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Opening Statement of Hon. Bob Filner Chairman, and a Representative in Congress from the State of California

Good morning and welcome to the Committee on Veterans’ Affairs’ hearing on “The Truth about Veterans’ Suicides.” 

On December 12, 2007, this Committee held a hearing entitled “Stopping Suicides: Mental Health Challenges within the Department of Veterans Affairs.”  Nearly five months later, we are again holding a hearing on the tragic issue of suicide among our veterans and what the VA is doing to address what is clearly an epidemic.  In November of last year, CBS News aired a story entitled “Suicide Epidemic Among Veterans.”  On April 21, 2008, CBS News aired a story “VA Hid Suicide Risk, Internal E-Mails Show.”

The first step in addressing a problem is to understand the scope and extent of the problem.  In the case of the VA and the epidemic of veteran suicides, either the VA has not adequately attempted to determine the scope of the problem, which is an indictment of the VA’s basic competence, or the VA knows the extent of the problem, but has attempted to obfuscate and minimize the problem to veterans, Congress, and the American people, which is an indictment of the leadership of the entire Department.

In December, Dr. Katz, in testimony before this Committee, stressed a low-rate of veteran suicide, stating that “from the beginning of the war through the end of 2005 there were 144 known suicides among these new veterans.”  In responding to the figures used by CBS, Dr. Katz stated that “their number for veteran suicides is not, in fact, an accurate reflection of the rates of suicide.”

Either Dr. Katz knew that the CBS figures were indeed an accurate reflection of the rates of suicide at that hearing or had a sudden epiphany only days later.

In an internal email, Dr. Kussman, on December 15, 2007, referring to a newspaper article, writes that “18 veterans kill themselves every day and this is confirmed by the VA’s own statistics.  Is that true?  Sounds awful but if one is considering 24 million veterans.”  That same day, Dr. Katz responds: “There are about 18 suicides per day among America’s 25 million veterans.  This follows from CDC findings that 20% of suicides are among veterans it is supported by CBS numbers.”

In February of this year Dr. Katz sends an email stating  “Shh! – Our suicide prevention coordinators are identifying about 1000 suicide attempts per month among the veterans we see in our medical facilities.  Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

There was silence from the VA.

Armen Keteyian, Chief Investigative Reporter for CBS News, characterized the VA’s internal emails as “a paper trail of denial and deceit – a disservice to all veterans and their families – [that] has rightfully been exposed.”

In an April 24, 2008, newspaper article, a VA spokeswoman stated that “there are an estimated 1,000 suicide attempts per month among the 7.8 million veterans treated by Veterans Affairs, she said.”

The VA spokeswoman may have misspoke, or this could be yet another example of the VA’s attempt to hide the true magnitude of the problem.  In the VA’s most recent budget submission, the VA claims it will treat 5.2 million veterans this year, and 5.3 million next year – 2.5 million fewer veterans than the 7.8 million quoted in the newspaper article.

In April, a Dallas Morning News editorial, describing a “recent spike in suicides among psychiatric patients treated at the Dallas VA hospital” stated that “descriptions of how four veterans committed suicide in four months – prompting the psychiatric ward to close – suggest that patients went to conspicuous and time-consuming lengths to end their own lives.  There seemed to be ample time for staffers to stop them had they been doing their jobs better.”

The Rand Corporation, in a recently published study entitled the “Invisible Wounds of War, found that since October 2001, approximately 1.6 million U.S. troops have deployed, and that “upward of 26 percent of returning troops may have mental health conditions.”  The study estimated that approximately 300,000 of those deployed suffer from PTSD or major depression.  Among those with PTSD or major depression, only half had seen a mental health provider or physician to seek help in the past 12 months, and among those who had sought help, “just over half received minimally adequate treatment.”

The study defined minimally adequate exposure to psychotherapy as consisting of at least eight visits with a mental health professional such as a psychiatrist, psychologist or counselor in the past 12 months, with visits averaging at least 30 minutes.  How does VA mental health care treatment stack up against this definition of minimally adequate care?

The Rand study also found that “the VA too faces challenges in providing access to OEF/OIF veterans, many of whom have difficulty securing appointments, particularly in facilities that have been resourced primarily to meet the demands of older veterans. 

Better projections of the amount and type of demand among newer veterans are needed to ensure that the VA has the appropriate resources to meet the potential demand.  New approaches of outreach could make facilities more acceptable to OEF/OIF veterans.”

I think many of us believe that the VA health care system has been pushed to the edge in dealing with the mental health care needs of our veterans.  And, I believe that we are witnessing either an inability to address this problem, or a purposeful attempt to minimize the problems faced by veterans and the VA and sweep the epidemic of veteran suicides, and the mental health care needs of our returning servicemembers, under the rug.

So this morning we are going to attempt to get a better idea of the scope of this epidemic, and what the VA is doing to respond to it.  What specific steps has the VA taken since December, steps not previously planned before December, to get a better idea of the scope of the problem, and what has it done to begin to address the problem? 

Finally, I believe we must also seek real accountability from the VA, and, Mr. Secretary, we look to you to provide that accountability.