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Hearing Transcript on Stopping Suicides: Mental Health Challenges Within the U.S. Department of Veterans Affairs.

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STOPPING SUICIDES: MENTAL HEALTH CHALLENGES WITHIN THE U.S. DEPARTMENT OF VETERANS AFFAIRS

 



 HEARING

BEFORE  THE

COMMITTEE ON VETERANS' AFFAIRS

U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED TENTH CONGRESS

FIRST SESSION


DECEMBER 12, 2007


SERIAL No. 110-61


Printed for the use of the Committee on Veterans' Affairs

 

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COMMITTEE ON VETERANS' AFFAIRS

BOB FILNER, California, Chairman

 

CORRINE BROWN, Florida
VIC SNYDER, Arkansas
MICHAEL H. MICHAUD, Maine
STEPHANIE HERSETH SANDLIN, South Dakota
HARRY E. MITCHELL, Arizona
JOHN J. HALL, New York
PHIL HARE, Illinois
MICHAEL F. DOYLE, Pennsylvania
SHELLEY BERKLEY, Nevada
JOHN T. SALAZAR, Colorado
CIRO D. RODRIGUEZ, Texas
JOE DONNELLY, Indiana
JERRY MCNERNEY, California
ZACHARY T. SPACE, Ohio
TIMOTHY J. WALZ, Minnesota

STEVE BUYER,  Indiana, Ranking
CLIFF STEARNS, Florida
JERRY MORAN, Kansas
RICHARD H. BAKER, Louisiana
HENRY E. BROWN, JR., South Carolina
JEFF MILLER, Florida
JOHN BOOZMAN, Arkansas
GINNY BROWN-WAITE, Florida
MICHAEL R. TURNER, Ohio
BRIAN P. BILBRAY, California
DOUG LAMBORN, Colorado
GUS M. BILIRAKIS, Florida
VERN BUCHANAN, Florida

 

 

 

 

Malcom A. Shorter, Staff Director


Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans' Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined.

 

       

C O N T E N T S
December 12, 2007


Stopping Suicides: Mental Health Challenges Within the U.S. Department of Veterans Affairs

OPENING STATEMENTS

Chairman Bob Filner
        Prepared statement of Chairman Filner
Hon. Steve Buyer, Ranking Republican Member
Hon. Stephanie Herseth Sandlin, prepared statement of
Hon. Harry E. Mitchell, prepared statement of
Hon. Cliff Stearns, prepared statement of
Hon. Leonard L. Boswell
Hon. Donald A. Manzullo


WITNESSES

U.S. Department of Veterans Affairs, Ira Katz, M.D., Ph.D., Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Administration
    Prepared statement of Dr. Katz


Bowman, Mike and Kim, Forreston, IL
    Prepared statement of Mike and Kim Bowman
Coleman, Penny, Rosendale, NY, Author, Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War
    Prepared statement of Ms. Coleman
Meagher, Ilona, Caledonia, IL, Author, Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops
    Prepared statement of Ms. Meagher
Zivin, Kara, Ph.D., Research Health Scientist, Health Services Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs
    Prepared statement of Dr. Zivin


SUBMISSIONS FOR THE RECORD

U.S. Department of Veterans Affairs, Michael Shepherd, M.D., Physician, Office of Healthcare Inspections, Office of Inspector General, statement


American Legion, Joseph L. Wilson, Deputy Director, Veterans Affairs and Rehabilitation Commission, statement
Disabled American Veterans, Joy J. Ilem, Assistant National Legislative Director, statement
Iraq and Afghanistan Veterans of America, Todd Bowers, Director of Government Relations, statement
National Coalition for Homeless Veterans, statement
Vietnam Veterans of America, Richard F. Weidman, Executive Director for Policy and Government Affairs, statement


MATERIAL SUBMITTED FOR THE RECORD

Additional hearing material:

Hon. Michael J. Kussman, M.D., M.S. MACP, Under Secretary for Health, U.S. Department of Veterans Affairs, sample of letter sent to veterans, informing veterans of the National Suicide Prevention toll-free hotline number, 1-800-273-TALK (8255), and pocket-sized card with VA Suicide Crisis Hotline phone number/information, as well as a Crisis Response Plan

U.S. Department of Veterans Affairs Pamphlet, entitled "Suicide Prevention, Men and Women Veterans, Knowing the Warning Signs of Suicide, dated September 2007

Post Hearing Questions and Responses for the Record:

Hon. Bob Filner, Chairman, Committee on Veterans' Affairs, to Hon. Gordon H. Mansfield, Acting Secretary, U.S. Department of Veterans Affairs, letter dated December 14, 2007, and VA responses.

Hon. Harry E. Mitchell, Member of Congress, U.S. House of Representatives, to Hon. James Peake, M.D., Secretary, U.S. Department of Veterans Affairs, letter dated February 8, 2008, and response letter dated February 27, 2008, following up to request additional information not supplied in earlier VA responses to questions for the record.

Hon. Bob Filner, Chairman, Committee on Veterans' Affairs, to John D. Daigh, Jr., M.D., CPA, Assistant Inspector General, Office of healthcare Inspections, U.S. Department of Veterans Affairs, letter dated December 14, 2007, and response letter dated January 24, 2007.

Hon. Bob Filner, Chairman, and Hon. Steve Buyer, Ranking Republican Member, Committee on Veterans' Affairs, to Hon. James B. Peake, M.D., Secretary, U.S. Department of Veterans Affairs, letter dated December 21, 2007,  and response letter dated February 5, 2008, requesting additional data on suicide rates among veterans.

Hon. Bob Filner, Chairman, and Hon. Steve Buyer, Ranking Republican Member, Committee on Veterans' Affairs, to Rick Kaplan, Executive Producer, CBS Evening News With Katie Couric, letter dated December 21, 2007, and response letter dated May 16, 2008, from Linda Mason, Senior Vice President, Standards and Special Projects, CBS News.


STOPPING SUICIDES: MENTAL HEALTH CHALLENGES WITHIN THE U.S. DEPARTMENT OF VETERANS AFFAIRS


Wednesday, December 12, 2007
U. S. House of Representatives,
Committee on Veterans' Affairs,
Washington, DC.

The Committee met, pursuant to notice, at 10:10 a.m., in Room 345, Cannon House Office Building, Hon. Bob Filner [Chairman of the Committee] presiding.

Present:  Representatives Filner, Snyder, Michaud, Herseth Sandlin, Mitchell, Hall, Hare, Berkley, Rodriguez, McNerney, Space, Walz, Buyer, Stearns, Boozman, Brown-Waite, Bilirakis, and Buchanan.

Also Present:  Representatives Boswell, Manzullo, and Kennedy.

OPENING STATEMENT OF CHAIRMAN FILNER

The CHAIRMAN.  This meeting of the House Committee on Veterans' Affairs is called to order. 

I appreciate your attendance, and I appreciate your interest in this very important issue of mental illness, particularly of the suicides that have occurred in our veterans' population, especially those involved in combat situations. 

So this is going to be a very tough hearing, an emotional hearing.  It is an issue the military, the U.S. Department of Veterans Affairs (VA) and the American public does not like to talk about.  Yet, we owe it to our fighting men and women.  We owe it to their families.  We owe it to our future mental health as a Nation to explore this issue in as much depth as possible. 

This year, as we try to deal with the influx of veterans who are coming from Iraq and Afghanistan, plus the needs of our older veterans, which continue, it has been a great challenge for this Committee and for this Congress and for this Nation. 

Earlier in the year, and in a series of articles since, The Washington Post reporters dealt with the terrible scandal at Walter Reed which had the effect, as other local newspapers around the country did stories, on their military and veterans' hospitals, of a wake-up call, for all of America.  Their veterans, their troops coming back from the current war were not getting the treatment, the care, the respect, the honor and the dignity that Americans thought they deserved. 

Because of that awareness that really spread throughout America, this Congress was able to add almost $13 billion of new money for healthcare for veterans, an unprecedented increase of 30 percent or more, based on the public perception that we had to do more. 

The injuries that come from this war are very great, both physically and mentally, and yet, America has not really come to grips with it. 

One of the television networks, ABC, whose reporter Bob Woodruff had suffered a blast injury and traumatic brain injury (TBI) in Iraq, opened up that subject to millions of Americans.  And we know more now about TBI and how to treat it. 

Recently, the CBS network opened up again to millions of Americans the issue of suicides amongst our veterans.  They had a great deal of difficulty getting information from the authorities or from the U.S. Department of Defense (DoD) or from the Department of Veterans Affairs.  That is one of the issues we are going to explore today, the issue of information and the tracking of these issues.  But they had to spend 5 or 6 months tracking down statistics in different States because nobody seemed to be interested in Washington, of understanding the statistics. 

Their report of several weeks ago again opened the eyes of millions of Americans to statistics, which went way beyond what people had thought or imagined as to the number of suicides, not only amongst our returning vets but amongst veterans from previous wars.  I think it is now recognized that as many Vietnam veterans have now committed suicide as had died in the original war.  That is a terrible, terrible statistic and says we have to do more. 

So what we are going to do today is try to open up this subject which is very difficult for the families involved and for our government.  We want to talk about the statistics.  Why doesn't the VA do more about trying to understand the nature of the issue?  We leave it to citizens like Ilona Meagher, who will be testifying later, to keep a Website for tracking suicides, of which she is one person with limited resources.  This is what our government should be doing. 

We want to talk about the stigma of mental illness and how we try to deal with this as a Nation.  We want to talk about the apparent inability of the military to look at mental illness and people's honest attempts to deal with it as something to be recognized, promoted, encouraged.  It is denied.  Anybody who admits mental illness is threatened with no promotions or no jobs in law enforcement when they leave the military. 

It is an issue for all of us in America but particularly for those in the military, and we have to face it honestly and come to grips with it.  That is what we hope to do today. 

We have a brave mother and father who have decided that their son's suicide must be talked about and understood to help others, and other families, prevent that.  We have citizens, authors who have dealt very directly with this issue and, of course, the professionals within the VA system and those in the veterans service organizations (VSOs) who try to help their members deal with these issues. 

So we will have a very tough hearing, as I said earlier, but it is an important hearing.  America must look at these issues.  We have to decide that we have to deal with them in a far more open and dedicated manner, and that is our objective today. 

I would yield for an opening statement to the Ranking Member, Mr. Buyer.

[The statement of  Chairman Filner appears in the Appendix.]

OPENING STATEMENT OF HON. STEVE BUYER

Mr. BUYER.  Thank you, Mr. Chairman. 

Some in this room today, including several of our witnesses, have been personally devastated by the loss of a loved one who has chosen to take their own life.  Before I begin, I want to personally thank you for testifying about your extremely personal and painful experiences.  While I know nothing can compensate you for the loss of your loved ones, we can hopefully find ways to help deter another soldier from succumbing to such tragedy. 

I hope that, as we delve into these sensitive matters, we do not lose sight of the fact that every case that we will discuss here today represents a human life, a veteran, a family, and a tragedy.  Discussing the tragic circumstances surrounding a suicide of one who has worn the uniform should be done with great respect and in recognizing also their service to our country.  We must search for answers and solutions to veteran suicide. 

As most of our witnesses will attest this morning, tracking suicide rates nationwide is very difficult, and it is clear to me that the data we currently have does not give us a definitive understanding nor a scope of the problem.  There seems to be significant variations among the data provided by CBS News, the VSOs, the DoD and the VA.  These veterans' lives were important, and it would be a dishonor to them and to their service if information is not accurately portrayed.  Accurate information is crucial to identifying risk factors, to providing better prevention and treatment protocols. 

Therefore, it is imperative that the VA have a better method to systematically collect and to track suicides so we can get a true understanding and scope of our challenge.  It is my understanding that the VA is beginning to work with the DoD to do this, and I applaud them.  But, again, I cannot overstate the urgent need to do it quickly.  When decision makers do not have accurate data, we must rely on anecdotal evidence.  While this can raise awareness, it does not help us make informed decisions on how best to develop strategies to diminish the risk and to prevent the events of suicide. 

Notwithstanding the tragic stories that surround this hearing, I believe we can point to the steps that the VA and the DoD have taken to help veterans and servicemembers deal with mental health challenges. 

The VA has already formulated a comprehensive strategy for suicide prevention, focusing on the needs of both new veterans from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) and on those of prior conflicts.  The specific program for suicide prevention is based on public health and clinical models and activities both within the VA facilities and the civilian medical community. 

The cornerstone of this program is the VA's new 24-hour veteran suicide prevention hotline, which opened its lines in July of 2007.  Since its inception, the VA reports that they have made more than 1,300 referrals to suicide prevention coordinators and have rescued 317 veteran callers.  Veterans experiencing thoughts of suicide can call 1-800-273-TALK for help. 

We have seen clearly that early intervention and treatment has a significant and demonstrated impact and is crucial to preventing suicide.  It is important to recognize the warning signs and to ensure that servicemembers receive the treatment they need right away. 

This starts with DoD.  I am very encouraged that a new training program called BattleMind, developed at the Walter Reed Army Institute of Research, that is being developed and is working to help soldiers transition from the combat zone to the home front. 

Mr. Chairman, I would sum this up with this.  VA and DoD have made strides in the treatment of mental health disorders that can lead to suicide.  However, until families like the Bowmans no longer bear such pain, not enough is being done.  I welcome their testimony here today, and I hope this hearing can help us gain a better understanding of how to offer more effective and timely assistance for those troubled servicemembers to prevent them from turning to such a tragic option. 

On a personal note, as I see the parents sitting in front of me, your quest for answers will never end, and probably on your last breath there will still be the thoughts of your son.  At the age of 16, my best friend committed suicide.  His baseball cap sits in my office.  I think people walk in, and they think it is my baseball cap, but it is that of a very dear friend.  I constantly search for answers because none of us knew, even as close as we were to him.  And, of course, the parents would drill us all the time about the signs.  What were they?  And there were no signs.  There were no risk factors.  It was just one of these bizarre strikes of the mind that just—I do not have an answer.  I just want you to know I carry the pain of suicide, and I am in constant search of answers.  And I am haunted, haunted by suicide.  Even among my colleagues—if you want to talk about something that is not discussed, in the 15 years I have been in Congress, it is the number of suicides of sons and daughters of Members of the Senate or of the House, and it is not discussed—or the attempts.  It is that dark side. 

So you know what?  It is not just us, and it is not just those in the military.  You can touch any sector of our society.  So, as we delve into this issue, we have to also be very sensitive, because I recognize there are anti-war advocates who also want to say that these individuals who then commit suicide and who have worn the uniform are somehow victims, and that is not right either, as we are trying to find out actually how can we prevent and how can we be helpful to someone who thinks that suicide is some form of option that can help them. 

So, on a personal note, I thank you for your bravery to come here and to talk about your son, and I know you are doing this because you absolutely believe that your testimony here today can help someone else. 

Thank you.  I yield back.

The CHAIRMAN.  Thank you, Mr. Buyer. 

Our first panel will be Mr. and Mrs. Mike Bowman, whose son, Tim, an Army specialist in the Illinois National Guard from Bravo Troop, 106th Calvary, committed suicide. 

Before that, if you will allow me, Mr. and Mrs. Bowman, to ask our colleague Mr. Boswell if he would just step forward for 2 minutes.  He is the author of Public Law 110-110, the Joshua Omvig Veterans Suicide Prevention Act, named after a young man in his own district, whose parents have now become friends with the Bowmans. 

The Bowmans are being introduced by our other colleague from Illinois, Mr. Manzullo. 

Mr. Boswell, please. 

OPENING STATEMENT OF HON. LEONARD L. BOSWELL

Mr. BOSWELL.  Thank you, Mr. Chairman, Ranking Member Buyer and Members of the Committee.  I appreciate your holding this hearing and your leadership on this issue. 

To Mike and Kim, we extend our hand in friendship, our concern and sympathy for the loss of your son, Tim, and we pledge to do our best to stop this. 

As we all know, suicide is sweeping through our veteran population, and the Committee has shown leadership in addressing the issues our veterans face today.  I want to thank you again for allowing me to speak on this important issue. 

Suicide is an epidemic which is encompassing much of our veteran population.  For too long, suicide among veterans has been ignored, and now is the time to act.  We can no longer be afraid to look at the facts, and the sad fact is we are missing adequate information on the number of veterans who commit suicide each year. 

I was shocked, and I am sure all were, when we saw the CBS Evening News report focusing on veteran suicides.  They found that in 2005, over 6,200 veterans committed suicide—120 per week.  The report also found that veterans were twice as likely to commit suicide as nonveterans.  These statistics are devastating. 

As a result of this report, I immediately introduced H.R. 4204, the "Veterans Suicide Study Act," which several Members of the Committee have cosponsored.  If time had permitted, there would be many, many more, because no one—no one—who I approached chose not to sign on. 

This legislation will direct the VA to conduct a study to get the real facts on the rate of suicide among veterans.  It is just one step that we must do to ensure that we have adequate information so we can treat our veterans as they return from combat. 

I would also like to personally thank the Chairman and the Ranking Member on the full Committee for their action in support of the Joshua Omvig Veterans Suicide Prevention Act earlier this year.  Now that this crucial piece of legislation has been signed into law, I am confident our veterans will begin to receive more of the vital care they need. 

While the Joshua Omvig bill puts in place a comprehensive approach in treating high-risk veterans, we still need to know the facts.  So I implore the Committee, and the Congress, to act swiftly on H.R. 4204 so we can ensure we have the data we need to treat our Nation's heroes.  Our veterans have dedicated their lives to keep our great Nation safe, and it is now our duty and our time to protect them. 

So I want to thank you again for allowing me to share this time with you, Mr. Chairman, and I am sorry I have to go to a markup.  Thank you very much.  

The CHAIRMAN.  Thank you, Mr. Boswell, for your leadership on this issue. 

Mr. Manzullo, if you want to introduce your constituents. 

Thank you for being here with us. 

OPENING STATEMENT OF HON. DONALD A. MANZULLO

Mr. MANZULLO.  Thank you, Mr. Chairman.  I have the honor today of introducing, three constituents who are testifying before the Committee today. 

In inverse order, on the second panel is Ilona Meagher.  Ilona's father was a Hungarian freedom fighter and also became a member of the United States Armed Forces, so he is a veteran of both the Hungarian and the American Armed Forces.  Ilona is a tremendous campaigner, a seeker of truth, and she wrote this book, "Moving a Nation to Care," about the very subject of which we are discussing this morning. 

The other two constituents really exemplify the people about whom Ilona Meagher is concerned, and they are the Bowmans from Forreston, Illinois.  Kim and Mike live about 10 miles from my farm in the same county in northern Illinois.  Their testimony is nothing less than startling and compelling.  They would rather be anywhere in the world than here today to talk about what happened in their lives and to their precious son. 

I encourage the Members of this Committee to continue their leadership, to draft legislation or whatever is necessary, in order to make sure that the Bowman’s testimony is not in vain and that their son's life is not in vain and that the lives of other young men and women who have taken their lives, will be used in order to prevent those situations from occurring in the future. 

The CHAIRMAN.  Thank you, Mr. Manzullo. 

Mr. and Mrs. Bowman, you are recognized for your testimony.  I had a chance to talk to you yesterday and to understand a little bit more about Tim, about the incredible job he was doing overseas, about the soldier that he was, about the close relationship you had with him, about your patriotism and his.  So, again, I cannot say I am looking forward to your testimony, but I just thank you for having the courage to be here and for making sure that Tim's life and death will be used to help other people. 

Please, Mr. Bowman.

STATEMENTS OF MIKE AND KIM BOWMAN, FORRESTON, IL (PARENTS OF SPECIALIST TIM BOWMAN, U.S. ARMY, ILLINOIS NATIONAL GUARD, BRAVO TROOP, 106TH CAVALRY)

Mr. BOWMAN.  Mr. Chairman and Members of the Committee, my wife and I are honored to be speaking before you today, representing just one of the families who lost a veteran to suicide in 2005. 

As my family was preparing for our 2005 Thanksgiving meal, our son Timothy was lying on the floor of my shop office, slowly bleeding to death from a self-inflicted gunshot wound.  His war was now over; his demons were gone.  Tim was laid to rest in a combination military-firefighter funeral that was a tribute to the man that he was. 

Tim was a life-of-the-party, happy-go-lucky, young man who joined the National Guard in 2003 to earn money for college and to get a little structure in his life.  On March 19th of 2005, when Specialist Timothy Noble Bowman got off the bus with the other National Guard soldiers of Foxtrot 202 who were returning from Iraq, he was a different man.  He had a glaze in his eyes and a 1,000-yard stare, always looking for an insurgent. 

Family members of F202 were given a 10-minute briefing on post traumatic stress disorder (PTSD) before the soldiers returned, and the soldiers were given even less.  The commander of F202 had asked the Illinois Guard Command to change their demobilization practices to be more like the regular Army, only to have his questions rebuffed.  He knew that our boys had been shot up, had been blown up by improvised explosive devices, had extinguished fires on soldiers so their parents would have something to bury, and had extinguished fires on their own to save their lives.  They were hardened combat veterans now, but were being treated like they had been at an extended training mission. 

You see, our National Guardsmen from the F202 were not filling sandbags.  They departed in October of 2003 for 6 months of training at Fort Hood and Fort Polk.  On Tim's 22nd birthday, March 4th of 2004, Foxtrot left for Iraq, where they were stationed at Camp Victory.  Their tour took them directly into combat, including 4 months on the most dangerous road in the world, the highway from the airport to the Green Zone in Baghdad, where Tim was a top gunner in a Humvee.  Tim, as well as many other soldiers at F202, earned their Purple Hearts on that stretch of road known as "Route Irish."  We are still waiting for Tim's Purple Heart from various military paperwork shuffles. 

My wife and I are not here today as anti-war protesters, and let me make that very clear.  Our son truly believed that what his unit did in Iraq helped that country and helped many people that they dealt with on a daily basis.  Because of his beliefs, I have to believe in the cause that he fought and died for.  That does not mean I do not feel that we lost track of our overall mission in Iraq. 

When CBS News broke the story about veterans suicides, the VA took the approach of criticizing the way the numbers were created instead of embracing it and using it to help increase mental healthcare within their system.  Regardless of how perfectly accurate the numbers are, they obviously show a trend that desperately needs attention. 

CBS News did what no Government agency would do.  They tabulated the veterans suicide numbers to shed light on this hidden epidemic and to make the American people aware of this situation.  The VA should have taken those numbers to Capitol Hill, asking for more people, funding and anything else they need to combat this epidemic.  They should embrace this study, as it reveals the scope of a huge problem, rather than complain about its accuracy. 

If all that is going to be done with the study is to argue about how the numbers were compiled, then an average of 120 veterans will die every week by their own hand until the VA recognizes this fact and does something about it.  The VA mental health system is broken in function and understaffed in operation.  There are many cases of soldiers coming to the VA for help and being turned away or misdiagnosed for PTSD and then losing their battle with their demons. 

Those soldiers, as well as our son Timothy, can never be brought back.  No one can change that fact.  But you can change the system so that this trend can be slowed down dramatically or even stopped. 

Our son was just one of thousands of veterans that this country has lost to suicide.  I see every day the pain and grief that our family and extended family go through in trying to deal with his loss.  Every one of those at-risk veterans also has a family that will suffer if that soldier finds the only way to take battlefield pain away is by taking his or her own life. 

Their ravished and broken spirits are then passed on to their families as they try to justify what has happened.  I now suffer from the same mental illness that claimed my son's life—PTSD from the images and sounds of finding him and hearing his life fade away, and depression from a loss that I would not wish on anyone. 

If the veterans suicide rate is not classified as an epidemic that needs immediate and drastic attention, then the American fighting soldier needs someone in Washington who thinks it is.  I challenge you to do for the American soldier what that soldier did for each of you and for his country:  take care of them and help preserve their American dream as they did yours.  To quote President Calvin Coolidge, "The Nation which forgets its defenders will itself be forgotten." 

Today, you are going to hear a lot of statistical information about suicides, veterans and the VA, but keep one thing in mind.  Our son, Specialist Timothy Noble Bowman, was not counted in any VA statistic of any kind.  Let me repeat that.  Our son is not included in any VA count.  Now, why, you ask?  He had not made it into the VA system because of the stigma of reporting mental problems.  He was National Guard, and he was not on a drill weekend when he took his life.  Therefore, he was not counted as active duty.  The only statistical study that he was counted in was the CBS News study.  And there are many more just like him.  We call them KBAs, killed because of action, the unknown fallen. 

I challenge you to make the VA an organization to be proud of instead of the last place that a veteran wants to go for help.  It is the obligation of each and every one of you and all Americans to channel the energies, the resources and the intelligence and wisdom of this Nation's best and brightest to create the most effective, efficient and meaningful health-care system for our men and women who have served. 

We must all remove the stigma that goes with the soldier's admitting that he or she has a mental issue.  Let those soldiers know that admitting they have a problem with doing the most unnatural thing that a human being can do is all right.  Mental health issues from combat are a natural part of the process of war and have been around for thousands of years, but we categorize that as a problem. 

Take that soldier who admits a head and mental health injury from combat and embrace him as a model for others to look up to.  Let the rank-and-file know by example that it is okay to work through your issues instead of burying them until it is too late.  Grab that soldier and thank him for saying, "I am not okay," and promote him.  A soldier who admits a mental injury should be the first guy you want to have in your unit, because he may be the only one who really has a grasp on reality.  But instead, he is punished and shunned, and by that example, he has become the model for PTSD and suicide. 

While we are at it, why do we call it a disorder?  That title, in itself, implies ramifications that last forever.  It is an injury, a combat injury, just like getting shot.  And with proper care and treatment, soldiers can heal from this injury and can be as productive and as healthy as before. 

We, as a country, have the technology to create the most highly advanced military system in the world, but when these veterans come home, they find an understaffed, underfunded, underequipped VA mental health system that has so many challenges to get through it that many just give up trying.  The result is the current suicide epidemic among our Nation's defenders, one of which was our son, Specialist Timothy Noble Bowman, a 23-year-old soldier and our hero.  Our veterans should and must not be left behind in the ravished, horrific battlefields of their broken spirits and minds.  Our veterans deserve better. 

Thank you, Mr. Chairman.

[Applause.]

[The statement of  Mr. and Mrs. Bowman appears in the Appendix.]

The CHAIRMAN.  Mrs. Bowman, do you have anything to add?  Thank you for being here with Mike.  And, again, thank you for your courage in being here. 

Mr. Michaud, you are recognized. 

Mr. MICHAUD.  Thank you very much, Mr. Chairman and Mr. Ranking Member, for having this very important and timely hearing today. 

And it is going to be a tough day going through all of the testimonies, but I appreciate your remarks, Mr. Bowman. 

Thank you, Mrs. Bowman, for coming. 

Our soldiers, as you know, put their lives in harm's way to protect our country.  Not all wounds are physical.  The memories of the war do not disappear when they take off the uniform.  A lot of us have seen the casualties of war.  Maine recently lost one of its sons to suicide.  Kyle Curtis, who served in Iraq, took his own life, like your son. 

My question is:  When your son came back, did he try to get some assistance from the VA?  Did either one of you notice any changes in the way your son was acting?  Did you try to see or to encourage him to get help? 

Mr. BOWMAN.  Timothy was a very smart kid, for one thing, and that gave him the ability to—as soon as he would start to open up in a situation where he thought his anger or his drinking problem or any sign that he was having trouble was going to be visible by us, he would immediately change the subject, or if we were sitting around our patio, he would go home.  He would find a way to leave that situation that was putting him in that position, so that he could close that door in the back of his mind again and go on to something else. 

He had shown us small signs but not enough to trigger anything, because we did not know what we were looking for.  And we, as National Guard families, are never educated on what to look for, because it is volunteer.  You know, you show up at a readiness group meeting, and there is somebody there who gives us a 10-minute briefing.  That was 2 months before the guys got home.  Then you go through the process of the homecoming, and you realize that they are going to be changed when they come out of combat.  That is fact.  So then they hit your back door, and sure, there are some issues that you see, yet they think it is normal, and they portray it as being normal, and they tell you that it is normal.  "This is just the way I am now." 

Now, he showed us one little sign.  He showed certain friends other little signs.  If we had all gotten together, we would have seen a larger picture, and we would have known he was in more trouble.  But he was so good at hiding that that nobody knew for sure. 

And he was a model employee.  He worked for me in the family business.  We have an electrical contracting business.  He would have been the third generation in 40 years.  He was an absolute model employee.  He went to work every morning regardless of what happened the night before or anything else.  So, you know, you would discount any problem he was having at night because he did such a good job during the day.

So trying to read the picture was very, very tough for him, especially with our not being educated on what the signs should be. 

Mr. MICHAUD.  Not knowing where you live in relationship to the VA hospital, other than providing resources to the VA so they can hire staff to take care of the need that is out there, as well as to provide additional resources so if you live in a rural area, they could contract with providers in a rural area, do you think it would be helpful if the VA established a program for those individuals who might not want to go to the VA facility to have counseling online, on a computer? 

With technology today, a lot of individuals, particularly our younger individuals, are on the computer all of the time.  Do you think it would be helpful if the VA established a program where someone could actually access help from home, whether it is to a clinic or to the VA hospital? 

Mr. BOWMAN.  I would say, yes, definitely.  As in the case with Tim and with a lot of his unit buddies, they are very well-computer-connected.  They stay connected with us now via e-mail and by all kinds of ways through the computer. 

I would think that would be an easy way, especially as long as they can enter it anonymously, because you have the stigma of, if you walk into a VA clinic, somehow that information is going to get back to your commanding officer.  And until that stigma is removed, that you have just admitted to having a mental health issue, they have to be able to find help in some way so it is not going to come back to haunt them in their careers. 

A lot of these guys who come home from Iraq, a lot of the guys in Tim's unit are 10-years-plus in the National Guard.  They want to get to their 20 years.  They do not want to get out.  So they do not want to have a problem with their careers down the road, which means they also do not want to have a problem with promotions.  And it is a known fact that if you voluntarily admit that you have a mental health issue that your chance of progression in the military ranks at that point is pretty well shot. 

So, with the computer, it is if you can make it anonymous and can make it helpful.  By "helpful," I mean it is peer-to-peer counseling. 

We had a discussion this morning about this very issue.  The Vet Centers were a wonderful idea, but then all of a sudden, the VA comes along and they decide they have to have a guy with a title and a suit as a counselor at the Vet Center.  Now, what did that do?  That took that soldier who was walking in with that issue and made him on the defensive right off the bat.  He was not talking to his peer anymore.  He was talking to somebody who was sitting at another level above him. 

If you take a Vet Center and you make it a room with a couch and a pop machine and you put guys in there who are not in uniform and who are not in a suit or anything else and they just sit and talk, you will have veterans opening up.  But if you take a guy with PTSD and you shove him in a room with a doctor in a suit, he is going to shut that door. 

Mr. MICHAUD.  Thank you very much.  It has been very helpful. 

Once again, I am sorry for the loss of your son, but I really appreciate both of you and your willingness to come forward to talk about your tragedy in order to help others who have not taken their lives.  Hopefully, we will be able to move forward in a positive, productive manner. 

So, once again, thank you very much for coming here today. 

Mrs. BOWMAN.  Thank you. 

Mr. MICHAUD.  Thank you, Mr. Chairman. 

The CHAIRMAN.  Ms. Brown-Waite, you are recognized. 

Ms. BROWN-WAITE.  Thank you very much, Mr. Chairman. 

Mr. and Mrs. Bowman, all of us here who are parents can only imagine what it is like to lose a child.  It is the toughest thing that a parent ever does. 

One of the questions that I was just asking counsel was—I do not believe, in many of the Community Based Outpatient Clinics (CBOCs) where they offer mental healthcare, that that information gets back to the commanding officer.  And I think we need to look at that.  I know the CBOCs in my district consider anyone who seeks mental health or any kind of care as a VA case, and it is not reported to the National Guard commanding officer or to the Reserves or even if the person is ready reserve call-up. 

Tell me why you believe that—tell me why veterans who have served believe that the information gets back to the commanding officer.

Mr. BOWMAN.  The 118 soldiers who were in F202 have basically all—they have all adopted us.  We are their adoptive parents now, and they are all our adopted sons.  I talk with these boys all the time, and they open up to me because they know that I will understand about their mental status.  They ask me questions about Tim. 

I have a list as long as my arm of soldiers in that unit who are all seeking counseling of some form or another privately, all away from the military, away from the VA, some as far as 100 miles away from home, to make sure that that information does not get back to their unit. 

Now, you say that that information should be kept anonymously by the VA and should never make it back.  If that is true, then you are not—I am sorry, not "you"—then they are not educating the rank-and-file soldiers to let them know that it is safe to go to the VA.  You have to change that stigma.

And I know for a fact that I can call four or five guys right now who will tell you the same thing.  They are all active-duty National Guard.  They will not go to a VA center for this because they are going back.  My son's unit is going to Afghanistan in the spring, and they do not want to risk a redeployment opportunity by having a mental health issue all of a sudden show up on their records.

Ms. BROWN-WAITE.  Please do not misunderstand me.  I am not questioning it.  I am just saying what I believe is the policy.  I will certainly check on that, as to if someone goes to a VA hospital or to a CBOC, that that information is kept private.  Certainly, under Health Insurance Portability and Accountability Act (HIPAA), for example, which covers the privacy of medical records, that would be absolutely prohibited unless the patient releases any information. 

So what I am saying is, believe me, I do not think there is a person on this panel on either side of the aisle who would ever stand for, if that is the policy, its continuing.  If it is not the policy, I agree with you, it needs to be out there loud and clear, absolutely loud and clear, to our military. 

The last casualty in my district happened to have been someone who was active-duty who committed suicide.  I do not believe that the people who are active-duty even are properly informed.  In this case, the young man was crying, and one of his buddies came up to him and said, "Can I help you?  Do you need to talk to someone?"  He said, "Yes."  So the buddy left to go get the chaplain, and in the meantime, this young soldier committed suicide.  What should have happened was, if it were just the two of them, he should have stayed there with him and should have gotten, called, you know, just perhaps gone outside the door and called for help.  So there are certainly ways that we could do a better job at suicide prevention. 

Again, thank you very much for coming and for sharing your story.  And I will follow up on that issue. 

Mrs. BOWMAN.  Thank you.

Ms. BROWN-WAITE.  Thank you. 

The CHAIRMAN.  Thank you, Ms. Brown-Waite. 

By the way, I would not just concentrate on the official records, on whether they are sealed or not.  It is the knowledge of when someone walks into a clinic.  People talk; their buddies talk.  The information is there even if the exact record may not be held.  It is that information and that sense that seeking help is itself the problem for the military. 

So, you know, when you are in a small community like this, everybody knows what everybody is doing.  I would think that that is more of the sense than someone's individual record being given. 

Would you agree, Mr. Bowman? 

Mr. BOWMAN.  Yes, it very true, especially in a National Guard unit because, traditionally, those men are closer than a regular military unit because they all live in the same neighborhood also.

The CHAIRMAN.  Mr. Hare, I know the Bowmans live near your district. 

Mr. HARE.  Thank you, Mr. Chairman. 

I want to thank the Bowmans for their courage in coming today and for telling the story, the chilling story, about your son, Tim.  I had the opportunity to sit with both of you this morning with my friend, Representative Manzullo.  I cannot begin to express my sorrow for your loss.  My son is about the age of your son. 

I find it appalling that you have not received the Purple Heart for your son, and I want you to know, this morning, Representative Manzullo and I will work very hard, and we promise you that we will get this situation taken care of quickly.  I cannot imagine that that is something that has not already been done, but we will work on that. 

Your son was a brave young man.  He served this country honorably.  We talked a lot about some of the things, about Iraqi veterans and Afghanistan veterans coming back.  One of the things that you talked about, Mr. Bowman, too, was about how on a Monday you are in Iraq and on a Thursday you are home.  You may be playing soccer or watching your kid's soccer game or doing things, but it is a very different war, and it has put tremendous stress upon people. 

I just want to ask a couple of things of both of you.  We talked about this this morning, but I think, for the record, it is important. 

You know, the Chairman has a wonderful idea, and that is to screen every person who comes back for PTSD.  You know, Representative Murtha said if you are in combat for more than 6 months you are a prime candidate.  For those particularly in the Guard and in the Reserves who have to come out and say, "Hey, I think I have a problem here," they are really setting themselves up, as you said, for a possible loss of employment, a possible loss of being redeployed again in their units.  So I wonder if you think that makes sense, from a perspective of testing everybody. 

But also, I was amazed when you said you only had a 10-minute briefing prior to your son's coming home.  A lot of parents—I know Mrs. Bowman this morning was obviously very upset.  You do not know what to look for.  This is not just an individual problem.  It seems to me, Mr. Chairman, this is a problem that affects the entire family.  How do you know what to look for if you do not know what to look for or know what the signs are? 

So it puts you at a handicap, and then the parents and the family end up feeling like somehow they could have intervened or should have intervened, but if you do not know what you are looking for, you are relying upon bits and pieces.  Like you said, Mr. Bowman, different groups of people had to come up and say, hey, Tim said this or Tim said that. 

So I don't know.  If you would spend maybe just a couple of minutes talking about the need—and I thoroughly agree with the Chairman that every person coming back should be screened.  I think we should look farther down the road, because it does not necessarily manifest itself within 30 days of coming home.  It could be 4 or 5 years.  We have seen this. 

Then also, maybe, just how little knowledge you had or the families had before your sons and daughters were coming back from this war to know even what to look for. 

Mr. BOWMAN.  The redeployment process, basically reintegrating back into society—we were talking with Chairman Filner last night about the unboot camp, the reverse boot camp.  It is something that we have lobbied with the Illinois National Guard for a long time.  You cannot just educate the soldier; you have to educate the family. 

Now, obviously, I am speaking from the standpoint of a National Guard parent, but Army Reserves and Marine Reserves would pretty well fall into the same category.  I have a young Marine Reservist who lives right up the road from me who is going through the same type of scenario right now. 

You cannot make it optional.  Our education meeting from the State Family Readiness Group was optional.  You did not have to be there as a family member.  So, out of 118 families, we might have had half of them there, so there were 50 families who were there.  The meeting was about an hour long. 

We spent, I would say, about 10 minutes with a brochure on PTSD, and then the rest of the time dealt with the health insurance, because, see, a lot of these guys have families.  They need to know when the health insurance runs out, their last check.  They need to know all of the financial aspects.  When does my husband have to go back to work?  When does my son come off of Federal title and go back onto State title?

It is all of these questions because, at that point, those are much higher on the priority list than PTSD.  So you start out the meeting talking about health issues, and that gets shoved off to the side.  Then they hand you a magnet with a bunch of phone numbers on it that says, "Here is where you call for help." 

It does not work because the excitement of the moment, the excitement of the homecoming overtakes everything.  So you have to come back to the issue after they are home.  There is a 2-week period of coming home.  Let them be with their families for a couple of weeks, and then bring them back.  It has been a long-talked-about idea through a lot of families.  Bring the families with them, and do not make it optional.  Yes, you are going to have to pay for it because a lot of these guys have kids, but what would you rather pay for, a couple of weeks in a camp where you can educate the family and the soldier or looking at another statistic and another news report where you have lost another veteran to suicide who took his own life? 

You have to make it appealing to people.  You cannot make it something that is so absurd or grueling that nobody is going to pay any attention. 

Mrs. BOWMAN.  It is one more battle.

Mr. BOWMAN.  Yes, it suddenly becomes another battle, exactly. 

There are ways to do that.  You know, you get the right people involved in the situation.  You look at how you can educate kids with cartoons and video games and how they excel with that type of training because they relate to it.  And that is the kind of re-education that not only the soldier needs but the families need and all of the family. 

Mr. HARE.  Just one final thing.  I know I am out of time. 

With regard to the price, the price that your family has had to pay, and particularly for those people who have lost their lives because they did not know where to go, I do not think we even ought to be quibbling over whether or not we can afford to do this.  This is something that I think we have a moral obligation to do for the men and women who serve this country. 

So, with that, I yield back.

The CHAIRMAN.  Thank you, Mr. Hare. 

Mr. Stearns? 

Mr. STEARNS.  Thank you, Mr. Chairman.  Thank you for holding this hearing. 

Let me echo sincerely the comments of my colleagues, in which we are very sorry for this tragedy.  Having three boys, I think anybody who has children certainly identifies with the grief that you are going through. 

But I would say to you, in all candidness, that your coming here is good for us, but it is probably good for you to talk about it and to tell us, in the ways that you are doing, so that we better understand.  As to the actual telling of it to us by you, I think and hope and pray that it helps you too, as you mentioned that you have post traumatic stress symptoms yourself.  Obviously, every death is a tragedy, but losing those who fought so bravely to protect us in this room, and in this country, is something that we cannot discount and that we cannot brush aside. 

In hearing from your testimony that he was one of those who spent four months on the most dangerous road in Iraq, going from the airport to the Green Zone, Members of Congress go to Iraq, but we fly by helicopters from the airport to the Green Zone, so we are not in that dangerous zone. 

I read also that you indicated that his Purple Heart has still not arrived.  Is that true? 

Mr. BOWMAN.  That is correct.

Mr. STEARNS.  That is something that we will look into, too. 

The thing that struck me about this is—and Members will talk about this.  Mrs. Bowman, is it possible I could ask you a question and get your feeling too?  I notice your husband is doing all of the talking. 

When you look back at it, do you think the Veterans Administration, if they sent people to your home—I know I asked the staff here, does the Veterans Administration have counseling?  It says they provide readjustment counseling and outreach services to all veterans who serve in any combat zone.  Services are also available for their family members for military-related issues.  Veterans have earned these benefits, and these services are provided to them, but, I mean, that means you have to go to the Vet Center to get it. 

So, Mrs. Bowman, in retrospect, is there something that the Veterans Administration could have told you or something that you could have done, where you felt that you just did not have the psychological skills or that you did not have the education?  I mean, is there a void there that we, as Members of Congress, could legislate and could tell the Veterans Administration that we are not going to wait for the families to come to the Vet Centers and that we are going to send the people to you once we identify those individuals coming back? 

Mrs. BOWMAN.  Right.  It is just like my husband said.  If we would have been included with Tim in some kind of a program where we had to report back to someone, where we had some kind of screening or a one-on-one with all three of us or with the two of us, as far as what we have seen or have not seen, and Tim on his own, so that we could, you know, get together and realize there is an issue here and that they could now help us deal with this and give us the tools to do that. 

Mr. STEARNS.  I have been in hearings for something like this, and I chaired a Subcommittee on Commerce, Consumer Protection and Trade, and we dealt with families who had children who took steroids and who committed suicide.  So I have looked at this. 

What I found is that, if there is employment for the individual, that is a big step—but Timothy had employment—and if he is adequately compensated and has enough cash flow or something so that he at least is not on the edge there.  Secondly, it is that he has significant counseling by folks, and if necessary, he is provided medication. 

Was he provided medication? 

Mrs. BOWMAN.  He did not ask for medication.

Mr. STEARNS.  He did not ask.  Is there a reason why he did not ask? 

Mrs. BOWMAN.  He did not realize he had the problem he did.

Mr. STEARNS.  So he did not even realize that this post traumatic stress disorder was affecting him, and he was not receptive to counseling or to the medication? 

Mrs. BOWMAN.  No.

Mr. STEARNS.  Okay.  Then the last thing I found was some kind of education.  Did he have a high school degree? 

Mrs. BOWMAN.  Yes.

Mr. STEARNS.  He did.  Okay. 

So, once those three are in place, then the building of the self-esteem is the key.  And the parents somehow have to convince him or her that everything is going to be all right; we are going to work through it.  In this case, it did not happen, and it is so tragic and sad. 

I think, as legislators, we can direct the Department of Veterans Affairs to not only brief you but to come into your house and set up perhaps a casual type of counseling where the veterans themselves, who are back and who are, shall we say, aware of this problem, can sit down with Timothy and say, "Okay, let's shoot the breeze here and talk about it.  What is happening in life?  Who are you dating?" and things like that.  So, I mean, that is what you are telling me would have been a big step. 

My last thought here is that both of you feel that you were—or were not—adequately briefed enough to know how to help Timothy.  Can you just elaborate on that a little bit? 

Mr. BOWMAN.  No, we were not briefed on what direction to send him.  The only information we got was, like, of a mandatory nature.  Before you could do anything, as far as getting him help, you had to get him registered with the VA.  He had to go to the VA office with his DD-214 and get registered there, and then you could start the process. 

He came home with a battlefield injury that was going to be with him for the rest of his life, a broken hand that was a little bit handicapped after comb