Veteran Suicide Prevention Efforts Under Scrutiny

In a House Veterans’ Affairs Committee hearing on efforts to prevent veteran suicide, the VA confirmed that it is focused on ensuring it has enough mental health care providers. The VA currently employs 5,500 psychologists and 3,203 psychiatrists. According to Maureen F. McCarthy, MD, deputy chief, VHA Office of Patient Care Services, the VA currently has 236 psychiatrist vacancies.

Veteran service organizations, House members, and the VA all agreed that hiring and retaining qualified mental health care providers is an essential component in reducing suicides. “We are aware that access to mental health care is one significant part of preventing suicide,” McCarthy said in prepared testimony. “VA is determined to address systemic problems with access to care in general and to mental health care, including substance use disorders in particular. VA has recommitted to a culture that puts the veteran first.”

As House members, veteran service organizations, and the VA have all admitted, the frequently quoted 22 veterans suicides each day statistic is based on dated and limited data. To better understand the scope of the problem, the VA is working with the CDC to obtain a more current and accurate count of veteran suicides—a move that many veterans advocacy groups have called for.

“Vietnam Veterans of America calls for an updated veteran suicide report that includes data from all 50 states and U.S. territories, and also strongly suggests that VA mental health services develop a nationwide strategy to address the problem of suicides among our older veterans—particularly Vietnam-era veterans,” Thomas J. Berger, PhD, executive director of the Veterans Health Council of the Vietnam Veterans of America (VVA) told the committee in his prepared remarks.

According to Dr. McCarthy, the data will be available later this summer and will accessible to researchers. “We so wanted to have this information to you by this hearing. We don’t,” she said.

Challenges Remain

Ensuring access to care is one of the VA’s chief challenges. “We have to change our messaging to be more welcoming to all veterans,” Dr. McCarthy told the committee. “There are still veterans out there that do not know that they are eligible for benefits.”

Another one of the challenges is streamlining the transition from the military to the VA. “VA research has indicated that rates of suicide among those who use VA services have not shown increases similar to those observed in all veterans and the general U.S. population,” McCarthy explained. “This research suggests that an improved health care transition between DoD and VA could help mitigate suicide risk as well as other increased risks of morbidity.” According to McCarthy, the VA and DoD are working to create a seamless transition for mental health medications from the DoD to the VA, following a safety review

Following up on the Preventing Veterans Suicide – A Call to Action summit, in March, VA announced 8 steps it planned to take to improve its suicide prevention programs. They are:

1. Elevating VA’s suicide-prevention program with additional resources to help manage and strengthen current programs and initiatives;

2. Meeting urgent mental health needs by providing veterans with same-day evaluations and access by the end of calendar year 2016;

3. Establishing a new standard of care by using measures of veteran-reported symptoms to tailor mental health treatments to individual needs;

4. Launching a new study, “Coming Home from Afghanistan and Iraq,” that will look at the impact of deployment and combat as it relates to suicide, mental health, and well-being;

5. Using predictive modeling to guide early interventions for suicide prevention;

6. Using data on suicide attempts and overdoses to guide strategies to prevent suicide;

7. Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;

8. Enhancing veteran mental health access by establishing 3 regional telemental health hubs; and

9. Continuing to partner with the DoD on suicide prevention and other efforts for a seamless transition from military service to civilian life.

“While these initiatives are laudable, VVA also believes strongly that they cannot fully succeed without a significant increase in the recruitment, hiring, and retention of VA mental health staff, as well as timely access to VA mental health clinical facilities and programs, especially for our rural veterans,” Berger told the committee.