More Veterans Are Dying by Suicide While the VA Sits on Millions Allotted for Prevention

More Veterans Are Dying by Suicide While the VA Sits on Millions Allotted for Prevention
New GAO report reveals the department left nearly $5 million in unused funds this year.
Dan SpinelliDecember 18, 2018 2:42 PM


The Department of Veterans Affairs has been clear: Preventing suicide among the nation’s more than 20 million former service members is its top clinical priority. With a burgeoning suicide rate among veterans from the Iraq and Afghanistan wars, the VA has dumped more than $24 million since 2013 into a national outreach campaign for at-risk veterans centered around a one-stop crisis hotline.

But that ambitious outreach initiative has faltered in recent years amid a leadership vacuum within the VA and unclear metrics for success, according to a report released this week by the nonpartisan Government Accountability Office. While the number of suicides among veterans was climbing steadily, the GAO found that the VA’s prevention efforts faltered without a permanent leader or clear chain of command in place.



Suicide rates have risen nationwide, but a veteran is nearly twice as likely to die by suicide as a non-veteran. Rates among active-duty service members are more comparable to the relevant civilian population, but the military-wide suicide rate still doubled between 2005 and 2012. No single issue leads to suicidal behavior, but recent scholarship that examines the wars in Afghanistan and Iraq has highlighted how the suicide risk for veterans increases as they are exposed to pain and desensitized to violence while deployed. Brain injuries and family history boost the risk as well.

When the suicide rate among veterans reached 27.4 per 100,000 persons in 2010, the VA embarked on a program to attempt to reach them before they were in crisis. The VA began paying a contractor for outreach, primarily as a vehicle to get out the word about its signature crisis hotline. In addition to managing the Veterans Crisis Line’s website, the contractor was also responsible for developing social media posts and messaging campaigns through billboards and flyers. The program saw a steady boost in content creation over its first four years before a sharp drop-off of more than 53 percent last year.

VA officials attributed the decline to the lack of a permanent director in the suicide prevention office. During the three-month period when the position of permanent national director for suicide prevention was left vacant, representatives from the contractor never met with the leadership of the Veterans Health Administration, which oversees the department’s suicide prevention campaign, as required by their contract. Even after Keita Franklin was detailed as acting director for six months beginning October 2017, VHA staff told the GAO that “suicide prevention leadership was not available for weekly meetings to discuss suicide prevention outreach activities.” As a result, the department only created 159 pieces of content for social media posts during all of fiscal year 2017.

Without a permanent leader in place to sign off on outreach efforts, staffers redirected their time to “updating the [Veterans Crisis Line] website,” the report found. That same year, staffers working on the outreach campaign began reporting to officials in the Office of Mental Health, a change in direction that led to a greater focus on mental health outreach in lieu of strictly suicide prevention. Outside of simple metrics like tracking the number of people who visited the crisis hotline’s website, VHA officials also neglected to set measurable goals for the outreach program or any other “meaningful targets for evaluating the campaign,” the GAO reports. (Franklin was named permanent director in April.)

Despite the leadership vacuum and ensuing bureaucratic confusion, a remarkable amount of money was directed to the program. This fiscal year, the VA was allocated $6.2 million to spend on suicide prevention paid media—promoted social media posts and sponsored keyword searches, for example—but by September only spent $57,000 of its budget, less than 1 percent of the total. (Officials from the VA said they planned to spend up to $1.5 million by the close of the fiscal year.)



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https://www.motherjones.com/politics/2018/12/more-veterans-are-dying-by-suicide-while-the-va-sits-on-millions-allotted-for-prevention/