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Witness Testimony of Thomas J. Berger, Ph.D., Vietnam Veterans of America, Senior Analyst for Veterans’ Benefits and Mental Health Issues

Mr. Chairman, Ranking Member Miller, Distinguished Members of the House Veterans’ Affairs Subcommittee on Health and honored guests, Vietnam Veterans of America (VVA) thanks you for the opportunity to present our views on oversight of the Department of Veterans’ Affairs Suicide Prevention Hotline”.  We should also like to thank you for your overall concern about the mental health care of our troops and veterans.  With your permission, I shall keep my remarks brief and to the point.

The subject of suicide is extremely difficult to talk about and is a topic that most of us would prefer to avoid.  But as uncomfortable as this subject may be to discuss, VVA believes it to be a very real public health concern in our military and veteran communities, and as veterans of the Vietnam war and those who care for them, many of us have known someone who has committed suicide and others who have attempted it.

In 2003 media reports of suicide deaths and suicide attempts among active duty OEF and OIF soldiers and veterans first began to surface after a spate of suicides in Iraq during the first months of the war.  Subsequent major television news stories, independent research studies and additional investigative reports (including the release of e-mails from a top-level VA administrator who seemingly suggested not disclosing veteran suicide information to the media) disclosed the high rate of suicides and suicide attempts in our nation’s veteran community. All this culminated in the announcement by VA Secretary Dr. James Peake in the late spring of 2008 that the Department of Veterans Affairs (VA) had formed a blue-ribbon panel of mental health experts to study and develop recommendations to help reduce the number of suicides among America’s veterans.

On Tuesday, September 9, 2008 the VA issued a press release which stated that the panel had completed its draft report “praising the VA for its comprehensive strategy in suicide prevention that includes a number of initiatives that hold great promise for preventing suicide attempts and completions.”  Among the items addressed in the draft report was the VA’s Suicide Prevention Lifeline or suicide hotline, initiated in July 2007 in conjunction with the Substance Abuse and Mental Health Services Administration (SAMHSA).  According to the press release, “nearly 33,000 veterans, family members or friends of veterans have called the lifeline…” and “Of those, there have been more than 1,600 rescues to prevent possible tragedy.”  

The Suicide panel report dated September 9, 2008, stated: “The suicide rate among young male veterans who served during the Iraq and Afghanistan wars reached a record high in 2006, the latest year for which records are available, according to data released by the Department of Veterans Affairs.” The question that occurs is what impact, if any, have the measures taken by the Department of Veterans Affairs (including the “hotline”) and/or the Department of Defense had on the apparent diminishment of the rate of suicides among this group in the last two years? Has there been any change in the way in which these statistics are gathered or compiled during this period?

In the absence of any yet implemented VA national suicide surveillance plan or program for veterans, these call data seem impressive, and the VA is to be congratulated in this endeavor because one veteran  “rescued” from suicide is worth the effort, but real questions remain, for example --

  • What is the daily number of calls?
  • How many calls have to be re-routed to high-volume back up call centers?
  • What is the definition of “rescue”?
  • 1,600 “rescues” represents only .048 percent of the calls.  What is the status of the rest of the calls?
  • Is there a follow up/tracking procedure? For one month? For three months?
  • How many calls are from veterans already enrolled in the VA system?
  • How many have attempted suicide previously?
  • How many veterans participated in combat?

The VA deserves congratulations on the implementation of the suicide hotline as it represents a cornerstone in its strategies to reduce suicides and suicidal behaviors among veterans.  However, the real “first line of defense” against suicide for the last twenty five years has been the VA Vet Centers of the Readjustment Counseling Service of the Department of Veterans Affairs (VA). There is still a need to hire additional professional counseling staff at existing Vet Centers, in order that the Vet Centers have the organizational capacity to meet all of the demands and needs of every generation of combat veterans.

Further, the hotline can be improved upon significantly by instituting a better tracking system, linking into VA health care, better identification of where the veterans served, and other significant epidemiological markers.   We encourage this Subcommittee to exercise diligent oversight as the VA addresses the eight major recommendations of the blue ribbon work group on Suicide Prevention.

I shall be glad to answer any questions you might have. Again, I thank you on behalf of the Officers, Board, and members of VVA for the opportunity to speak to this vital issue on behalf of America’s veterans.