. A cassette tape will be required to demonstrate behaviors and symptoms for suicidal thoughts to veterans, and no budget is needed because one veteran provides for it. Since the educations section will be held in the DeBakey Veterans Affairs Medical Center, which is among the largest veterans medical center, no charges will be required. Due to the challenges of light, the power generator will also be hired. The other promotional resources will include branded calendars, t-shirts, caps, and hand bands. The 12-weeks education is intended to reduce the rate of suicide among male veterans by eighty percent.

The program's budget is critical to ensure the resources available are utilized in the most appropriate budget. The budget should also align with the timelines required to complete the program. The budget creating will be determined before the start of any activity of the project.

Expenditure

Project evaluation is one of the most common methods for evaluating a program or a project. A program evaluation there is critical under the project of preventing suicide among male veterans. The evaluation process starts with collecting real-time data during the project's planning, execution, and implementation. Evaluation is a continuous process that should start from planning to the implementation stage. The key stakeholders, particularly the veterans' society and medical facility, should continuously evaluate the project and ascertain whether the project has met the intended goals and objectives.

The main reason for evaluating the project is to ascertain whether the budget allocated in the program was well utilized. In case the project was not appropriately used, the project's senior management should be held accountable. Therefore, the project evaluation enables more accountability and transparency on using the resources in the project. An evaluation report is critical, particularly to funders, since they can decide whether to fund such a project in the future or not. In most cases, when the resources have been well utilized, the funders recommend other charity organizations to fund the same organization in the future. A good evaluation process takes opinions from every person and ensures no one is left behind. Therefore, I will conduct an evaluation first because it is a requirement from the donor and secondly as a measure to ascertain whether the resources were well utilized or not.

Suicide prevention for the male veterans' program may not have gone perfectly as planned during the project charter, scope, and scheduling. Therefore, the evaluation process should ensure that the mistake made on the progress will never be repeated in case a similar project is to be held in the future. Additionally, the evaluation process will determine whether the goals to prevent suicide among male suicide have been met or not. I will also conduct the project evaluation to improve the decision-making by determining the personnel that manages to accomplish their duties efficiently. The project evaluation will enhance collaboration between the defense forces and the medical facility. Through the evaluation process, the stakeholders from key departments must cooperate in recommending a future program.

Human and financial resources are critical for the success of the project. The program occurs as a result of high cases of suicide among male veterans, particularly in Texas. The programs focused more on the male veterans since the previous statistics show that male veterans are four times likely to commit suicide than their counterparts' females. Although the male veterans are the targeted population, the program also involved other key stakeholders such as medical professionals and non-veterans. The non-veterans are supposed to be equipped with the knowledge to identify mentally ill male veterans and report the cases to the medical or VA department for monitoring of the individuals. The family members are critical members to understand the psychological needs of the veterans' members and take them to hospitals for medication before they are overwhelmed by suicidal thoughts.

Human resources are the most critical resource in the program. Fifty specialists from VHA, VA, CDC, DoD and TVC will be incorporated into the program to offer education on how the male veterans with suicidal thoughts can be identified and assist in visiting the medical facility for check-ups. The program will take place in the DeBakey Veterans Affairs Medical Center in Texas, one of the major medical centers for veterans. Ten specialists from each category will be assigned 2.4 hours to advise the veterans and non-veterans to prevent suicide among the male veterans. The program will be conducted during the week and specifically on Saturday, where the majority of the citizens are free from their regular duties. The program will be conducted for eight weeks comprising both the veterans and the non-veterans. The remaining four weeks will be specifically for the male veterans in the United States.

The healthcare facility will ensure that enough teaching resources on the effects of drug abuse and how they lead to suicidal thoughts are shared among the targeted group. Due to technological advancement, healthcare personnel should cooperate with computer experts to produce a soft copy of the education that can easily be shared through the internet. The Department of VA should be responsible for controlling the program together with the defense forces.

The evaluation activity will be exposed to male veterans through various methods. After every learning activity, the male veterans will be exposed to either oral or written questions based on the learning process's nature. Based on how the question will be answered, the evaluator will either repeat the topic or look for a different methodology to address the same health, social or economic challenge. Through the digital framework, such as using cloud computing technology, most of the data concerning the male veterans will be gathered and stored for analysis after the program.

The healthcare professional will conduct the other evaluation activity through lab and diagnostic tests to assess depression among the male veterans. Since most of them will not be willing to undergo the laboratory and diagnostic test, the processes will be conducted towards the end of the program. Most male veterans will be willing to undergo the tests after being guided and counseled on the importance of mental stability when fighting suicidal thoughts. The male veterans should also be grouped in tens to discuss the mental challenges they undergo during their duties. Since some male veterans may be reluctant to share their experiences, I will provide an email where an individual can comment or seek advice directly from the specialist without engaging their peers.

The other evaluation activity will focus on where most of the male veterans commit suicide near VA offices. The information provided by the male veterans will be used to change and streamline most of the policies in the department. Donald Trump's initiative to reform the senior management in the department attracted various reactions. For instance, in 2019, Robert Wilkie indicated that veterans were wrong to die twice in their countries. The evaluation program will ensure that the management loophole in the VA department will be revealed and recommendations provided to lawmakers for moderation. The other evaluation activities will be the level of training and the use of firearms and related to drug abuse. Most suicide cases are executed using firearms by veterans.

Suicidal thought occurs to the male veterans during the time of stress. The male veterans also face suicidal thoughts when facing physical and mental challenges. Male veterans suffering from stress, physical and emotional challenges will be exposed to medical intervention for treatment and monitoring (Nock MK, Borges, Bromet EJ, Cha CB, Kessler Lee, 2008). Most male veterans will be aware of their suicidal thoughts at one time or the other in their course of duty. If most of the suicide thoughts occur after an operation, the department of defense should be recommended to reduce duties and responsibilities for at least three months after the operation. Most researches indicate that most male veterans commit suicide after stressful operation outside the United States. The evaluation results will also enable the healthcare personnel to determine the number of male veterans that have experienced suicidal thoughts.

Although some veterans will not know if they have ever been in suicide thoughts, they will be required to answer basic questions. The male veterans will indicate whether they have ever felt hopeless or trapped in private or in public. If the healthcare personnel notes that some of the male veterans experienced intolerable emotional pain or preoccupied death or violence will be included in the data for people vulnerable to commit suicide. Male veterans with swings of sadness and happiness will require particular medical intervention (Carroll, Kearney & Miller, 2020). Other critical symptoms and signs that will be the focus will be increased use of alcohol and drugs and change in sleep and personality patterns.

Using the evaluation results, the medical health personnel will evaluate the result and determine the most effective move based on the National Institute for mental Health (NIFMH) policies. The results will also guide the family members based on the NIFMH policies, which suggest that members of the society remove all types of items that can commit suicide, such as knives and firearms. People with suicidal thoughts should be engaged in talks to make the veterans busy and less thoughtful about suicide.

The advertisement message indicates that men are more likely to suffer in silence than their counterparts' females. It is the role of every citizen in the United States and particularly Texas to support men in preventing suicide (Shekelle, Bagley & Munjas, 2009). Male veterans are four times more likely to commit suicide for failing to express themselves whenever they face physical and mental challenges in the course of their duties.

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Centers for Disease Control (2017). Programs for the Prevention of Suicide Among Adolescents and Young Adults. Retrieved on May 22, 2017, from

Carroll, D., Kearney, L. K., & Miller, M. A. (2020). Addressing suicide in the veteran population: Engaging a public health approach. Frontiers in psychiatry, 11, 1212.

Dillon, K. H., Cunningham, K. C., Neal, J. M., Wilson, S. M., Dedert, E. A., Elbogen, E. B., ... & Kimbrel, N. A. (2018). Examination of the indirect effects of combat exposure on suicidal behavior in veterans. Journal of affective disorders, 235, 407-413.

Granello, D. (2016). Using a Partnership Approach for Suicide Prevention Programming: An Enhanced Public Health Approach. IntJEmergMentHealth, 18(2). Grohol., J. (2004). An Introduction to Suicide. Retrieved on May 30, 2017, from https://psychcentral.com/library/suicide_general.htm

Kimbrel, N. A., Meyer, E. C., DeBeer, B. B., Gulliver, S. B., & Morissette, S. B. (2018). The impact of cannabis use disorder on suicidal and nonsuicidal self‐injury in Iraq/Afghanistan‐era veterans with and without mental health disorders. Suicide and Life‐Threatening Behavior, 48(2), 140-148.

Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. (2008). Suicide and suicidal behavior. Epidemiol 30:133–54.

Norr, A. M., Smolenski, D. J., & Reger, G. M. (2018). Effects of prolonged exposure and virtual reality exposure on suicidal ideation in active-duty soldiers: an examination of potential mechanisms. Journal of psychiatric research, 103, 69-74.

The comparison between the male and female non-veterans and veterans cases of suicide. The table below also summarizes the common types of methods used to commit suicide.

In my case, I utilized PIot's pyramid model to determine how people commit suicide (Musaraj, 2019). The most bottom part indicates the larger population has suicidal thoughts, which have occurred at least once in their lifetime. However, suicide thoughts might not be recurrent for every individual. However, individuals with more recurrent suicide ideation are more vulnerable to committing suicide if necessary measures are not taken. The uppermost part indicates people, particularly men, who cannot express their negative feelings towards committing suicide. The large population in the upper parts is men, particularly veterans (Dillon, Cunningham, Neal, Wilson, Dedert, Elbogen & Kimbrel, 2018).

Expenditure