Recently, Department of Veterans Affairs (VA) Secretary Dr. David Shulkin declared suicide prevention his top clinical priority. As part of his prevention effort, effective July 5, 2017, VA began offering veterans with other-than-honorable (OTH) administrative military discharges, an estimated 500,000 veterans, access to the full array of VA services if they require emergency mental health treatment. Former service members may enter the system to use this benefit by visiting a VA emergency room or Vet Center or by calling the Veteran Crisis Line. If it is determined to be a mental health emergency, the veteran may qualify for up to 90 days of care, which can include inpatient, residential, and outpatient care. During this time, the Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA), will work together to determine if the veteran’s mental health issue is related to military service, which would make the veteran eligible for continuing medical care.
The Government Accountability Office reviewed military documents of veterans with OTH discharges between 2011 and 2015, and found that over 13,000 veterans with post-traumatic stress disorder and traumatic brain injury received OTH discharges. According to the military’s policy, these factors should have been considered in the character of discharge decision, but were not. Prior to Secretary Shulkin’s change in policy, these veterans with OTH discharges generally lacked access to VA mental health care services.
Despite VA’s dedicated efforts to reduce veteran suicide an average of 20 veterans per day take their own lives, 21 percent higher than non-veterans. In order to reduce this number VA established a crisis line and placed suicide prevention coordinator teams at every VA medical center. To date, the crisis line has answered 2.3 million calls, participated in 289,000 chats, replied to 55,000 texts, dispatched emergency services over 61,000 times, and provided over 376,000 referrals to VA suicide prevention coordinators. Most recently, the VA announced its efforts to train all its employees to recognize suicide warning signs to help ensure vulnerable veterans do not fall through the cracks. Recent independent assessments by Altarum and the RAND Corporation, found that the VA provides mental health and suicide prevention services that are superior to the private sector by as much as 30 percent across seven different performance indicators.
VA has made significant improvements in its mental health and suicide prevention services and the Department reports that veterans who choose VA are at lower risk for suicide. Unfortunately, many veterans do not elect to use VA, or they are ineligible to receive care. Secretary Shulkin noted that 70 percent of veterans who commit suicide are not regular VA patients. The most comprehensive study to date covering veteran suicide, published in July 2016, further demonstrates the increased risks for veterans who do not utilize VA services. This study found that since 2001, the rate of veterans using VA services who committed suicide increased by 5.4 percent, compared to an increase of 38.4 percent for those who did not use, or have access to, VA’s health care services. The statistics for female veterans are of particular concern. During the same time period, the rate of female veteran suicide decreased by 2.6 percent for VA users, but increased by 81.6 percent for women veterans who did not use VA services.
While more work is required to eliminate veteran suicide, this new policy to expand mental health care to eligible veterans with OTH military discharges is a step in the right direction. Secretary Shulkin stated, “we want these former service members to know there is someplace they can turn if they are facing a mental health emergency.”
Veterans in crisis should call the Veterans Crisis Line at 800-273-8255 (press 1), or text 838255.