The ‘needle hasn’t moved’ far or fast enough on suicide prevention efforts

Elizabeth Howe
September 27, 2018 - 3:45 pm

(Photo by Michael B Zingaro)

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The House Committee on Veterans’ Affairs held a hearing on Capitol Hill today to discuss veteran suicide prevention — maximizing effectiveness and increasing awareness. While the committee commented several times on the positive impact of veteran suicide prevention efforts thus far, the numbers from the most recent National Suicide Data Report released by the VA this week were fresh in everyone’s mind.

“These numbers leave me with a lot of questions — ones I hope we can find the answers to today,” said committee Chairman Phil Roe

The five-member panel included Dr. Gregory Brown, director of the Center for Prevention of Suicide; Michael Richardson, Wounded Warriors vice president of independent services and mental health; retired Lt. Col. James Lorraine, president and CEO of America’s Warrior Partnership; Bill Mulcahy, co-founder of Guard Your Buddy and Dr. Keita Franklin, VA national director of suicide prevention.

The two-hour hearing covered a wide range of the factors that impact veteran suicide and veteran suicide prevention including advances in technology, restructuring the stigma around mental illness and research on program effectiveness. Many of the questions posed by committee members were not asked so much so for immediate answers but as the beginnings of further research.

For example, one committee member emphasized the impact of homelessness on veteran suicide — 35.8 veterans per 100,000 have taken their own lives while 81 per 100,000 veterans who have experienced homelessness in the past year have done so — to prompt a stronger focus on this specific factor.

“If we prevent homelessness, we can prevent many veteran suicides,” said Representative Scott Peters.

Another committee member, Representative Elizabeth Esty, brought up the link between firearms and veteran suicide.

“Recognize in our country that we have the second amendment, which I’m in favor of, but for men, in particular, it’s a huge issue,” said Esty. “Sixty-six percent are using firearms and the access that veterans have to firearms is pretty great.”

Throughout the hearing, several topics came up again and again: synchronization and overdoses.

“The needle's not moving,” said committee member Representative Jodey Arrington. “We’re spending a lot of money, we’ve got a lot of programs — 1,100 — and it’s frustrating.”

Many of the questions and topics of discussion focused on the idea of further collaboration, more effective synchronization of these 1,100 programs and aggregation of the plethora of data available in order to see some movement towards the ultimate goal of zero veteran suicides. Between the VA and the Department of Defense, between the private sector and the government, between different prevention programs, between various research projects — separately these efforts have not succeeded. Much of the hearing’s conversation was about combining these efforts.

And overdoses.

Congressman Mike Coffman (D-CO) told the story of Marine veteran, Noel Harter, who was given a strong psychotropic anti-depressant that required close monitoring. He was never scheduled for a secondary VA appointment and soon thereafter killed himself. This brought up concerns about how VA’s prescription behaviors could contribute to a higher risk of suicide.

“By having a drug-centric modality of treatment where it is a drug to sort of stabilize them, then it’s another drug to help them go to bed at night, then it’s another drug to help them get up in the morning, and not too far along, they’ve got a cocktail of drugs.

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Dr. Keita Franklin, the VA’s National Director of Suicide Prevention explained VA needs to analyze more data surrounding prescriptions so that medications aren’t the first line of defense for veterans.

“I would offer that we get to a place where we’re looking at the data on that so how much are we prescribing? Over what period of time? And do we have goals around that,” said Franklin. “Talk therapy, like community-based interventions, support structures so that it’s used when it needs to be used but it’s not necessarily the first and the go-to and/or only treatment method.”

40 percent of all U.S. opioid overdoses deaths involve a prescription opioid. As the awareness of prescription-related suicides rises, VA continues to create more developments to prevent overdoses in the veteran community. Recently they added naloxone kits, an opioid antidote, to Defibrillator cabinets.

But even medication is only one piece of the veteran suicide conversation. From agency communication to drug safety, suicide is complex.

Many of the individuals in the room had a very personal connection to the cause — committee members, panel members and audience members alike.  

“This is the most important hearing happening on Capitol Hill today,” said ranking member Representative Tim Walz despite the Kavanaugh hearing underway across the courtyard. “Because of the heartache here and what needs to be done...We’re at the beginning of this journey.”

Watch the full hearing here.

Kaylah Jackson also contributed to this article.

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