By Sandra Basu
WASHINGTON—The VA is pushing back hard against accusations last month that calls to the Veterans Crisis Line (VCL) were not being handled appropriately.
“Several media outlets have recently chronicled the challenges of the Veterans Crisis Line, reporting that calls to the Veterans Crisis Line were rolling over and were being ignored or unanswered. That is simply untrue,” VA Under Secretary of Health David Shulkin, MD, wrote in an op-ed piece that was distributed to several news organizations.
The greatest fear for VA, Shulkin noted, is that “veterans or their families who read hastily-reported news stories become afraid to speak up because they believe their calls will go unanswered.”
“That would yield devastating results,” he wrote.
His comments came days after Congress passed a 2017 spending bill for VA, mandating that the VCL provide individuals who contact the hotline with immediate assistance from a trained professional and adheres to all requirements of the American Association of Suicidology.
“There is absolutely no excuse for a veteran to contact the Veterans Crisis Line and not get the help they are seeking,” pointed out Rep. David Young (R-IA), who sponsored a bill addressing those issues that had also passed in the House at the end of September.
The congressional action reflects concerns of lawmakers that some veteran calls to the VCL are going unanswered and follows news media reports of challenges with the crisis line.
News outlets published an email in which Gregory Hughes, the former VCL director in May, indicated that some staff were only taking one to five calls a day.
In June, meanwhile, the Government Accountability Office (GAO) released a report stating that the VCL is not meeting its call response time goals and text messages sent to the group sometimes go unanswered. The investigation found that while VA’s goal is to answer 90% of VCL calls at the VCL primary center within 30 seconds, an estimated 73% of 119 calls tracked within that timeframe didn’t meet that standard.
GAO also tested the VCL’s text messaging services and found that four of 14 GAO test text messages did not receive responses. Of the remaining 10 test text messages, eight received responses within two minutes, and two received responses within 5 minutes.
“VA officials stated that text messages are expected to be answered immediately, but, as with online chats, VA has not yet developed formal performance standards for how quickly responders should answer text messages,” the report stated.
VA said at the time of the report that it concurred with GAO’s recommendations.
Earlier this year, the VA Inspector General also found a variety of issues with VCL, including that some calls were not getting immediate assistance. The IG made seven recommendations to VA for improvement of the VCL and backup center processes.
In addition, lawmakers sent VA a letter last month, requesting information to assure that it has addressed the deficiencies identified by the VA OIG.
In his op-ed piece last month, Shulkin said the agency is “currently strengthening the Veterans Crisis Line, doubling it in size, opening a new hub in Atlanta and using best-in-class business practices to improve capacity and our effectiveness as a life-saving resource.”
“This will allow us to soon answer all calls to the crisis line with trained VA responders,” he emphasized.
Shulkin also said suicide prevention efforts are being expanded, while greater access to services are being provided.
“In addition, we are working to ensure same-day access for urgent mental health needs at every one of our 168 medical centers. We will reach this goal by the end of this year,” he said.
He said agency officials are “continuing to hire more VA mental health professionals and are aggressively utilizing tele-mental health, predictive analytics, and other strategies where services are limited.”
Still he said that “VA cannot fully address this issue alone.”
“Of the 20 veterans who died each day by suicide in 2014, 14 were not connected to VA for care in the past year,” he pointed out. “So we are enhancing our partnerships with community-based providers to broaden the network of mental health professionals and are researching new solutions.”
A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.
When Terrence O’Neil, MD, retired as chief of nephrology at the James H. Quillen VAMC in Johnson City in December 2016, he left in his wake decades of work treating kidney disease—nearly 35 years in the Air Force and DoD, plus 11 more at VA.