Not too long ago, suicide rates for active military members and veterans were lower than those of the general population. Yet the military (active and veterans) now represents 20 percent of all suicides in the United States after a doubling of suicide rates between 2001 and 2009.

Veterans Day, a national holiday Nov. 11 that honored living military veterans, should not pass without recognizing the increased risk for military personnel who served in Iraq and Afghanistan and those receiving Veterans Administration services. They, too, are represented disproportionately in national suicide rates, says the Centers for Disease Control and Prevention.

An estimated 20 veterans a day commit suicide, according to a study by the Department of Veterans Affairs. In Connecticut, 49 veterans died by suicide in 2014 (the most recent statistics available), a suicide rate of 25.9 per 100,000 population. Both the Connecticut rate and the national veteran rate (38.4) exceed the age-adjusted, general-population suicide rate in the United States (13.0).

The Veterans Administration has developed a suicide prevention treatment plan that includes techniques to distract people enduring intense suicidal thoughts.

“Offer your support in getting them help,” says Dr. Linda Durst, the Institute of Living‘s medical director. “Being critical or judgmental about their experience will only invalidate their experience and shut down their ability to communicate with you.”

Veterans who attempt suicide are more likely to succeed because they often use firearms. (The VA hands out gun locks and recommends veterans keep their weapons unloaded.) Substance abuse is also a theme nationally in suicides.

“The population that suffers from substance abuse disorders is at an extremely high risk of suicide because of the nature of he substances,” says Dr. J. Craig Allen, Rushford‘s medical director, “which can increase the rates of depression, decrease inhibitions and increase impulsivity. And the one variable that’s most highly correlated with suicide is alcohol.”

If you or someone you know is considering suicide, visit the National Suicide Prevention Hotline at 1.800.273.8255 or click here. The Veterans Crisis Line is 1.800.273.8255 (Press 1). To learn more about Hartford HealthCare’s Behavioral Health Network, click here.