Tagged: Department of Veterans Affairs
You know it’s bad news if it gets released on a Friday right before Superbowl Weekend.
On Friday, February 1, the Department of Veterans Affairs released a new report, detailing the suicide problem among veterans and highlighting the demographics most affected. The report found that about 22 veterans per day, on average, committed suicide in 2012. Similar numbers of veterans committed suicide each day in 2010 and 2011. The long-term average is about 20, according to the VA. The data showed that veterans identified as having committed suicide were more likely to have higher levels of academic achievement, were more likely to have been married, widowed or divorced and more likely to be non-Hispanic whites.
The report also says that women who commit suicide may be underreported as veterans, because their veteran status is less likely to be identified on their death certificates. This means that the actual rate of suicide among veterans is likely to be somewhat higher.
Meanwhile, the Veterans Administration is having trouble ensuring that veterans reporting a need for mental health care are receiving treatment in a timely manner: The Veterans Affairs Office of the Inspector General found that a number of VA clinics in the Atlanta area had unacceptably high numbers of patients seeking mental health or substance abuse treatment on the wait list in 2010.
They also found that the VA had not established a metric or standard to ensure that once a veteran had been seen in an initial appointment, that the veteran could receive follow-up or continuing treatment in a timely manner.
Because of this glitch, VA staff could see a new patient quickly, and then put him back on the wait list. In this manner, clinical directors could look good in their reports and evaluations, while still having large numbers of patients on long waiting lists for appointments and follow-up care.
Another report by the VA Office of the Inspector General issued in 2012 excoriated the Veterans Health Administration for the same reason – indicating not much had changed in the two years between the IG inspection of the Georgia clinics in 2010 and this report:
In VA’s FY 2011 Performance and Accountability Report (PAR), VHA reported 95 percent of first-time patients received a full mental health evaluation within 14 days. However, this measure had no real value as VHA measured how long it took VHA to conduct the evaluation, not how long the patient waited to receive an evaluation.
For example, if a patient’s primary care provider referred the patient to mental health service on September 15 and the medical facility scheduled and completed the evaluation on October 1, VHA’s data showed the veteran waited 0-days for their evaluation. In reality, the veteran waited 15 days for their evaluation.
The report went on to note that a wait list of 50 days was regular and routine among those not seen in the first 14 days – which was 52 percent of them. Since the number was an average, a significant number of these veterans seeking mental health care waited longer than that.
The Inspector General also found that the VHA’s own numbers were neither accurate nor reliable, and they routinely and significantly overstated their success in meeting the 14 day requirement established by the Secretary of Veterans Affairs.
Further, according to the office of Representative Jeff Miller (R-FL), the chairman of the House Veterans Affairs Committee, VA clinics were operating with mental health care staff vacancies as high as 23 percent, and 70 percent of VA mental health staff believed they did not have enough staff to cover the workload.
The Department of Veterans Affairs did announce it was increasing mental health staff by 9 percent last April, and in August of 2012, the President signed an executive order directing the significant expansion of mental health care staff throughout the VA.
President Barack Obama signed an executive order on August 31st directing a number of federal agencies to expand access to mental health care and services for servicemembers, their families and veterans. The measure comes amidst an epidemic of suicides among military members — amounting to as much as one per day.
Specifically, the executive order contained the following provisions:
- The Department of Veterans Affairs was directed to increase their veteran crisis hotline capacity by 50 percent.
- The VA was also directed to ensure that all veterans reporting themselves to be in crisis “connect with” a trained mental health professional within 24 hours or less.
- The VA was directed to work with the Defense Department to develop and implement a 12-month suicide prevention campaign (apparently they have to be told to do this).
- In areas where the VA has trouble recruiting qualified professionals, the President has directed them to form “pilot sites,” which will contract with local professionals to provide needed services.
- The VA is directed to hire 800 “peer-to-peer” support counselors, and as many as 1,600 new mental health care workers.
The President announced the executive order during a visit to Fort Bliss, Texas.
One former Army psychiatrist, however, says the order doesn’t go far enough. Writing for Time Magazine, COL Elspeth Cameron Ritchie argues that the Veterans Administration is already trying to hire 1,600 additional mental health care professionals, even without the executive order.
COL Ritchie has published extensively on mental health care issues concerning veterans and survivors of traumatic experiences. She collaborated with a number of colleagues to make additional recommendations for the President. Among them:
- Educate civilian mental health workers on how to work with veterans.
- Educate police and corrections officers on best practices in working with veterans.
- Train more college counselors.
- Bring more anti-PTSD medications to market, or expand their use.
- Re-look at security clearance questionnaires that force servicemembers to reveal mental health treatment, potentially discouraging some servicemembers from seeking treatment.
COL Ritchie also wrote “we need to re-look at gun laws, and ensure that gun safety is emphasized. This is the ‘third rail’ of suicide prevention, and I fear that no Presidential candidate will discuss this.”
What do you think of COL Ritchie’s implication that military members and veterans either aren’t trained on the safe handling of firearms, or that their access to firearms must be restricted?
Do you think this and her other suggestions would make a difference?
(Photo credit: MSNBC)