We Can Jumpstart the Effort with Passage of Important Mental Health Legislation Today

On April 29, 2019, IAVA joined with Congressional leaders from both parties and many of our friends in the Military and Veteran Service Organization (VSO) community for a press conference at the US Capitol Building to make an urgent call for action to combat the veteran suicide crisis. The tragic and sobering impetus of this gathering was a suicide just outside the emergency room at the Cleveland VA Medical Center early that morning.

One month before, President Trump signed an executive order establishing the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) Task Force. This initiative, led by VA Secretary Robert Wilkie, aimed to align the various efforts of federal agencies and develop a coordinated public health Roadmap to end not just veteran, but all suicides. The Roadmap to guide this fight was due in March 2020, one year after the Task Force launch, but was delayed due to the COVID-19 pandemic and only just released on June 17th.

The Roadmap outlines an ambitious plan focused on public awareness campaigns and coordinated research that, through significant coordination and collaboration between government agencies, could make a positive impact in reducing nationwide suicide numbers. This is a solid start and IAVA is encouraged to see the groundwork being laid for bringing increased national attention to solving the problem of veteran suicide, but the reality is that this is not an adequately comprehensive Roadmap. At a minimum, there are existing opportunities for action now that could have immediate impacts.

The Roadmap lists as its top priority a national public health campaign partnering with every agency in the Task Force, as well as with non-governmental organizations, the private sector, religious leaders, and other organizations. Executing an effective nationwide communication plan will require top communicators in all of the participating agencies. Communication has not been a strong suit of the VA, from its failure in 2018 to spend five of the six million dollars allocated for suicide-prevention outreach to its struggles to effectively communicate relevant information widely during the ongoing pandemic. We sincerely hope that this public health campaign is done in earnest and a high priority is placed on leveraging the best resources from all agencies and organizations involved while also enlisting the necessary outside help to maximize effective messaging and outreach in this very important endeavor.

IAVA has long advocated for awareness and education campaigns around mental health injuries in order to improve the public’s understanding of veteran suicide. When IAVA asked our members why they thought the military/veteran community is not getting the mental healthcare they need, our members reported stigma as the top concern. Recognizing the importance of removing this barrier, IAVA hopes the plans laid out in the Roadmap to destigmatize suicide and seek care will be appropriately and effectively executed. If done well, this effort should build on the success that IAVA and other VSOs achieved in our 2014-2015 campaign to pass the Clay Hunt Suicide Prevention for American Veterans (SAV) Act, which made enormous strides in destigmatization and literally changed the way that officials, the media, and the public talk about suicide.

PREVENTS also recommends the creation of an interagency federal funding mechanism to facilitate state and local level grant programs. These grant programs would support and facilitate the implementation of “evidence-informed” mental health and suicide prevention programs focused on veterans in their communities. IAVA strongly favors these types of efforts and in order to be done effectively, PREVENTS must engage with appropriate agencies and programs and demonstrate clear communication, transparency and collaboration. Based on the Task Force’s track record thus far, IAVA is concerned about how well this will be executed. IAVA has nearly a decade of experience coordinating care through our Quick Reaction Force (QRF) ensuring all veterans and family members have access to a wide variety of resources, benefits and support systems, regardless of location or need. We encourage the Task Force to work with IAVA and other relevant organizations who have the experience and knowledge to help inform this process. If done correctly, a successfully executed grants program would be an important step in reaching the 14 of 20 veterans who die by suicide every day who are not receiving VA care.

The Roadmap also called for a foundational change to the way research is conducted at VA and all agencies involved in the PREVENTS Roadmap implementation process. Among top priorities are improving the speed and accuracy with which research is translated into practice, removing funding barriers that prevent collaboration, and the sharing of quality datasets. Coordinated effort in research is something IAVA has been advocating for and we believe that DoD and VA should partner with academia, public and private research groups in order to garner the best results to better understand and address veteran suicide.

The Roadmap also focuses on developing additional suicide prevention training for professionals that regularly interact with veterans. IAVA is glad to see the Task Force highlight gatekeeper training as we have long advocated for more investment in order to educate veterans and their families, friends, and community members. However, despite the severe shortage of mental health professionals and inpatient care at VA, PREVENTS recommends no additional funding for VA mental health services or efforts to increase the national level of mental health care professionals. Research shows that mental health professionals at VA provide higher quality treatment, are more culturally competent, more likely to be trained in evidenced-based care, and have more knowledge on Post Traumatic Stress Disorder, Military  Sexual Trauma and Traumatic Brain Injury than the private sector.

IAVA is pleased to see the recommendation for the implementation of programs that address firearms safety and voluntary reduction of access to lethal means. Veterans have a high degree of familiarity with firearms and are more likely than their civilian counterparts to own them.  Efforts to increase time and space, like the use of trigger locks and safe storage have long been supported by IAVA and we applaud the Task Force for including this as a priority. We also believe that any efforts to reduce access to lethal means should be collaborative with firearm advocacy groups and VSOs.

The female veteran suicide rate is 2.2 times higher than their civilian peers after adjusting for age and sex, compared to male veterans who are at 1.3 times higher risk than their civilian counterparts. While this is mentioned in the introduction of the PREVENTS Roadmap, IAVA is disappointed that there are no women veteran-specific programs to address this issue in the recommendations. IAVA represents veterans of all backgrounds and would like to see the Task Force strategies and implementation plans to support veterans, like LGBTQ veterans, who are disproportionately at-risk for suicide and who have higher suicide rates. 

IAVA has significant concerns regarding the Roadmap’s evaluation strategy and lack of measurable milestones. In moving forward, IAVA recommends establishing and reporting on meaningful metrics that can accurately measure success of this momentous and critically important initiative. Additionally, IAVA recommends the Task Force ensure that the effort is made a true national priority and receives the proper levels of funding, expert personnel, and oversight necessary to carry out this monumental task. We encourage full transparency in this effort, and true partnership and collaboration with public, private, and non-profit sectors, especially the VSO/MSO community.

Legislative Action

The Commander John Scott Hannon Veterans Mental Health Care Improvement Act (S. 785), sponsored by Senate Veterans Affairs Committee (SVAC) Chairman Jerry Moran (R-KS) and Ranking Member Jon Tester (D-MT) with IAVA’s strong backing, is aggressive and ambitious, offering critical resources to help veterans struggling with mental health challenges. A centerpiece of the bill is the provision of grants to non-VA organizations that provide mental health services or alternative treatment to veterans – consistent with the grants referenced in the PREVENTS plan. The bill passed unanimously out of the Senate VA Committee earlier this year and has broad bipartisan support. While the nationwide PREVENTS campaign begins to organize, Congress and the White House must work together and enact this singularly important legislation now.  All Americans should take a minute to ask Congress for help HERE.

IAVA Has Your Back

We know suicide prevention and mental health is a top concern for IAVA members. Forty-four percent report having suicidal ideation since joining the military, a 13 percent rise since 2014. That is why we have built recommendations for policymakers to address veteran’s mental health into our latest Policy Agenda: A Lasting Legacy, our Roadmap for America. 

We know that this time can be stressful and IAVA’s Quick Reaction Force (QRF) is here to help! This program provides confidential 24/7 peer support, comprehensive care management, resource connections, and can help with accessing your VA benefits. To get connected to a Veteran Care Manager for immediate help anytime, day or night, please call 855-91RAPID (855-917-2743) or fill out our online form. Our services are remote, free and confidential and QRF is here for all veterans, regardless of era, discharge status or location. If you are a veteran or a veteran family member facing challenges or have questions, QRF is here to help you get back on your feet and meet your goals.