VA SUICIDE PREVENTION PROGRAM
FACTS ABOUT VETERAN SUICIDE JULY 2016
VA believes every Veteran suicide is a tragic outcome. Regardless of the numbers or rates, one Veteran suicide is one too many. We continue to spread the word throughout VA that “Suicide Prevention is Everyone’s responsibility.” These new data about Veteran suicide will inform our Suicide Prevention programs and policies, especially for groups at elevated risk for suicide, including older and female Veterans. VA continues to address Veterans’ needs through strategic partnerships with community and federal partners and seeks to enhance these partnerships. Meanwhile, we continue to serve as a leader in evidence-based care for suicide prevention.
VA relies on multiple sources of information to identify deaths that are likely due to suicide and has undertaken the most comprehensive analyses of Veteran suicide rates in the U.S. We have examined over 50 million Veteran records from 1979 to 2014 from every state in the nation. This effort extends VA’s knowledge from the previous report issued in 2010, when over 3 million Veteran records from 20 states were available.
Veteran Suicide Statistics, 2014
- In 2014, an average of 20 Veterans died from suicide each day. 6 of the 20 were users of VA services.
- In 2014, Veterans accounted for 18% of all deaths from suicide among U.S. adults, while Veterans constituted 8.5% of the US population. In 2010, Veterans accounted for 22% of all deaths from suicide and 9.7% of the population.
- Approximately 66% of all Veteran deaths from suicide were the result of firearm injuries.
- There is continued evidence of high burden of suicide among middle-aged and older adult Veterans. In 2014, approximately 65% of all Veterans who died from suicide were aged 50 years or older.
- After adjusting for differences in age and gender, risk for suicide was 21% higher among Veterans when compared to U.S. civilian adults. (2014)
- After adjusting for differences in age, risk for suicide was 18% higher among male Veterans when compared to U.S. civilian adult males. (2014)
- After adjusting for differences in age, risk for suicide was 2.4 times higher among female Veterans when compared to U.S. civilian adult females. (2014)
Overview of data for the years between 2001-2014
- In 2014, there were 41,425 suicides among U.S. adults. Among all U.S. adult deaths from suicide, 18% (7,403) were identified as Veterans of U.S. military service.
- In 2014, the rate of suicide among U.S. civilian adults was 15.2 per 100,000.
- Since 2001, the age-adjusted rate of suicide among U.S. civilian adults has increased by 23.0%.§ In 2014, the rate of suicide among all Veterans was 35.3 per 100,000.
- Since 2001, the age-adjusted rate of suicide among U.S. Veterans has increased by 32.2%.
- In 2014, the rate of suicide among U.S. civilian adult males was 26.2 per 100,000.
- Since 2001, the age-adjusted rate of suicide among U.S. civilian adult males has increased by 0.3%
- In 2014, the rate of suicide among U.S. Veteran males was 37.0 per 100,000. • Since 2001, the age-adjusted rate of suicide among U.S. Veteran males has increased by 30.5%.§ In 2014, the rate of suicide among U.S. civilian adult females was 7.2 per 100,000.
- Since 2001, the age-adjusted rate of suicide among U.S. civilian adult females has increased by 39.7%.§ In 2014, the rate of suicide among U.S. Veteran females was 18.9 per 100,000.
- Since 2001, the age-adjusted rate of suicide among U.S. Veteran females has increased by 85.2%.
VA Aggressively Undertaking New Measures to Prevent Suicide Veterans Crisis Line Expansion
- The 24/7 Veterans Crisis Line (VCL) provides immediate access to mental health crisis intervention and support. Veterans call the national suicide prevention hotline number, 1-800-273-TALK (8255) and then “Press 1” to reach highly skilled responders trained in suicide prevention and crisis intervention. VCL also includes a chat service and texting option. We are continuing to modify phone systems to allow for direct connection to the VCL by dialing “7” when calling the VA medical center.
We are hiring over 60 new suicide intervention responders/counselors for the VCL
Each responder receives intensive training on a wide variety of topics in crisis intervention, substance use disorders, screening, brief intervention, and referral to treatment.
- Since the establishment of the VCL through May 2016 the VCL:
- Has answered over 2.3 million calls, made over 289,000 chat connections, and over 55,000 texts;
- Has initiated the dispatch of emergency services to callers in imminent suicidal crisis over 61,000 times;
- Has provided over 376,000 referrals to a VA Suicide Prevention Coordinator (SPC) thus ensuring Veterans are connected to local care.
Using Predictive Analytics to identify those at risk and intervene early
- Screening and assessment processes have been set up throughout the system to assist in the identification of patients at risk for suicide.
- The VA will use predictive modeling to determine which Veterans may be at highest risk of suicide, so providers can intervene early.
- Veterans in the top 0.1% of risk (who have a 43-fold increased risk of death from suicide within a month) are identified before clinical signs of suicide are evident in order to save lives before a crisis occurs.
- Patients who have been identified as being at high risk receive an enhanced level of care, including missed appointment follow-ups, safety planning, follow-up visits and individualized care plans that directly address their suicidality.
Bolstering Mental Health Services for Women
Since 2005, VA has seen a 154 percent increase in the number of women Veterans accessing VHA mental health services. In FY 2015, 182,107 women Veterans received VA mental health care.
- VA has enhanced provision of care to women Veterans by focusing on training and hiring Designated Women’s Health Providers (DWHP) at every site where women access VA, with 100% of VA Medical Centers and 90% of Community- Based Outpatient Clinics having Designated Women’s Health Providers.
- VA has trained nearly 2,500 providers in women’s health and continues to train additional providers to ensure that every woman Veteran has the opportunity to receive her primary care from a DWHP.
- VA now operates a Women Veterans Call Center (WVCC), created to contact women Veterans to inform them about eligible services. As of February 2016, the WVCC received 30,399 incoming calls and made about 522,038 outbound calls, successfully reaching 278,238 women Veterans.
- VA is leveraging telemental health care by establishing four regional telemental health hubs across the VA healthcare system.
- In FY 2015, 12% of all Veterans enrolled for VA care received telehealth-based care, totaling more than 2 million telehealth visits that touched 677,000 Veterans, including 380,000 telemental health encounters.
- Since FY 2003, VHA has provided more than 2 million telemental health encounters, expanding its role as a world leader in telehealth and telemental health services, including services provided directly into the Veteran’s home.
Expanding TeleMental Health Services
Free Mobile Apps to Help Veterans and their Families
VA has deployed a suite of 13 award-winning mobile apps to support Veterans and their families with tools to help them manage emotional and behavioral concerns. These include:
PTSD Coach (released 2011; 233,000 downloads in 95 countries) is a VA and DoD joint project and is widely acclaimed, winning numerous awards. It is a tool for self-management of PTSD, and includes: a self-assessment tool; educational materials about PTSD symptoms, treatment, related conditions, and forms of treatment; relaxation and focusing exercises designed to address symptoms; and immediate access to crisis resources, personal support contacts, or professional mental healthcare.
- CBT-i Coach for insomnia (released 2013; 86,000 downloads in 87 countries) was a collaborative effort between the Department of Veterans Affairs’ National Center for PTSD (NCPTSD), Stanford University Medical Center, and the Department of Defense’s National Center for Telehealth and Technology (T2). CBT-i Coach is a mobile phone app designed for use by people who are having difficulty sleeping and are participating in Cognitive Behavioral Therapy for Insomnia guided by a healthcare professional.
- ACT Coach for depression (released 2014; 23,000 downloads in 93 countries) supports people currently participating in Acceptance and Commitment Therapy (ACT) who want to use an app in conjunction with their therapist to bring ACT practice into daily life.
- Mindfulness Coach, (released 2014; 39,000 downloads in 95 countries) provides tools to assist users in practicing mindfulness meditation.
- Moving Forward (released 2014; 5,400 downloads in 54 countries) teaches problem solving skills and can be used in a stand-alone fashion or while participating in Problem Solving training.
Leveraging VA Vet Centers and Readjustment Counselors
Vet Centers are community-based counseling centers that provide a wide range of social and psychological services including professional readjustment counseling to Veterans and active duty Service members, including members of the National Guard and Reserve components who served on active military duty in any combat theater or area of hostility.
- There are 300 community-based Vet Centers, and 80 mobile Vet Centers located across the 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and the US Virgin Islands (www.vetcenter.va.gov).
- In FY 2015, the Vet Centers Vet Centers provided over 228,000 Veterans, Service members and families with over 1,664,000 visits.
- To use Vet Center services, Veterans or Service members:o Do not need to be enrolled with VA Medical Centers;o Do not need a disability rating or service connection for injuries from either the VA or the DOD, and;o Can access Vet Center services regardless of discharge character.
- The Vet Center Combat Call Center is an around-the-clock confidential call center where combat Veterans and their families can talk with staff comprised of fellow combat Veterans from several eras. In FY 2015, the Vet Center Combat Call Center took over 113,000 calls from Veterans, Service members, their families, and concerned citizens.
Telephone Coaching for Families of Veterans
Coaching Into Care (www.va.gov/coachingintocare) assists family members and friends in helping a Veteran seek care. Coaching Into Care provides a motivational “coaching” service for family and friends of Veterans who see that a Veteran in their life needs help.
Coaching involves helping the caller figure out how to motivate the Veteran to seek services. The service is free and provided by licensed clinical social workers and psychologists. Since the inception of the service in January 2010 through November 2014, Coaching Into Care has logged 18,088 total initial and follow-up calls.
Innovative Public-Private Partnerships to Reach Veterans
VA is working with public and private partners across the country with the goal of ensuring that wherever a Veteran lives, he/she can access quality, timely mental health care. VA is working with universities, colleges and health professional training institutions across the country to expand their curricula to address the new science related to meeting the mental and behavioral health needs of our Nation’s Veterans, servicemembers, and their families. • VA has recently partnered with the University of Michigan Health System and its Military Support Programs and Networks (M-Span) to support student Veterans as they transition from military to student life. Their Peer Advisors for Veteran Education (PAVE) program which is expanding to 42 campuses across the country and VA’s Veterans Integration to Academic Leadership (VITAL) and VA’s Peer Support Program will coordinate referrals, share resources and collaboratively help student Veterans successfully navigate college life and provide support.
VA is also supporting community provider organizations through innovative partnerships:
- VA recently partnered with the Bristol Myers Squibb Foundation (BMS-F) to share subject matter expertise across a range of topics relevant to Veterans and their families including: Student Veteran Programs, Caregiver Training Programs, Faith/Chaplain/Spirituality-based mental health Programs and other mental health and well-being programs.
- VA has also recently partnered with Give an Hour (GAH) to share training resources on various mental health topics to be disseminated to GAH’s provider network, so more Veterans have access to evidence-based mental health care and are competent in military culture. In addition, VA’s Make the Connection Veteran focused outreach campaign is collaborating with GAH’s Change Direction Campaign to reduce negative perceptions associated with seeking mental health care and promote mental health literacy among Veterans and the general public.
- VA has also partnered with Psych Armor Institute (PAI) to share subject matter expertise on a range of mental health and caregiving topics to help civilians better serve Veterans through training that PAI is delivering free of charge to the public and VA.
- VA Campus Toolkit (www.mentalhealth.va.gov/studentveteran) is a resource for faculty, staff, and administrators to find resources to support student Veterans and learn about their strengths, skills, and needs.
- VA is hosting annual Community Mental Health Summits at each VAMC. Each facility will focus on building new partnerships and strengthening existing partners to meet the needs of Veterans and Veteran families residing in their catchment area.
- Each VAMC has appointed a Community Mental Health Point of Contact to provide ready access to information about VA eligibility and available clinical services, ensure warm handoffs at critical points of transition between systems of care, and provide ongoing liaison between VA and Community Partners.
Maintaining the High Quality of VA Mental Health Care
The Altarum/RAND report, Veterans Health Administration Mental Health Program Evaluation (2011) concluded that, “Timeliness for mental/behavioral healthcare in VHA is as good as or better than in commercial and public plans.” A recent publication comparing VA mental health care to private sector care examined medication treatment for mental disorders, finding:
- Across 7 performance indicators, VA “performance was superior to that of the private sector by more than 30%.”
- The authors conclude that: “Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.”http://ps.psychiatryonline.org/doi/10.1176/appi.ps.201400537 Proactive Outreach to Reach Veterans Needing Care
- VA works proactively to connect Veterans and their families with the resources they need. In addition to VA’s Make the Connection outreach campaign and extensive suicide prevention outreach, many specific mental health programs and services have outreach as part of their efforts. Suicide Prevention Coordinators are required to conduct at least five outreach activities per month in all of their local communities and are able to provide a Community version of Operation S.A.V.E. to Veterans and others.
- Partnering with community organizations has broadened VA’s outreach efforts and promotes more positive outcomes from community providers.
- Make the Connection is VA’s award-winning mental health public awareness campaign. Its primary objectives are to highlight Veterans’ true and inspiring stories of mental health recovery, reduce negative perceptions about mental health and seeking mental health care and to connect Veterans and their family members with local, mental health resources.
- Over the past four years, Make the Connection has seen tremendous engagement with Veterans, Veteran family members, and supporters. Via MakeTheConnection.net, the campaign’s outreach efforts, and social media properties including Facebook and YouTube pages, the following has been achieved (through May 2016):
- 10.5 million website visits;o 333,000 resource locator uses (local VA and other community sources of support);o 14.4 million video views;
- 19,700 YouTube subscribers;o 3.4 million likes on the MTC Facebook page, making it one of the largest government Facebook communities in the country;o 39.8 million engagement actions on Facebook (likes, comments and/or shares);
- More than 2 billion impressions of the campaign’s Public Service Announcements, earning more than $27M in free, donated airplay; o Outreach has resulted in over 190 organizations broadcasting campaign messaging through their communication platforms and o More than 730,000 pieces of material distributed nationwide
For more information, Veterans currently enrolled in VA health care can speak with their VA mental health or health care provider. Other Veterans and interested parties can find a complete list of VA health care facilities, Vet Centers, their local Suicide Prevention Coordinators, and other resources under the resource section of www.veteranscrisisline.net or at www.va.gov.
For more information about this Fact Sheet, contact Dr. Caitlin Thompson, National Mental Health Director for Suicide Prevention and Community Engagement at 202- 461-4173.