Much of the focus by the Veterans Health Administration has been on the growing number of younger veterans who commit suicide, in fact statistics show that elderly veterans kill themselves in larger numbers than other people the same age.
Robert Neilson was drafted in 1961. He spent two years in the Army just before the Vietnam War. He was recently at the VA Hospital in San Diego as part of his treatment. Three years ago, the 76-year-old came into the VA after contemplating suicide.
"That's what really brought me into the emergency room. That wasn't really the first time," Neilson said. "Two months after I got out of the service, I attempted suicide."
After he got out of the Army, Neilson remembers going back home to New Jersey. He was standing on a subway platform watching a speeding train.
"And I figured if I just hold my hands in the air, I could just let (the train) suck me in," Neilson said. "Somebody shouted, "What are you doing?" And that was enough to snap me out of the trance, but I still didn't seek any help. I just figured, OK, I'll just struggle through life."
It would take another 50 years for Neilson to get help dealing with the trauma of a sexual assault he experienced in the military..
"And the guilt was, I wasn't strong enough to overpower that person. Plus, it was a high-ranking person," he said.
That was all he wanted to say about the incident that has haunted him most of his life.
All sorts of service-related issues can lie dormant only to crop up later in life, said Ron Stark. Stark founded Moving to Zero, a nonprofit group in San Diego, where he counsels fellow veterans who have contemplated suicide. More than a few are elderly.
Stark retired from the Navy in 1994. He served aboard a submarine in the Arctic in the 1970s and again during Desert Storm. For some older veterans, no accomplishment is ever enough, he said.
"We have things about stolen valor. Nobody wants to misrepresent themselves," he said. "So I'm a Vietnam-era veteran. I'm not a Vietnam veteran. I was in Desert Storm, but I wasn't in combat We're always talking about what we're not quite."
Veterans struggling with suicide aren't always wrestling with memories of combat. Although he was never in combat, Stark suffered from depression most of his life. He remembers sitting by the roadside with a pistol and contemplated pulling the trigger.
"The military didn't make me who I was," he said.
But the military establishes life-long habits, both good and bad. A soldier strives to be someone people can rely on, especially in critical situations.
"You have a bad day at work and you go home. You have a bad day on a submerged submarine, then people die," he said.
So if you're not feeling 100 percent, maybe it's better to keep it to yourself, he notes. Stark describes suicidal feelings as a brief moment of blackness when other options fade from view.
The VA National Suicide Data Report for 2005 to 2016, which came out in September, highlights the alarming rise in suicides among veterans age 18 to 34, who had the highest rate of suicide - 45 per 100,000 veterans. But those 55 and older still represent the largest number of suicides among veterans. Part of the reason for this is that the veteran population in the US tends to be older.
For veterans age 55 to 74 years old, the rate of suicide is 26 per 100,000, while nationally, the suicide rate in the same age group is 17.4 per 100,000. The rate ticks up even higher for veterans over 85 years old.
The Veterans Health Administration has focused on finding risk factors that could lead someone to kill themselves, such as isolation, previous suicidal thoughts and access to firearms. Older men are also more likely to reject treatment for mental health issues, which is another big risk factor.
The problem is that the VA still doesn't know who will attempt suicide among the people who have those risk factors, said Colin Depp, a psychologist at San Diego VA who has researched suicide among older veterans.
"We're not very far ahead in understanding who's out there, who's really likely to take their lives in the next hours, days, months," he said.
The VA emphasizes getting potentially suicidal veterans in the door, where health-care workers deploy a range of treatments, he said.
As part of his own treatment, Neilson - the vet who was 73 before he sought treatment himself - is now writing letters of encouragement to fellow veterans who are just beginning treatment, as part of a VA program.
Neilson pulled out one of the letters he has written and explained how he can help a veteran he will never meet in person.
The letters are just one more nudge to keep veterans away from that dark moment when suicide feels like the only option.