County, VA partner to improve suicide data, mental health services

WASHINGTON — The U.S. Department of Veterans Affairs and Allegheny County are partnering to improve the collection of veteran suicides, the county’s top veterans affairs official announced Wednesday, part of a broader push by the county to more effectively connect veterans to mental health services in the Pittsburgh region.

The VA and county have struck a data-sharing agreement that will help the medical examiner identify individuals who have committed suicide as military veterans, said Dwight Boddorf, chief veterans affairs officer for Allegheny County Veterans Services. In situations when the next-of-kin cannot be found, the medical examiner can reach out to the VA to confirm the status of the deceased.

In addition, Mr. Boddorf said, the county is working to standardize forms across all departments and contractors to ask about military service and veteran status. Currently, that is not a mandatory data field, leading to potential oversights in linking people to services.

The county also is working to connect with veterans who have attempted suicide and wind up in emergency rooms of non-VA hospitals, he said, as part of a statewide veteran suicide working group created last year with the VA. That would involve better communication with Allegheny Health Network and UPMC, he said.

“How can we work with [Allegheny General Hospital], UPMC, other emergency rooms to make sure there’s an appropriate follow-up for those individuals, that they are handed over to the VA, if appropriate, and if not, what other services are in place?” Mr. Boddorf told a virtual gathering of the Veterans Breakfast Club that featured VA Secretary Denis McDonough and U.S. Rep. Conor Lamb, D-Mt. Lebanon.

Veterans’ mental health “is a very complex issue, but we’re always open to new partners and ideas, and we’re happy the VA is being so proactive with us and open to us on interagency cooperation,” Mr. Boddorf said.

A national problem

The local initiatives come as officials in Washington have moved to improve mental health services to address rising rates of veteran suicides.

The VA estimated the suicide rate among veterans reached 27.5 per 100,000 in 2018, up from a rate of 18.5 in 2005, according to the agency’s most recent suicide report released last year.

That upward tick is mostly because the U.S. veteran population has steadily declined. Still, the number of suicides rose in 2018 for the second consecutive year, the VA found. The number of suicides reached 6,435, or more than 17 suicides a day, up from 6,399 suicides in 2017 and 6,310 suicides in 2016.

About 11 out of those 17 veterans who die by suicide each day were not recently engaged in VA health care, said Sarah Woodring, a suicide prevention case manager for VA Pittsburgh, in an interview Wednesday.

“A lot of our focus then also needs to be on the community,” Ms. Woodring said.

The VA has been expanding outreach to local agencies and groups and the general public to try to reach veterans in need, she said. It’s a common misconception, she said, that the responsibility falls to professional clinicians to help someone access care.

“You just need to try to recognize common signs and symptoms in the people around you, and not be afraid to ask the questions, validate the experience that they’re going through and stay with them to get them to care,” Ms. Woodring said. “Everyone has a role to play in preventing suicide.”

Mr. Lamb, a Marine Corps veteran and a top member of the House Committee on Veterans’ Affairs, successfully advanced legislation on the issue last year.

In September, Mr. Lamb introduced a package of three bills with Republican co-sponsors to expand the VA’s mental health care research, treatments and suicide prevention efforts.

One bill would require the VA to establish a two-year program that widens the treatment options for posttraumatic stress disorder, depression and anxiety. That bill would mandate a VA study on providing integrative health services such as yoga, meditation, acupuncture, chiropractic care and other treatments that help with mental or physical health conditions.

A second bill would require the VA to launch an initiative to identify predictors of mental health disorders, and the third bill aims to expand the VA’s partnerships with outside academic and research entities to analyze the vast amounts of data it collects through its electronic health records and research program.

Those bills were folded into a veterans’ mental health bill that former President Donald Trump signed into law in October.

On Wednesday, Mr. McDonough — who the Senate confirmed as VA secretary by an overwhelming 87 to 7 vote in February — told the group he was working on a new task force in Washington to better align money and programming to mental health and suicide prevention needs.

The task force will be chaired by Susan Rice, director of the U.S. Domestic Policy Council at the White House, and include members of the departments of Health and Human Services, Education and Labor and the Treasury, Mr. McDonough said.

“Too often, each agency is doing their own thing, but when we’re all at the same table we can actually accelerate this,” Mr. McDonough said.

A claims backlog

Mr. McDonough also took questions during the Zoom meeting about long wait times for VA approval of veterans’ compensation and pension claims, which ballooned during the COVID-19 pandemic as both the VA and private sector hospitals canceled the in-person exams required to process claims.

In October, the Trump administration abruptly shifted all such compensation and pension exams to private sector hospitals. Mr. McDonough said the VA was expanding the use of tele-health appointments and widening the base of contracted physicians to speed up such exams.

“I know there’s a lot of frustration with the reliance on contractors for the conduct of C&P exams,” he said. “So we’re trying to crank up the contractors, but we also want you to have options available if the contractor option is not attractive to you.”

Mr. McDonough said top VA officials have been having conversations to increase the availability of inperson C&P exams at VA facilities.

The secretary said the VA also was investing heavily in hiring staff at the National Personnel Records Center in St. Louis, which provides supporting documents, to iron out delays there.

The VA has reduced the backlog to under 190,000 claims, from 210,000 when Mr. McDonough took office three months ago, he said.

“This may be faint hope here, but I want you to know that I am tracking this very closely,” he said. The backlog “got much too high because of the pandemic. We’re pouring as many options and as many resources as we can to get determinations made to get them out the door.”