VA, nation wage war on suicides among veterans

Homelessness, easy access to guns among key factors.

— Three veterans WASHINGTON killed themselves last week on Department of Veterans Affairs health care properties, barely a month after President Donald Trump announced an aggressive task force to address the unremitting problem of veteran suicide.

Trump’s executive order was a tacit acknowledgment of what the deaths rendered obvious: The department has not made a dent in stemming the approximately 20 suicide deaths every day among veterans, about 11/2 times more often than those who have not served in the military, according to the most recent statistics available from the department.

A 2015 measure that required officials to provide annual reviews of mental health care and suicide prevention programs has found that veterans often receive good mental health care at many VA centers — but that has not decreased suicide rates. A relatively new program, known as the Mayor’s Challenge, that helps city and state governments reach more veterans through more public health programs via VA partnerships has shown some promise, but no data exists yet demonstrating suicide reductions.

While the VA has been the public face of the issue, veterans are in many ways an amplification of the same factors that drive suicide in the broader U.S. population: a fragmented health care system, a shortage of mental health resources, especially in rural areas, a lack of funding for suicide research and easy access to guns. All of these contribute to the drastically increased suicide rate among all Americans, which rose 33% from 1999 to 2017.

High rates of homelessness, traumatic brain injuries, post-traumatic stress and a military culture that can be resistant to seeking help are all aggravating factors for veterans, whose rates of suicide have been the subject of numerous hearings on Capitol Hill.

“We are not even at the Sputnik stage of understanding problems with mental health,” said Robert Wilkie, the secretary of Veterans Affairs. “I have said this is the No. 1 clinical priority that is made manifest by the president putting VA as the lead for this national task force.”

Some programs to address veteran suicide show promise. A study of nine ERs at the VA found 45% fewer suicidal behaviors among patients who received follow-up outreach after suicide attempts; as a result of this study, all VA medical centers have put into place the Safety Planning Intervention program.

Since the department in 2017 began tracking suicides at VA facilities, there have been more than 260 suicide attempts, 240 of which have been interrupted, department officials say.

Yet about 70% of veterans do not regularly use the VA.

“The vast majority of veterans that die by suicide are not seeking services,” said Julie Cerel, a professor at the University of Kentucky and president of the American Association of Suicidology. “So the VAs are kind of at a loss of how to serve this group of people. Yet when they do end their lives, it becomes the responsibility of the VA,” in the viewpoint of critics, she said.

Leadership turmoil — a consistent trait of the Trump administration — has complicated the VA’s attempt to address suicide. The agency’s director of its prevention office, Caitlin Thompson, resigned in 2017 after tangling with political appointees.