WASHINGTON–Despite declaring veteran suicide as its No. 1 clinical priority, VA’s suicide prevention outreach efforts dropped off in 2017 and 2018, and a lack of clear goals and inconsistent leadership has impacted its success, according to a Government Accountability Office report.
The report released in December also found that VA was projected to spend only $1.5 million of its $6.2 million outreach media budget allocated for 2018.
According to the report, the amount of social media content developed by VA for suicide outreach efforts decreased dramatically from 2016. The contractor hired to run the social media campaign developed 339 pieces of social media content in FY 2016. That dropped to 159 in FY 2017 and only 47 in the first 10 months of FY 2018. The contractor is also required to develop two suicide prevention PSAs in each fiscal year.
At the time of GAO’s investigation, neither had been released, with one completed but not aired and the other still in development. The delay meant that VA had not aired a suicide prevention PSA on television or radio in over a year, the first time there was a gap of more than a month since June 2012.
VA placed the blame for this decrease in activity and the lack of spending on outreach on a lack of leadership and constant program reorganization. Most notably, the national director for suicide prevention position was vacant from July 2017 through April 2018. VA officials told GAO that they did not have leadership available to make decisions about the suicide prevention campaign during this time.
This resulted in VA not having a campaign kickoff meeting for 2018–a meeting where VA leaders and contractors would have discussed lessons learned from the prior year’s campaign and determine their approach for the coming year.
“By not assigning key leadership responsibilities and clear lines of reporting, VHA’s ability to oversee the suicide prevention media outreach activities was hindered, and these outreach activities decreased,” the GAO report states. “As a result, VHA may not have exposed as many people in the community such as veterans at risk for suicide or their families and friends to its suicide prevention outreach content.”
The report also found that VA lacks targets for the majority of the metrics it uses to gauge the effectiveness of its campaign. For example, a 2018 report showed that during one month there were 21,000 social media mentions of keywords specific to VA suicide prevention, such as “VCL” or “veteran suicide” across social media platforms, with these mentions earning 120 million impressions.
There was no indication, however, of whether this was lower or higher than expected. In addition, the report did not indicate what percentage of these mentions were driven by VA’s outreach activities, and contained no indication of whether the mentions were positive or negative or what activities were taken based on this increased awareness. Currently VA’s only established target is to rank in the top 10% of the Nielson ratings.
In 2017, VA officials proposed collaborating with VA’s Center of Excellence for Suicide Prevention to examine the metrics and to obtain veterans’ perspectives on the campaign. However, according to GAO’s report, VA officials said this effort never began due to the lack of senior leadership.
The report was released immediately prior to a joint Senate and House VA Committee hearing where legislators had the chance to express their frustration directly to VA’s top leadership.
“When veterans between 18 and 34 are committing suicide at the highest rate, the department’s failure to communicate service and attempt to reach veterans in this age group via social media is shameful,” declared House VA Committee chairman Mark Takano (D-CA). “The VA offers excellent medical services but, to quote the Disabled American Veterans, they are useless in actually preventing suicide if veterans and family members don’t know they exist or are unable to access them.”Steven Lieberman, VA’s acting principal deputy under secretary for health, assured legislators that VA would do better in 2019. “This year, I’m making sure we’re spending the funding 100%, and I’m reviewing the budget monthly,” he said. “We agree that we didn’t have robust enough metrics at the time of the GAO’s findings. We are in the process of developing more robust metrics.”