Lisa Kearney, PhD, executive director of VA’s Veterans Crisis Line (VCL),
WASHINGTON, DC — Most of the career of Lisa Kearney, PhD, at the VA has revolved around reducing the stigma associated with mental healthcare and increasing access for veterans who need it. That focus began during her days at the San Antonio VA, helping integrate mental health into primary care, and then working to roll that effort out nationwide. In 2019, she was tapped to become VA’s acting deputy director of suicide prevention—a role she didn’t expect to stay in for long.
“If you’d asked me then if I was staying in suicide prevention, I would have said no, because it wasn’t the space I grew up in,” Kearney admitted.
However, she would quickly discover that her background in integrating mental healthcare positioned her perfectly to spearhead VA’s suicide prevention efforts, and in May 2021 she became the executive director of VA’s Veterans Crisis Line (VCL), which was launched in 2007.
Veteran suicide has been under a particularly intense spotlight for the last several years, as data revealed that the veteran population is at a much higher risk for suicide than the general population — 53.2% after age-adjustment.
That increased risk, along with a host of challenges that are specific to veterans, makes a separate suicide call line for veterans a medical necessity, Kearney said.
“Veterans are extremely resilient. They’re trained to endure challenges. And there is a unique stigma about getting help,” Kearney explained. “We want to train our community of responders in the unique aspects of military culture and veteran culture.”
The VCL is also coordinated with VA’s healthcare system so that veterans and their friends and family who call in are not only receiving suicide prevention care but also are getting connected with VHA.
“We have that national resource to ensure there’s engagement afterward,” Kearney said, noting that the period of time immediately following a call for help is critical.
To help put veterans at ease when they call, VCL opened a Peer Support Outreach Call Center in 2021, which is staffed by veterans, many of whom are intimately familiar with the challenges their callers face.
“[Many of the staff] are veterans themselves in recovery from mental health concerns and substance use concerns who know that pathway of hope,” Kearney said. “And there is something in particular about connecting veteran to veteran. After the call, we identify particular veterans for further follow-up and engagements.”
Peer-support specialists will reach out later to connect those callers with resources, whether it’s mental health services, education services or primary care needs.
The child of a Vietnam veteran, Kearney grew up understanding the importance of one veteran talking to another.
“When I was a little girl, I remember falling asleep at nighttime and my dad would sometimes be on the front patio with his buddy. There was a lot of laughter at times, but also times when people were going through struggles,” Kearney said. “And I would see those individuals supporting each other.”
Veteran suicide data compiled in 2019 showed that 47% of veterans who died by suicide did not have a recent mental health diagnosis. For Kearney, this is clear evidence that a successful suicide prevention strategy needs to do more than just connect callers with mental health resources.
“[Callers talk about] medical problems, PTSD, substance use, family issues and a whole host of things,” she said. “And that’s really reflective of what we know are risk factors for suicide. It’s not just a mental health problem. I so appreciate that we at the VCL can connect people with a variety of services.”
Issues that callers bring up include: recent cancer diagnoses, the loss of a child, an ongoing or recent divorce and the loss of a job.
“These are moments of crisis that would have anyone face an extraordinary amount of stress that doesn’t have to do with a PTSD diagnosis or major depression,” Kearney said.
This is one of the reasons VA released a national strategy for suicide prevention in 2018 that includes an emphasis on community prevention, looking for ways that VA can work with community partners to address the social and economic factors that create those moments of crisis.
Data shows that VCL is doing something right. A recent study found that callers were over five times more likely to have less distress from the beginning of the call to the end and were five times less likely to have suicidal ideation by the time they hung up. They were more likely to engage in care afterward and generally reported feeling better after the call.
One of the biggest challenges, Kearney said, is to make it clear to veterans and the public in general that it’s OK to talk about suicide and to reach out for help.
“It can be a little bit difficult for us to talk about it. People get anxious about it,” Kearney explained. “You have to realize you’re not putting thoughts in someone’s head if you ask them if they’re having thoughts about suicide. You have to realize how important you are in someone’s life and in providing hope.”
She added, “VCL isn’t just for veterans. If you’re concerned about a veteran or servicemember, you can call us up, and our responders will walk you through things you can say and [send you] to resources.”
That effort to reduce stigma around suicide might have been made a little easier with the implementation of the nationwide three-digit suicide hotline (988) in July. Veterans calling 988 will be prompted to dial “1,” which will then forward them to the VCL.
“This will absolutely connect us to more veterans,” Kearney declared.
The Saturday morning that 988 went live, Kearney was in the office monitoring how it was impacting VCL’s call numbers when she received a text from her father.
“He said, ‘I didn’t know this was national, honey.’”
Kearney sent him to the VCL website, so he could read more about it.
Later, he texted back. “Exciting. I wish this was in effect when I was in crisis. I’m glad it is now.”