Studies indicate that American war veterans are far more likely to commit suicide than non-veterans.  Until recently, getting emergency help and counseling services has been difficult or impossible for many vets. But the situation may be improving, thanks to a national suicide prevention hotline put in place last year by the estimates that about 20 percent of American soldiers returning from duty in Iraq and Afghanistan show symptoms of post-traumatic stress disorder, placing them at higher risk for suicide.

"If someone calls and they are in extreme distress or have immediate plans to hurt themselves, we? keep them on the phone, and try to keep them talking to us and safe until we can get them immediate help," says Kemp. The hotline director estimates that, so far, the service has sent about 4600 calls out to local suicide prevention coordinators, resulting in the actual prevention of at least 720 imminent suicides.

Many non-governmental veterans groups, such as Iraq-Afghanistan Veterans of America (IAVA), applaud the hotline; they say returning veterans have needed an efficient round-the-clock resource like this for a long time.

Before the hotline, most veterans were asked to call a referral service called the Army One Source.  "I had a friend of mine call [Army One Source] (to) say he was having suicidal thoughts," says Patrick Campbell, IAVA's legislative director. "They told him to go online and take a personality test, and call back with the results of that personality test! That's unacceptable."   

But the VA's national suicide hotline can only help those who do know about it. That's why veterans groups also support a related V.A. program dedicated to contacting every one of the nation's estimated half million-plus veterans to tell them about the hotline.

Not all the help provided by the hotline comes over the telephone. Local suicide prevention coordinators often meet people at the door of their facility and actually walk them to the people who can help them enroll and stay there while they complete the paperwork. "This is a compassionate answer to bureaucratic problems," says hotline coordinator Janet Kemp.

Veterans are sometimes embarrassed to seek mental health counseling upon returning home, seeing it as a sign of weakness to reach out. In recognition of this fact, several veterans groups have called for mandatory mental health screening upon discharge. Until such a program is in place, the hotline must rely mostly on word of mouth and advertising.

The National Suicide Prevention Hotline has launched a national campaign to convey the idea that calling the hotline is a sign of strength.

"We are really approaching it from the perspective of 'it takes a lot of courage to do this," says Kemp.  "'You've shown us you've got courage by your participation in the military. You need to take that a step further now and get the help you need and you deserve.'"

Even with the hotline, there is plenty of work to be done to make sure that the psychological wounds of war are addressed when veterans come home. According to a recent class-action lawsuit brought by Veterans For Common Sense and other activist groups, 18 U.S. veterans commit suicide on an average day ? more than typically die on the battlefield during a 24-hour period. Still, most experts agree the hotline is a good start.