Wisconsin Veteran Suicide Prevention
Reaching Out Saves Lives
From a 2021 AHW pilot study to a funded community campaign and a proposed statewide ground campaign — the evidence base, theoretical framework, and published research behind ReachOutWis.org.
Wisconsin Veterans die by suicide at 39.4 per 100,000 — more than twice the rate of the general population. Understanding why is essential to designing an effective intervention. Three overlapping factors drive the excess risk:
1. Mental health stigma. Military culture prizes stoicism and self-reliance. Veterans are trained to project strength and suppress vulnerability. Seeking help — especially mental health help — is perceived as weakness. This stigma is a powerful barrier to care-seeking, even when Veterans know help is available and potentially life-saving.
2. Disconnection from care. 61% of Veterans who die by suicide are not in VHA care at the time of death. Many have never engaged with VA mental health services. They may distrust large systems, have had negative experiences, or simply not know what is available to them.
3. Lethal means access. 70.8% of Wisconsin Veteran suicides involve firearms — far higher than the general population rate of 54.6%. The unique lethality of firearms (compared to other suicide attempt methods) means that firearm access during periods of crisis dramatically increases the risk of death. Secure firearm storage — even temporarily — is a proven intervention.
The theoretical model for this campaign draws on two well-established public health frameworks: Social Cognitive Theory (Bandura) and the Health Belief Model. Both emphasize that behavior change requires (1) perceived susceptibility and severity, (2) perceived benefits of action, (3) self-efficacy to act, and (4) cues to action that make the desired behavior feel accessible and normal.
The air campaign (WBA-PEP broadcast and digital media) addresses perceived susceptibility, severity, and perceived benefits through high-reach, emotionally resonant PSAs. By showing Veterans in authentic moments of struggle and recovery — with credible spokespersons like Daryn Colledge and Dr. Michael McBride — the campaign normalizes help-seeking and provides clear, actionable cues.
The ground campaign addresses self-efficacy and trust through peer-to-peer contact. A Veteran Peer Specialist who has lived experience with mental health challenges and has sought help is the most credible possible messenger for another Veteran. The peer connection reduces perceived social risk ("asking for help won't make me look weak") and removes practical barriers ("here's exactly how to get an appointment").
Together, the air and ground components address the full spectrum of behavior change prerequisites described in both frameworks — creating a theoretically coherent and practically integrated intervention.
Responsible firearm storage is not simply an add-on to the mental health message — it is a distinct, evidence-based intervention with its own theoretical grounding. The Means Restriction / Means Safety model is based on a well-documented empirical reality: suicidal crises are often temporary, impulsive, and highly sensitive to the availability of lethal means.
When firearms are temporarily stored away from the home — in a gun safe, at a shooting range, or with a trusted friend — during a period of crisis, the window for a lethal attempt closes. Research consistently shows that most people who survive a suicide attempt do not go on to die by suicide. Creating time and distance between an at-risk person and a firearm saves lives.
Our messaging is carefully framed not as anti-gun but as pro-Veteran — emphasizing that a Veteran who stores their firearm securely is making a smart, tactical decision to protect themselves and their family. This framing was developed with and validated by Veterans themselves in our focus groups.
The original AHW pilot grant launched the research infrastructure, message development process, and initial advertising campaign. This phase asked a foundational question: Can a mass media public education campaign change Veterans' attitudes toward help-seeking and firearm storage?
Working from evidence in media campaign research, the team engaged Veterans and community stakeholders through focus groups to develop authentic, culturally resonant messaging. Rather than imposing clinical or academic language, the team listened to Veterans describe their experiences and translate mental health concepts into language that felt real and credible.
Three advertising campaigns were deployed over 12 months through the Wisconsin Broadcasters Association's Public Education Program (WBA-PEP), reaching Wisconsin households via television, radio, and digital media. The campaign debuted under the BeThereWis.org brand before evolving into ReachOutWis.org.
A rigorous Qualtrics survey (400+ subjects at 3 time points, Veterans oversampled at 20%) measured changes in help-seeking attitudes, stigma, and firearm storage behaviors before, during, and after the campaign.
Building on the pilot's demonstrated impact, Phase 2 shifted from testing whether a campaign works to making it sustainable. The Community-Led Momentum Grant brought the War Memorial Center in as a full co-equal community partner alongside MCW, ensuring that the campaign would have an organizational home beyond the academic research cycle.
Key innovations in Phase 2 included updated message development through new focus groups (incorporating findings from Phase 1), a more sophisticated 5-campaign annual calendar timed to key Veteran events (Veterans Day, Memorial Day, Suicide Prevention Month, etc.), and the formal establishment of the Wisconsin Veteran Broadcasting Coalition (WVBC) — a network of broadcast partners committed to sustained, donated PSA airtime.
Phase 2 also formalized the website infrastructure (ReachOutWis.org), the resource directory, and the campaign's digital presence — creating a lasting community asset rather than a time-limited research project.
Phase 3 represents the logical next step in the project's evolution: if mass media campaigns alone can change attitudes, can adding a coordinated peer outreach ground campaign produce measurable changes in actual help-seeking behavior — and ultimately, in suicide rates? Phase 3 is designed to answer that question rigorously.
The proposed Ground Outreach Campaign (GOC) deploys trained Veteran Peer Specialists (VPS) across southeastern Wisconsin to conduct in-person outreach at community events, gun shows, sporting events, and Veterans organization meetings. VPS activities are coordinated with the continuing WBA-PEP air campaign to create a sustained, multi-channel intervention.
Evaluation uses a difference-in-differences design comparing SE Wisconsin (air + ground) to the rest of the state (air only) — a methodological advancement over the pre-post design of earlier phases that provides stronger causal inference.
Note: This proposal has not yet been approved. Content reflects the team's submitted application and is subject to revision based on funder feedback.
Phase 1 of this project produced peer-reviewed findings demonstrating measurable, statistically significant changes in help-seeking attitudes and firearm storage behaviors following the advertising campaign — particularly among Wisconsin Veterans.
Berger BD, Kohlbeck SA, et al. "Effect of Veteran-Focused Suicide Prevention Public Messaging on Help-Seeking Behavior and Secure Firearm Storage." OMEGA—Journal of Death and Dying, 2024. DOI: 10.1177/00302228241297553
This peer-reviewed paper presents the primary findings from Phase 1 of the campaign, demonstrating statistically significant positive changes in help-seeking attitudes, firearm storage attitudes, and self-reported secure storage behaviors following the advertising campaign, with particularly strong effects among Veterans.
Our work is grounded in the national Veteran suicide crisis data published by the U.S. Department of Veterans Affairs. In 2023, 6,398 Veterans died by suicide nationwide — a rate of 35.2 per 100,000, nearly twice the non-Veteran rate of 18.2 per 100,000. Wisconsin's rate of 39.4 per 100,000 is even higher.
73.3% of Veteran suicides nationally involve firearms. 61% of Veterans who die by suicide are not enrolled in VHA care. These statistics underscore the need for community-level interventions that reach Veterans outside traditional healthcare settings — which is exactly what this campaign is designed to do.
The Wisconsin Veteran Suicide Data Sheet provides state-specific context for our campaign. In 2023, 130 Wisconsin Veterans died by suicide — 120–129 male, with firearm involvement in 70.8% of cases. The Wisconsin rate of 39.4/100,000 is not significantly different from the national Veteran rate after age adjustment, indicating that Wisconsin's elevated rate reflects the national crisis, not a uniquely Wisconsin failure.
A core design principle of this project is that it must outlast grant funding. The War Memorial Center, Milwaukee — Wisconsin's premier Veterans organization and a 501(c)(3) — serves as both fiscal sponsor and long-term institutional home for the campaign. As campaign infrastructure, community relationships, and brand recognition are built, the War Memorial Center becomes an increasingly capable owner and operator of the campaign independent of academic funding.
The WVBC — a network of broadcast partners committed to donated PSA airtime — represents a multi-million-dollar media asset that requires no ongoing cash expenditure. As the coalition grows and formalizes commitments, the campaign's media reach becomes self-sustaining through the goodwill and civic commitment of Wisconsin broadcasters.
Veteran Peer Specialists trained during the ground campaign become a permanent community asset. Their skills, relationships, and networks persist beyond any single grant cycle. The goal is for VPS outreach to continue as a core function of the War Memorial Center's community programming — funded through a combination of donations, state Veteran services contracts, and community partnerships.