Health

A Trump executive order aims to bring down veteran suicides. Will it help?

The campus of the West Los Angeles VA Medical Center.
The campus of the West Los Angeles VA Medical Center.
Nancy Pastor for NPR

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About 20 veterans kill themselves every day in the U.S. The VA says the annual veteran suicide rate in California is around 39 per 100,000 people. That’s significantly higher than the suicide rate for the state population as a whole: 14 per 100,000. 

Since taking the top job at the Department of Veterans Affairs, Secretary David Shulkin has pledged to bring the number of veteran suicides down. 

President Trump helped boost this effort with an executive order signed last week. It guarantees one year of mental healthcare to all troops separating from the military. 

At the White House signing ceremony, Shulkin said 60 percent of new veterans currently don’t qualify for mental health care at the VA, and the first year of transition into civilian life is critical.

“That 12 month period after you leave service is the highest risk for suicide,” Shulkin said. “Almost 1½ to 2 times higher risk in that first 12 months when you leave the service.”

The President’s order directs the Departments of Veterans Affairs, Defense, and Homeland Security to put together an action plan within 60 days to implement the new policy. The VA is expected to begin providing mental health treatment and suicide prevention services to all newly separated servicemembers on March 9th.

The VA said in a statement the services will include a peer support call center run by the Department of Defense and the expansion of resources from the Military One Source program, normally reserved for active duty members, to newly separated veterans.

There are also plans to expand the VA’s Whole Health initiative, which creates a personalized health plan for patients including “the physical, mental, emotional, spiritual, and environmental elements that work together to provide the best quality of life for each Veteran.”

There are currently 18 Whole Health Flagship facilities, including the Greater Los Angeles VA Healthcare System. A spokesman told KPCC their programs include mindfulness, acupuncture, yoga and tai chi, and they are the only facility in the nation implementing a practice called “Mindful Self-Compassion.”

The Los Angeles VA spokesman added: “Over the past year we have hired 23 additional providers in mental health across our catchment area. We have developed a system for same day access for mental health across all sites and have increased telemental health to improve access to Veterans.”

Local service providers worry the VA already faces steep challenges connecting veterans to care. First: how to pay for it. 

“This doesn’t talk about funding. It talks about coming up with a plan,” said Steve Peck, CEO of the Los Angeles-based housing and services nonprofit U.S.VETS. “I’m hoping they will devote more money to this, because there is a tremendous need.”

Peck said there are major obstacles to expanding the VA’s mental health reach, including the stigma among military members against admitting they need help. There’s also an ongoing struggle to improve the patient experience at the VA. The agency’s reputation has taken a hit due to recent scandals involving long wait times and falsifying records.  

“Even though they do provide some terrific services, the reputation is that it’s bureaucratic and there are long wait times,” Peck said. “A lot of veterans don’t want to go to the VA.”

Peck said he hopes the VA partners with community organizations who have a broader reach connecting with local veterans.  

“I always think it’s a mistake for the VA to say, ‘we are going to handle the problem by ourselves,’” Peck said.

Peck said he would also like to see the VA focus on working with the Department of Defense to connect with troops in the six months before they separate from the military, as well as finding a way to maintain that contact for years after service. This would allow for a smoother access to health records, especially for those veterans who have experienced combat and may face challenges related to PTSD or other conditions. 

“A lot of the homeless veterans that we deal with don’t become homeless for several years,” Peck said. “So this has to be part of a larger plan that maintains contact with these veterans for several years after they transition.”