U.S. Marine Corps Pfc. Allison Lopez, a finance technician with Marine Corps Base Hawaii, helps load a truck with donated food for the Hui Mahi’ai Aina Homeless Camp, last year. U.S. Marine Corps photo by Lance Cpl. Isaiah Hill
WASHINGTON, DC — For decades, VA’s response to preventing veteran suicide has been focused almost exclusively on healthcare, specifically mental healthcare. In recent years, however, federal agencies have recognized that prevention requires a more holistic approach that tries to directly address the societal factors that lead to suicide.
They often cite recent research indicating that financial debt, unemployment, past homelessness and lower income were all associated with a higher likelihood of suicide attempts and that someone who experienced all four of these factors was 20-times more likely to attempt suicide.
President Joe Biden’s five-point strategy for reducing military and veteran suicide, which he released last fall, reflects this holistic approach. Priority four specifically deals with “upstream risk” and focuses on financial strain, lack of housing, food insecurity, unemployment and legal issues as factors in suicide risk.
“VA research shows that the first year following discharge from active military service may pose significant challenges, including homelessness, family reintegration, unemployment or underemployment, post-traumatic stress disorder and substance abuse, all of which can increase the risk for suicide,” Susan Black, LCSW-C, BCD, VBA’s National Suicide Prevention Officer explained during a House VA Subcommittee on Economic Opportunity hearing last month.
The challenges come in identifying veterans who are experiencing these issues. Veterans might not use a VA service in the first year following discharge, and, even if they do, issues like this might not naturally arise.
One way VA is trying to serve those veterans is through its Solid Start Program, which attempts to contact veterans three times during their first year following separation. Launched in 2019, Solid Start is meant to be a way of touching base with veterans to see how they are faring. During the call, VA representatives address issues or challenges identified by veterans and assist them with accessing benefits, services, healthcare, education and employment opportunities.
While the program successfully reaches up to 80% of older veterans, that success rate gets cut in half when it comes to younger veterans. According to VA leaders, the department is working on addressing this by using targeted emails and text messages, as well as providing two-way text messaging as a way for veterans to schedule their calls.
According to Black, VBA regularly shares data with VHA when they find that a veteran is experiencing a financial risk factor for suicide.
“[For example], we work with our loan guarantee [program], and we’re looking at those veterans who may be in loan foreclosure, so we work very diligently with loan foreclosure avoidance. Our staff have this information and will flag it. And then coordinating that data with our VHA counterparts and letting them know, especially if there’s someone seen as high risk in those situations.”
One of the biggest predictors of veteran suicide is homelessness and the risk of homelessness. According to the most recent data available from the American Housing Survey, there are 619,000 renter households with at least one member who served in the military that are experiencing what are considered “worst case housing needs.” That is defined as having an income at or below 50% of the area median income and a housing cost burden of 50% or greater, living in severely inadequate housing or both.
According to the survey, 15% of all households with former servicemembers fall into that category.
For decades, a joint program between VA and Housing and Urban Development—the VA Supportive Housing Program (HUD-VASH)—has attempted to address this by providing rental assistance in the form of vouchers. The vouchers cover a large portion of the veteran’s rent from participating landlords.
Despite a growing need for rental assistance, thousands of vouchers go unused every year, however. Subcommittee members expressed frustration at seeing the program not being taken advantage of by veterans in need.
One issue that HUD expects to address this summer is that the vouchers are not being funneled to the communities that need them the most.
“There’s a mismatch in where vouchers are sitting and where there’s need,” explained Peggy Bailey, senior advisor to the HUD secretary. “This relocation notice should be coming out in the next few weeks. It’s a voluntary relocation. Places that recognize that [they’ve] served all the veterans they can [will be given the chance] to voluntarily return vouchers back to HUD, so they can reallocate them.”
What HUD has less control over is finding landlords willing to take the vouchers, Bailey added. To help coax landlords, the agency is offering incentives like cash bonuses for one-year leases signed by homeless veterans, property damage guarantee funds and help with funding improvements to apartments.
Even with incentives, it becomes difficult, since landlords need to keep the rent on HUD-VASH units low and stable. With rents rising across the nation, and most significantly in major cities, landlords have the opportunity to make more than the incentives would provide by not participating in the program.
Bailey assured legislators that HUD is very proactive when it comes to identifying landlords and other housing agencies who can help make sure vouchers get used.
“We target headquarters staff as well as field staff to go out into the community and figure out what barriers exist,” she explained. “We not only pick up the phone, we show up at their door.”
