Veteran Suicide Prevention: Small Strides Forward

By Spring 2021 M-VETS Student Advisor Alexandra Morgan

For almost 10 years, the suicide rate among veterans has been 1.5 times higher than the rate for non-veteran adults.[1] Suicide is not an easy topic for anyone. Often times, the brave men and women who selflessly join the U.S. Armed Forces are portrayed and expected to be stronger than anything, even mental health. But as the statistics show, veterans may in fact be one of the most vulnerable populations. Awareness is the first step for any advocacy. It’s vital that U.S. citizens change the narrative surrounding the military, mental health, and veteran suicide. The tireless effort of advocacy groups, military families, and policy leaders has allowed the movement of veteran suicide awareness to drastically change the country from where it was a century ago. Until veteran suicide becomes a thing of the past, it is the responsibility of every U.S. citizen to spread awareness and continue the forward momentum.

History of Veteran Suicide Awareness & Prevention

Suicide among veterans is, unfortunately, not a new phenomenon. One study found reports from the Army Surgeon General as far back as 1843 that listed soldier and veteran deaths as “self-inflicted.”[2] However, awareness of the issue on a national scale has garnered attention only in recent decades. In fact, the United States did not see the opening of its first suicide prevention center until 1958 when a center was established in Los Angeles, California with funding from the U.S. Public Health Service.[3] Eight years later, the National Institute of Mental Health (NIMH) of the National Institutes of Health (NIH) established the Center for Studies of Suicide Prevention. Over the next 30 years, an increasing number of resources were allotted to study, understand, and combat suicide.

In the 1990s, suicide prevention became a central public policy issue. Both chambers of the U.S. Congress passed Congressional Resolutions that declared suicide to be a national priority and acknowledged that “no single suicide prevention program or effort will be appropriate for all populations or communities.”[4] It was not until 2007 that the first veteran-specific suicide prevention legislation made its way through Congress. The Joshua Omvig Veterans Suicide Prevention Act (JOVSPA) of 2007 emphasized the need for a comprehensive national strategy to combat the increasing numbers of veteran suicides.[5] The Act directed the Secretary of the Department of Veterans Affairs (VA) to establish a program providing education, counseling, and other resources to the veteran population.[6]

Since the enactment of JOVSPA, there have been a handful of federal initiatives aimed at meaningfully bolstering the country’s veteran-focused suicide prevention programs. In 2012, President Barack Obama signed Executive Order (EO) 13625, which was titled “Improving Access to Mental Health Services for Veterans, Service Members, and Military Families.”[7] Importantly, EO 13625 called for collaboration between the Department of Defense and the VA, including a year-long awareness and prevention campaign. Four years later, the VA launched REACH VET, a program that utilizes predictive modeling and medical record data to identify those veterans at highest risk for suicide.[8]

The VA published a 10-year National Strategy for Preventing Veteran Suicide in 2018 that laid out 14 goals relating to community involvement, improved healthcare options, and strengthened research and surveillance.[9] In 2019, President Donald Trump signed EO 13861, “National Roadmap to Empower Veterans and End Suicide,” which outlined a new Presidential taskforce charged with a number of researching and reporting duties.[10]

Current Status of the Crisis

In the short amount of time since veteran suicide prevention became a recognized national issue, resources available to veterans have increased exponentially. One of the most impactful developments in recent years was the creation of the Veterans Crisis Line (VCL), a free and confidential resource available to veterans whether or not they are enrolled with the VA.[11] Through the years, VCL has added online functionalities and text capabilities to increase access. To date, VCL reports that it has answered more than 5.4 million phone calls and dispatched emergency services to an individual in crisis over 184,000 times.[12] A number of other organizations—such as Suicide Prevention Lifeline, Vets 4 Warriors, and the American Foundation for Suicide Prevention—provide lifesaving resources to veterans and other U.S. citizens in need.

According to data released annually by the VA, veteran suicide continues to be a very real national crisis. While there was not a significant increase in veteran suicide rate from 2017 to 2018 (the data released in the 2020 report), the VA still reports an average of 17.6 veteran suicides per day.[13] Since 2008, the annual number of reported veteran suicides has exceeded 6,300.[14] Of note, the highest rate of veteran suicide occurs among those aged 18-35 years old.[15]

The 2020 Report reflects that federal efforts to prevent veteran suicide are paying off, even if in incremental amounts. In fact, one of the significant themes identified by the 2020 Report is that Veterans Health Administration (VHA) care matters. The veteran suicide rate for those who engaged in VHA care decreased by 2.5% while the rate for those who did not get VHA care increased at the same rate.[16] The decreasing rate of veteran suicides remains even when broken down by age, race, and ethnicity.

Prospects for the Future

Each session of Congress, veteran-focused bills are introduced but—like most legislation—only rarely see passage. Nonetheless, the bills introduced give a snapshot of the evolving national strategy. In the four months since the start of the 117th Congress, there have already been seven bills introduced relating to veteran suicide and mental health. A majority of the bills propose strengthening current aspects of the veteran suicide prevention programs. For example, one bill directs the Secretary of the VA to update the Lethal Means Safety and Suicide Prevention training course run by the VA.[17] Another bill requires the addition of a pilot program focused on suicide prevention to the Transition Assistance Program, a Department of Defense-run initiative that helps servicemembers transition to post-active duty employment.[18]

Most notably, Representative Andrew Garbarino (NY) introduced a bill entitled the “Veteran Suicide Prevention Act.”[19] This bill directs the Secretary of the VA to conduct a review of all veteran suicides in the 5-year period proceeding enactment of the bill.[20] This review would be required to capture specific data such as medication use, medical diagnoses, and combat experience/trauma. Rep. Garbarino’s bill has great bipartisan support with 16 Democrats and 10 Republicans co-sponsoring the legislation.

However, this isn’t the first time this bill has been considered by Congress. The Veteran Suicide Prevention Act has been introduced in the past five Congressional sessions. Each time, the bill does not make it past committee review. This is the story for many of the ideas presented to support veterans, mental health, and veteran suicide prevention. Even with bipartisan support, these bills struggle to make it through the gauntlet.

Looking forward, two points should be emphasized. To start, the data shows that current efforts are making a difference. Of course, no national crisis reverses course overnight. The VA’s 2020 Report—while undoubtedly sobering—provides a glimmer of hope and optimism. It is imperative that the federal government continues to prioritize the programs currently in place. Not only will that require continued funding but also a renewed sense of commitment to expanding resources.

Second, the power of collaboration should not be underrated. As the VA emphasized in the 2018 National Strategy, it cannot combat veteran suicide alone.[21] It will take the power of every agency, organization, and community collectively to truly cut down on the number of veteran suicides. Not only should the VA and the Department of Defense bear the duty of reducing veteran suicide but also the Department of Health and Human Service, the Department of Education, or even the Department of Justice. As with any nationwide critical issue, it will take the effort of the whole federal government to make meaningful strides in furtherance of ending veteran suicide.

[1] U.S. Dept. of Veterans Affairs, 2020 National Veteran Suicide Prevention Annual Report at 5 (2020) (hereinafter “2020 Report”), https://www.mentalhealth.va.gov/docs/data-sheets/2020/2020-National-Veteran-Suicide-Prevention-Annual-Report-11-2020-508.pdf.

[2] See Leo Shane III, Historic data on military suicide shows no clear link with combat operations, MilitaryTimes (Dec. 13, 2019), https://www.militarytimes.com/news/pentagon-congress/2019/12/13/historic-data-on-military-suicide-shows-no-clear-link-with-combat-operations/.

[3] National Action Alliance for Suicide Prevention, 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action, Appendix C (2012), https://www.ncbi.nlm.nih.gov/books/NBK109918/.

[4] S. Res. 84, 105th Cong. (1997); H. Res. 212, 105th Cong. (1997).

[5] H.R. 327, 110th Cong. (2007).

[6] Id.

[7] Exec. Order No. 13625, 77 Fed. Reg. 54783 (Aug. 31, 2012).

[8] See, e.g., Mike Richman, Crisis prevention: Study evaluates VA program that identifies Vets at highest risk for suicide, U.S. Dept. of Veterans Affairs (Sept. 20, 2018), https://www.research.va.gov/currents/0918-Study-evaluates-VA-program-that-identifies-Vets-at-highest-risk-for-suicide.cfm.

[9] U.S. Dept. of Veterans Affairs, National Strategy for Preventing Veteran Suicide at 12 (2018), https://www.mentalhealth.va.gov/suicide_prevention/docs/Office-of-Mental-Health-and-Suicide-Prevention-National-Strategy-for-Preventing-Veterans-Suicide.pdf.

[10] Exec. Order No. 13861, 84 Fed. Reg. 8585 (Mar. 5, 2019).

[11] What Is It, Veterans Crisis Line, https://www.veteranscrisisline.net/about/what-is-vcl (last accessed May 16, 2021).

[12] Id.

[13] 2020 Report at 4.

[14] Id. at 15.

[15] Id. at 19.

[16] Id. at 3.

[17] H.R. 2749, 117th Cong. (2021).

[18] S. 1296, 117th Cong. (2021).

[19] H.R. 1123, 117th Cong. (2021).

[20] Id.

[21] National Strategy for Preventing Veteran Suicide at 1.