Clinical Topics

Three VAMC Campus Suicides in a Week Heighten Concerns About Prevention

by Stephen Spotswood

May 14, 2019

WASHINGTON—Concern over the rate of veteran suicides reached a fever pitch last month after three veterans took their lives at VA facilities over a span of five days.

Two of the deaths occurred in Georgia—one in a parking garage at the Carl Vinson VAMC in Dublin and another outside the main entrance to the Atlanta VAMC in Decatur. A third veteran shot himself in the waiting room of a VA clinic in Austin, TX. VA had previously recorded at least 19 veteran suicides on VA campuses from October 2017 to November 2018.

President Donald Trump signed an executive order in March, ramping up efforts to prevent veteran suicide. The order prioritizes suicide-related research, encourages collaboration between federal agencies and the private sector and offers grants to state and local governments to support their own veteran suicide efforts. However, all of those initiatives will take time to bear fruit, while legislators and veterans’ advocates are asking what can be done immediately. 

“This is a national crisis that we all need to address,” declared House VA Committee Chair Mark Takano (D-CA). “Every new instance of veteran suicide showcases a barrier to access, but with three incidents on VA property in just five days, and six this year alone, it’s critical we do more to stop this epidemic.”

Rep. Max Rose (D-NY), an Army combat veteran who served in Afghanistan and a member of the House VA committee, believes the first step in responding is to ensure both VA and Congress are accurately tracking veteran suicides and suicide attempts on VA campuses. He introduced legislation last month that would require VA to provide notice to Congress no later than 60 days after each incident. With the notice, the department would provide: the enrollment status of the veteran; the date of the most recent encounter between the veteran and the VA health system; whether the veteran had private insurance; the branch of the armed forces and time period in which they served; marital, employment and housing status; and confirmation that the VA secretary had provided notice to immediate family members.

“It’s imperative that we receive not only basic information from the VA but substantive data on this rising trend of veterans committing suicide at VA facilities,” Rose explained. “Getting this data more quickly and thoroughly would guide Congress’ efforts in understanding this crisis and preventing these tragedies.”

As for why veterans are choosing VA campuses as the place to take their own lives, opinions vary widely.

Protests of Last Resort?

“Many of these suicides appear to be protests of last resort, where healthcare systems, treatment programs and the underlying cultures of the responsible federal agencies have failed them,” said AMVETS Executive Director Joe Chenelly. “We can no longer accept that ‘20 suicides a day’ is the norm and approach this crisis with passive resignation.”

AMVETs is calling for a joint investigation into the epidemic, seeking to examine drugs prescribed and treatment protocols in an effort to determine whether generally accepted healthcare practices have proven ineffective.

Richard Stone, MD, VA’s acting principal deputy undersecretary for health, told legislators at an unrelated Senate VA committee hearing last month that one of the reasons veterans are choosing to end their life on VA property is not as a form of protest but because they know VA will show them a level of respect after death that they would not receive elsewhere.

“A lot of these suicides are accompanied by notes saying, ‘I’ve come here to the campus because I know you’ll take care of me. I know you’ll take care of my family,’” Stone told legislators. “I wish it was as simple as me saying I could do more patrols in a parking lot and stop this epidemic. … Where we as a community and a society failed that veteran is a very complex answer.”

One area where Congress could provide useful legislation concerns members of the National Guard and Reserves, Stone said. “There are three suicides a day from guardsmen and reservists who have never been activated. Reaching never-activated guardsmen and reservists is something we need to talk our way through. If we can extend and activate our services to other than honorably discharged [servicemembers], we can surely activate those services for reservists and guardsmen.”

Stone also paused his testimony and asked everyone in the room to take out their cellphone and input the number of the Veteran Crisis Line—1-800-273-8255.

“Most laypeople will say—I don’t know what to do if a veteran is in crisis,” Stone said. “Pick up the phone and reach out and call the crisis line and ask what do I do?”

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