Understanding and identifying risk factors among patients who receive care is a top priority for clinicians and researchers in VA’s Veterans Health Administration (VHA). This is especially true when developing and analyzing the effectiveness of treatment for those most susceptible to suicide.
In the past eight years, VHA has enhanced mental health services across its system and supplemented it with specific programs for suicide prevention – like the Veterans Crisis Line. However, until recently information on suicide among all Veterans was not available. Earlier this month, a study on the changes in suicide rates for Veterans and non-Veterans was published that included indications that VHA patients were experiencing positive outcomes from care.
“Going into this study, we thought we would see a higher rate of suicide among VHA users,” Dr. Robert M. Bossarte said. “This is because sickness is a risk factor for suicide, and the basic assumption was that those seeking care would be at a higher risk than those who weren’t. The data showed the opposite was true: VHA users had a lower suicide rate than non-VHA users.”
Most importantly, according to Dr. Bossarte, the numbers—which were compiled from data provided by 23 states and VA’s Suicide Repository—pinpoint the population that is best helped by care and outreach initiatives. In this case: women Veterans.
While suicides among women Veterans increased by 40 percent from 2000 to 2010, compared to a 13 percent increase in women non-Veterans, the study shows that among women Veterans, those who use VA care have suicide rates as much as 75 percent lower than those who do not.
Male Veterans also saw reduction in suicide rates, about 20 percent, for those who used VHA services.
Standardized Veteran suicide mortality ratios, 2000 –2010
All lines in panel 1 and the total line in panel 2 are age and gender standardized. All other SMRs are gender stratified and age standardized. An SMR of 1 indicates that the number of observed deaths equals the number of expected cases. (Hoffmire, Kemp & Bossarte, 2015)
“I think it’s important to understand that the enhanced care that we provide at VA is making a difference,” Dr. Caitlin Thompson, Deputy Director for Suicide Prevention, said. “This study—which is the first in comparing suicide rates between both Veterans and non-Veterans and VHA users and non-VHA users—shows that VA treatment works. There is still much work to be done, especially for our Veterans who do not receive VA care. Through the information from this study, we can continue to better tailor our suicide prevention efforts so that we can ensure that ALL Veterans remain safe.”
One Veteran suicide is too many. Although the overall data shows Veterans are at higher risk for suicide than the general U.S. population, this study lays the groundwork for further research and proves VA’s efforts to curb suicides, especially when Veterans are in crisis, are making a significant impact.
Dr. Claire Hoffmire, lead investigator for the study, noted their ability to identify differences in suicide among Veterans who do and do not use VHA services is only possible because of the data obtained through partnerships with states and provides an opportunity to greatly increase understanding of risk for suicide among Veterans.
“Results from this study raise many important questions about suicide among women Veterans who do not use VHA services,” Dr. Hoffmire said. “However, we now have an opportunity to begin answering those questions”.
Learn more about VA services and programs
- Evidence-based therapies for PTSD, including prolonged exposure and cognitive processing therapy, have been shown to decrease suicidal ideation. These treatments are available at every VA medical center.
- The VA has numerous suicide prevention resources available including:
- Veterans Crisis Line (1-800-273-8255, PRESS1)
- Veterans Crisis Online Chat
- Suicide Prevention Coordinator at each VA Medical Center
- Comprehensive website with numerous other resources for Veterans and their families.
- VA has a Women Veteran Program Manager at every medical center who functions as an administrative leader for the Women’s Health Program, and an advocate for women Veterans.
- VA developed The Women Veterans Call Center, 1-855-VA-WOMEN (1-855-829-6636), to educate women Veterans about VA benefits and services. Call Center staff make referrals to Women Veteran Program Managers (WVPM), the Health Eligibility Center, the Veterans Benefits Administration and suicide and homeless crisis lines as needed.
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OK, folks. Is it a surprise to anyone that “VHA users had a lower suicide rate than non-VHA users?” The VA starts up a program(s) or service not offered before this (and why not?), and some Vets who had no options before go to the VA. Great. Those who still don’t trust the VA stay with what they had…and the suicide rate is higher without care than those getting any level of care at the VA. This is nothing to boast about. The comparison needs to be VA care vs other quality network care, whether DoD or civilian. This report is distracting us from the reality of the lack of quality programs and processes, beginning with access to care problems in the National News, but more importantly the lack of true preventive services and poor continuity and integration of behavioral health, emergency care, and the primary care provider. To give the VA credit, our entire nation is stuck with a crisis-oriented sick-care system, especially for mental health issues. The whole system needs to be turned on it’s ear. The VA actually started this brand of holistic healthcare delivery years ago with the invention of Primary Care Teamlets, but seems to have lost that direction. (I know this because I’m enrolled to one, and it’s not what it’s advertised to be.) What is more maddening is why the VA and entire DoD aren’t looking to repeat successes of other organizations, like the Henry Ford Health System in Detroit, who have figured out how to achieve zero suicides among those they are responsible for serving. While “one size doesn’t fit all,” the model works. To be sure, the VA does provide wonderful care in places, not due to their regulations, but due to exceptional employees who go the extra mile day in and day out. Thanks to those people for what they do. But let’s not throw up smoke screens with reports like this to make ourselves feel better, deflecting us from the real truth. We are better than this…and our Vets and their Families deserve a better level of care!
i think its time to start, releasing a few things to the IG and my old command. got a nice set of documents, digital video and pictures all ready to be picked up by UPS for the media as well. and congratulations to bob mac on his new found problems
lea wish i could post some contact info here for you but they would never allow it , never worth hurting yourself, you dont know me but i care and so do alot of others, just remember together we are strong and undefeatable stay with us because the mission isnt over and remember those values you learned in your service and apply them no matter what you have strength in integrity.
got a call today for a very nice lady from the crisis center who was trying to help and I agreed to let her get the VA to schedule an appointment for me and to their true colors as always while on the phone with the one lady who was trying to get the mental health lady to schedule and appointment for me the mental health lady at the other end in my CBOC was telling the my depression could be a medical condition because of my thyroid cancer and it would have to be ruled out before I could get an appointment with the mental health provider and my primary care doctor would have to schedule this and they wonder why we veterans do not trust them I am drowning here and told that crisis counselor things I have never told anyone and this is the crap I get from the VA here my town. I made a promise to someone that I would not harm myself and it s getting harder and harder to keep this promise I pray every day that God will give me the strength to keep it. Thank you all out there for the support but I sure am not getting from the VA.
The challenge is actually getting VA care…thats why we still see 22 vets a day still kill themselves. The delays have not been reduced…esp in mental health.
feel your pain here in NC too, every day it is like a puppy chasing his tail to get care and the VA Choice program what a joke have tried to use it 4 times and have never gotten a return call with approval or the paperwork to get outside care the only reason I have not finish my life is because I promised my fee-based pain management doctor that has long as the VA let me come to their clinic and work with their doctors that I can get better and deal with the pain and just the basis of existing and not living, but the day the VA stops paying for me to go there I will probably end it all because the VA could give a rats as about us.
dont do that lea the VA doesent care about you or me, but all of us veterans do .we have to care about each other and take care of each other because if we dont none of us will be left to come together and get the problems with the VA fixed , those responsible removed and tried for treason by a veteran tribunal, dont punish yourself for the failure of others, lets find our fortune together and have the hope of the fight and victory over those who would obscure us and seek our obsolescence , this country and its veterans administration still exist because of our blood sweat and tears, and we owe it to all our comrades who served with us and for us and never came home alive and those who felt they were betrayed and dishonored by their nation or sick from the poisons and testing the US government paid insurgent forces to use against our own troops, lost their hope and lives so we could live in their place would be for nothing. we have a duty to live and we are bound together in that duty. they should start by getting ready for a fight because they haven’t seen one like they are gonna get from me, and every veteran need to hold them accountable to their responsibilities with the same tenacity. im making it my lifes mission to change the VA attitude towards us and support our american veterans, when we walk into the VA they should shudder because they are in the presence of HERO or HEROINE and they can never know the sacrifice we knew nor were they ever bold enough to survive what we have and still live on. we should not be afraid of these VA servants because they serve the veteran and you all need to remember that and dont forget to remind them of that next time they use their backlog as an excuse why we should assume their problem is our problem….
I am totally stunned that so many people get less than satisfactory medical care at VA Hospitals. VA Hospitals and medical personnel saved my life on more than one occasion. I have been treated in Detroit, Washington DC, Baltimore and Martinsburg. Initially, I was a mess, I was destroying my life. My mental and emotional status were all screwed up. I resisted the treatment they were trying to provide. I didn’t believe the psychiatrists diagnosis. I wanted to do things my way and they kept trying to help me. I spent a lot of time on locked wards and in PHP. Eventually I got with the program. I started and continued the medications recommended to help me mentally. I received counseling and participated in veterans support groups specific to mental disorders. There were some small issues with certain personnel but it was nothing next to the good care and good Dr’s and medical personnel that cared for me. If there was a mismatch all I had to was request a provider change and it was done. They helped me to understand that I would be taking medication to balance my mental status for the rest of my life. The VA has been a Godsend for me, they helped me turn my life around. I have many physical problems along with the mental issues I found my experience with the Drs and medical and medical personnel to be much better than the civilian Dr’s and hospitals I frequented prior to coming to the VA. Certainly there are glitches in the system but that the same in any big organization dedicated to the support of thousands of people. I think if problems are reported by enough people fixes will be implemented ( sounds a little idealistic). However, there will always be the issues of money available, finding quality personnel, clinic demographics, etc. I hope that the powers of the VA Healthcare organization will aspire to make all of the VA hospitals better places for medical care, my heart goes out to the Veterans who have received inferior care.
Indiana system is exactly as described above, VA care is absolutely nonexistent, even if you can make it to a VA facility, you will likely be denied care, you probably wont even find yourself in front of a licensed physician, personally if the VA were dismantled and one years budget was distributed amongst ALL LIVING VETERANS we would all be multi millionaires the people of the united states would save billions every year , the economic impact of veterans with actual resources would be immense and we could seek and manage care both physical and psychiatric as needed with doctors we know and who give a hoot because they are getting paid by their patient. imagine veterans sharing the fruits of their labor instead of facilitating federal employees to live comfortably while we sleep on the streets or relegate to our final alternative of suicide which so many have already done. your self glorifying is disgusting and vile to the highest order, it makes me physically and emotionally sick when i constantly see and hear on tv print internet ads twitter and facebook how the va does so much for us, yet those of us who fought YOUR enemy as our own , we face the same corruption we went to stop. when we return home and as fate has it have survived the enemy we are killed by those who would call themselves friend..(place blame here)…..sometimes thank you is not enough, a lesson unfortunately the ungrateful will never learn.
Total BS. I have seen first hand in Denver how much the VA cares. Dr. (Name redacted) in the Aurora clinic should lose her license for malpractise. I am fortunate I am not dead because of her total incompetence. It’s in my medical records. Stop the lies. Stop using skewed statistics. Stop using Dr’s that tell you if you do not like something to call my congressman. The mental health program in denver is absolutely horrid. The life skills center is a joke run by people like (Name redacted) whom other counselors consider an arrogant ass. I will NEVER GO BACK TO THAT PLACE. By the way, since January, I have not had a psychiatrist at the Denver VA. I WAS STRONGLY URGED TO NOT SEE HER (Name redacted) EVER AGAIN BY A VERY GOOD FRIEND THAT IS AN INTERNIST THAT VERIFIED ANOTHER VA PROVIDERS SHOCK AT SEEING SHE PUT ME INTO A SUDDEN DEATH SYNDROME because of her prescribing habits. Save your lies. Tell the truth. You are part of the problem.