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© Arthon Meekodong via Canva.com Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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Hygiene in healthcare is an essential backbone to providing the safest, most optimal care to every patient. From everyday handwashing techniques and getting all necessary vaccinations to surveilling our health system before the onset of outbreaks, at Renown Health, creating and maintaining a low-infection environment is a group effort. From ensuring fundamental infection prevention practices are carried out to identifying process improvement opportunities, Renown’s Infection Prevention (IP) department is here to help care teams be successful in their role. This effort is led by members who are devoted in sharing evidence-based best practices to our patients, employees, healthcare organization partners and community. Making “Zero” A Reality Reducing healthcare-associated infections is possible when core infection prevention practices are incorporated into the daily care of our patients. These team members are dedicated to Renown’s commitment to creating a culture of Excellence, caring for our healthcare environment, and our care teams. “Often times, when asked what we do in our work it can be a challenge to answer because unpredictability is built into almost every day; and in that, we as a team must divide and conquer,” said Susanne James, Manager of Infection Prevention. Every day, each team member is assigned a day to perform required surveillance activities. Whether they are reviewing patients’ infections and isolation and evaluating lab orders for possible infectious processes or reporting communicable diseases to the local health authorities and the CDC, every Infection Preventionist participates in improvement projects and address issues as they arise. The Infection Prevention team plans, organizes, manages and evaluates the Infection Prevention Program and ensures IP policies reflect current best practice. They work closely with all departments at Renown in order to achieve high levels of standards that are implemented to reduce transmission of infection. “As a team, we perform ‘Infection Prevention Environment of Care Rounding’ on all units and departments to ensure our environment complies with regulatory requirements,” said Erika Clark, Operations Analyst at Renown Health. "We work together with Facilities and Site Practice Leaders to ensure a safe environment.” The pandemic challenged all Renown teams to find creative solutions for issues no one ever imagined. Our Infection Prevention department worked tirelessly alongside Renown's Hospital Incident Command Structure (HICS) and care teams in creating several lines of defense against COVID-19, including: Launching Renown's Alternate Care Site to meet the need for critical patients. Bringing on the new lab tests and specimen collection criteria. Managing demand for personal protective equipment (PPE). Bringing vaccines to staff and then to the community. Managing ill employees and our visitors. Keeping all locations informed on pandemic status and changes (which were occurring at breakneck speed). These initiatives enabled Renown's care teams to focus on providing the safest care possible to patients saving countless lives. This solidified the fact that together, the team can accomplish anything. “Infection Prevention is proud to be a valued and respected member of the care team,” said Susanne James. “We appreciate being a trusted resource and take this responsibility seriously as this enables us to provide staff the best possible tools to be successful.” Fight the Good Fight Against the Spread of Disease Educating patients and providers plays a huge part on the Infection Prevention stage. This team provides educational materials on a range of topics, some of the most important are, proper hand hygiene and the use of PPE. All these materials can be found throughout our health system and serve as an important reminder – infection prevention starts with all of us. “We partner with every aspect of the health system – environmental services, nutrition services, lab services, facilities, pharmacy, physical therapy and occupational therapy, respiratory care, patient access, security, nurses, providers and quality...just to name a few!” said Susanne James. Our Infection Prevention team also partners with Washoe County Health District and other public health agencies to report – and in turn, stop the spread of – diseases and exposures. These close partnerships poise our team to do what we do best: Fight the Good Fight. “I greatly appreciate everyone in the IP department for sharing their expertise as I learned a new position,” said Erika Clark. “I love working with my team and how closely we work with other departments to ensure excellence in all we do.” Our health system is ever-changing. But according to the experts in our Infection Prevention department, the three main ways to prevent illness and disease that remain the same time and time again are to: Clean your hands. Hand hygiene is the most effective way of preventing the spread of infections. The CDC recommends washing your hands with warm soap and water for 15-20 seconds or using an alcohol-based hand sanitizer. Clean your hands often and assist our patients to do the same. Learn expert hand-washing advice here. Get vaccinated. Immunizations are one of the top methods you can embrace the fight against preventable diseases, such as COVID-19, flu, measles, tetanus and more. Discover how you can get vaccinated with Renown. Keep germs from spreading. Practice good hygiene by covering your cough or sneeze or wearing a mask and sanitizing frequently touched spaces. Stay home if you feel ill to prevent the spread of illness and infection. Be sure to bring up any illness concerns with your primary care provider. “Every aspect of our health system has an infection prevention component, and we work daily to ensure our staff, patients and visitors are providing and receiving care free from potential harm or infections,” said Susanne James. “We are often the first call staff make when they have questions, concerns or just need someone to help improve process or outcomes.” Reveling with Renown Proudly defining themselves as a “small but mighty” team, the six-person Infection Prevention department moves mountains to ensure the safety of anyone who walks through Renown’s doors. The tight-knit nature of this team can be felt from miles away, and to them, being “small but mighty” is not a hindrance, as they have the support of the IP Champions and the entire health system.   “I originally came to Renown in 2018 as a nurse traveler, the facility and people I worked with immediately made an impact on me,” said Brian Stroud, Infection Preventionist at Renown Health. “My wife and I chose Renown and Reno due to the positive impact the people had on us. Everyone is welcoming, helpful and caring. Now, I am a full-time employee, and the team has made my transition into infection prevention trouble-free." Renown’s mission of providing a genuine difference for the health and wellbeing of the community is heightened and echoed by the Infection Prevention team. “I chose Renown because of the reputation Renown has earned in the community because of the excellent care and level of services provided,” said Shannon Oriola, Infection Preventionist at Renown Health. “I absolutely love this team and my Renown family!” “What brought me to Renown was the opportunity to acquire diverse skills which then motivated me to pursue my master’s degree,” added Paul DeLeon, Infection Preventionist at Renown Health. “What keeps me here is the people – Renown attracts hard working, ethical and caring people.” "My wife and I loved coming out to the Nevada mountains on vacations," added Russ Laarman, Infection Preventionist at Renown Health. "After being in Michigan for 47 years, we took the plunge and made NV our home. The experience has been great! I work with a great team that is very knowledgeable and works hard to ensure positive outcomes for our patients and colleagues at Renown.” Their pride shines through with their own individual accolades, both inside and outside of work. This past year: Shannon Oriola received a scholarship from the Association for Professionals in Infection Control and Epidemiology (APIC) for “improving outcomes through knowledge and practice,” which provided her with a $1,000 scholarship to attend the annual APIC conference in Indianapolis. Paul DeLeon earned his Certification in Infection Control and Prevention from APIC. Erika Clark completed Renown’s High Potential program, a six-month program that gives employees hands-on learning experience with several competencies, including emotional intelligence, effective communication, building successful relationships and organizational knowledge. Brian Stroud and his wife Charla became official Nevada residents. Russ Laarman scaled Mount Whitney. ...And the list keeps growing! Charged with the goal of keeping disease spread at bay, our Infection Prevention team remains vigilant and dedicated to their mission. Their commitment to Renown and to keeping our health system clean and healthy proves the age-old saying true: not all heroes wear capes. “I’m so very proud of the work Infection Prevention does every day, working with the vast teams throughout the health system to improve lives,” said Susanne James. “We would like to thank all of you for protecting the health and safety of your colleagues, our patients and the community.”

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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.

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Men are generally less likely to visit their doctor for exams, screenings, and consults compared to women. To address this, we've collaborated with Dr. Bonnie Ferrara of Renown Health, to compile a list of eight essential screenings that can help men maintain their health. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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Visiting a Renown Urgent Care location is an excellent option when you have a non-severe condition, such as a skin rash or sore throat, can't get in to see your primary care provider in a timely manner or if you need an appointment after regular business hours. To learn more about the ins and outs of Urgent Care, we spoke to David Lemak, MD, Division Chief Urgent Care, who let us know some reasons to visit Urgent Care, how to make your visit as efficient as possible, and more. Remember, for a life-threatening emergency, call 911 immediately! Urgent Care is similar to a Primary Care provider Urgent Care providers can do most of the things your Primary Care provider can do, with visits billed the same as an office visit. If you could put the word “severe” in front of your reason for visiting Urgent Care, please go to the emergency department right away For a list of what is an appropriate visit for Urgent Care click here. Also, we recommend that babies 2 months old and younger should go to the Renown Children’s Emergency Department, not Urgent Care.  Renown Health has 10 Urgent Care locations across northern Nevada There are five locations in Reno, two in Sparks, one in Carson City, one in Fernley and one in Fallon. For a complete list of Renown Urgent Care locations, click here.  Many of your Urgent Care needs can be accomplished via a virtual visit, from the comfort of your home or office Conditions Appropriate for a Virtual Visit Included:   - Common cold and cough symptoms - Muscular, tendon or joint pain not cause by injury  - Allergy or sinus symptoms   - Pink eye  - Urinary discomfort  - Backache  - Sexually transmitted illness screening   - Rashes or skin sores - Medication refills (no controlled substances) Some conditions are not appropriate for a virtual visit. They include:  - Chest or abdominal pain   - Shortness of breath  - Traumatic injuries  - Dizziness or confusion   - Bleeding    - High fever   - Persistent vomiting  - Loss of vision   - Substance abuse or psychiatric problems Book ahead for shorter wait times, but remember walk-ins are always available. Click here to make your appointment. This booking page conveniently shows the next available appointment at each location. Typically, mornings and late afternoon (right before dinner time) have the shortest wait times if you plan on walking in.   You will be asked to wait in your car when you arrive at a Renown Urgent Care facility. While you wait (or even before you arrive), patients are encouraged to complete all registration paperwork and co-pay information online.  Urgent Care is great for visits such as back-to-school physicals, camp physicals, commercial motor vehicle exams and more. Sometimes you cannot get in to see your primary care provider to meet the last-minute deadlines for certain school or work-related physicals. Many of these appointments can be completed at Urgent Care; we just recommend you call ahead and confirm that our facility offers what you need.  An Urgent Care provider can virtually order a PCR COVID-19 test.  Whether you have a possible exposure, are not feeling quite like yourself or need a negative test for upcoming travel, a COVID-19 test can be ordered for you. The cost for a visit to Urgent Care is dependent on your benefits, but the visit is billed the same as a standard office visit. If you don’t have insurance, a basic visit to a Renown Urgent Care will cost $125.

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Renown Health has always been on the frontlines of technological advancement, and that innovation remained unwavering during the COVID-19 pandemic. Our telehealth teams heeded the call to provide home monitoring for our patients, transforming how we provide care. The care providers at Renown successfully monitored lower acuity COVID-19 patients from the comfort of their own homes. Bernard Lee was diagnosed with COVID-19 and pneumonia, and was able to return home to continue his recovery with a home monitoring system. While at home, Bernard’s health took a turn for the worse while he was sleeping, but thanks to the continuous monitoring of Health at Home, his worsening vitals did not go unnoticed. “This monitoring system really saved my life,” Bernard said. “It was telling me that my sats were low, but I didn’t even feel the common COVID symptoms; I just felt tired.” Because of his low oxygen saturation (sats) and the continuous monitoring, he woke up to providers calling to check on him in the early morning. He was immediately transferred to the Renown Intensive Care Unit to be cared for and monitored by our expert care teams. Today Bernard is recovering, feeling great and continuously refers to the team and the home monitoring system as his guardian angels.

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Meet Haley Carroll Being a new nurse comes with many challenges and gaining experience is a journey, but Haley Carroll’s first day on the job was far from her first day in a hospital. Haley was diagnosed with lymphoma right before her senior year of high school, and she was declared cancer-free on December 2, 2015. Inspired by the incredible care she received during her cancer treatments and during her time at Renown Children’s Hospital, Haley enrolled in nursing school at the University of Nevada, Reno. She graduated in December 2020, just five years after beating cancer. “I’ve always been interested in nursing,” Haley says. “But once I was diagnosed and began to see everything that my nurses did for me, I knew that that’s what I wanted to do for patients, too.”

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Dr. Derek Beenfeldt first joined the Renown family in 2014 as a family medicine physician after graduating from University of Nevada, Reno, School of Medicine (UNR Med) in 2011. His son Davis was only 10 years old when Dr. Beenfeldt decided to change careers and attend medical school. Ten years later, Davis is following in his dad’s footsteps as a third year student at UNR Med. “I am proud of Davis for taking on the challenges and the commitment that I know goes along with attending medical school,” Dr. Beenfeldt said. “I also feel lucky that we have a medical school with such a great reputation and resources close to home.” The affiliation is a great source of pride for Dr. Beenfeldt. Not just because two important organizations in his life are joining forces, but he also sees it as both entities taking on an immense responsibility – the challenge to be better for incoming students, and subsequently to improve healthcare in Nevada. Davis is currently going through his rotations and spending countless hours a week at Renown Regional. His dad is right there by his side supporting him along the way. “It has been really interesting to have discussions about the UNR medical school with Davis, I recognize the names of many of the professors and courses from when I was a student,” Dr. Beenfeldt said. “I tried to be empathetic, as I can relate to how difficult and stressful this time is for him. Dr. Beenfeldt currently works as chief medical officer for Renown’s insurance arm Hometown Health, and Davis is still browsing specialties. “I don’t know what kind of medicine I want to focus on yet, but I feel lucky that I can attend medical school so close to home and have the option to continue helping my fellow Nevadans after I graduate.” UNR Med at a Glance UNR’s Medical School was established in 1969 Over the last 50 years, UNR Med has educated 3,900+ physicians More than 30% of UNR Med physician graduates continue to practice in Nevada UNR Med is the state’s oldest medical school

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Meet Connor Smith Life was hectic for Connor Smith. He had just finished at the top of his class at both the fire academy and paramedic school and was looking forward to starting work in northern Nevada. It was winter 2019, and he was ready to have some fun. The plan was to ride ATVs at Sand Mountain with his brother Cody, dad Lance and some friends, but a jump would change everything. Connor’s ATV took off but landed awkwardly, and he remembers immediately knowing he was paralyzed. Connor’s mom, Dana Shugar, was at home when she received the upsetting call from Cody, who told her he had an accident. Connor was flown to Renown Regional Medical Center, the area’s only Level II Trauma Center. After a seven-hour emergency surgery, Dana learned that Connor would live but only had a slight chance of walking again due to a spinal fracture. “The surgeon saved his life. It’s amazing how your life can change in a matter of seconds,” she said. Once his condition stabilized, Connor moved to the Renown Rehabilitation Hospital and began physical rehabilitation. “Thank God for the people at rehab,” Dana said. “Dr. Pence, the therapists, nurses and all the employees were a wonderful support system, explaining everything and answering all our questions. The kindness they showed got me through.” Connor agrees, calling the Renown rehab team nothing short of amazing.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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Has a male in your life been affected by depression? This could be your father, husband, son, brother, friend, or co-worker. Men often struggle to recognize when they need help. Learn how to support them by understanding their unique signs of depression. Psychologist Dr. Herbert Coard discusses depression in men and its often-overlooked warning signs. Every year, over 6 million men are diagnosed with depression, which can manifest differently than in women. Commonly misread, the signs can include anger and aggression rather than sadness, leading to challenges for loved ones and healthcare providers in recognizing the condition. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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