National VA Research Week , held this year from May 16–20, is a national initiative to promote the role of the VA’s research in advancing medical science. Today, the VA’s achievements include a critical focus on mental health. Caitlin Thompson, the VA’s National Director of Suicide Prevention and Community Engagement, speaks with Assurex Health about the organization’s mental health mission—and how their research, outreach and advocacy programs will continue to improve mental health not just for veterans, but for the American community at large.
Q. Military and veteran suicide first became a hot-button issue nearly 10 years ago. What changes have you seen to address suicide prevention since then?
A. General Peter Chiarelli first brought this issue to the forefront of the Department of Defense (DoD) back then. The VA established their own suicide prevention program, specifically to address the needs of veterans, in 2007. That program put suicide prevention coordinators at every VA and large community-based outpatient clinic in the country. We now have more than 300 suicide prevention coordinators—and it’s their job to oversee local policy and ensure there is a culture of suicide prevention among all VA-related facilities. That program also established the Veterans Crisis Line, which provides individual crisis support 24/7, 365 days a year.
But suicide remains a huge issue. We know that about 22 veterans die by suicide each day. It’s an estimate, of course, but it’s the best estimate we have. And we know that 17 of those 22 veterans who die by suicide have never touched VA care. So what that tells us is that we’re doing something right. We know that treatment works—and we know that the veterans who are reaching out for treatment are getting the help they need. Our focus today is on providing more outreach to veterans who aren’t using the VA. Not to force them into VA services, but to make sure they are receiving the right services and care that they need.
Q. One of the biggest challenges has been changing military culture surrounding asking for help. How have you seen the culture changing since many of these DoD and VA initiatives have been implemented?
A. This is an issue that both DoD and the VA continue to struggle with because there is such a warrior frame of mind in service members and veterans. There is a stigma to coming forward and asking for help. General Chiarelli’s work was really helpful to combat that kind of culture. He made it more OK for soldiers to ask for help and not fear career repercussions.
We’ve been working with the DoD on specific outreach programs. But we understand we need to go beyond the service member. And that means a lot of our public service announcements and specific outreach now include efforts directed toward family members and friends, because we know that they are often the first people to recognize something is wrong. So even if the veteran isn’t asking for help, the family members can understand what resources are available and help them get connected with what they may need.
One of our latest projects, one that I’m really proud of, is Make the Connection. It’s a website where veterans, service members and family members can individualize their experience and see videos of veterans who have struggled with mental health issues and gotten better. You can log on and say, “I’m a male Vietnam veteran who saw combat,” and be connected to videos of other people like you, so you can see that you aren’t alone. These are the kinds of programs that can help us continue to lessen the stigma and change the culture.
Q. The VA is also putting significant investment in a new program called the Million Veteran Program (MVP) to create an unprecedented gene and biomarker database. How will that help with mental health care?
A. This program is going to help us collect a lot of data—and then connect that data with our other research data. We have a suicide data repository that we’ve developed in partnership with the DoD. But the genomic piece of the MVP is crucial. It’s so new and it offers some really exciting possibilities to better understand who may be at a higher risk for suicide. It can speak so much to potential predictors of suicide and suicidal behavior once we can actually put all this data together.
Q. Where do you see the VA’s suicide prevention efforts moving in the future?
A. We need to make sure that we continue to look ahead. The data piece is important, and the data we will have in MVP and the suicide data repository can help us shape policy. We will continue to do predictive modeling work and testing how to use that information in the field, so we can identify the veterans who are at high risk for suicide and provide the right interventions.
We also want to improve access to care. We’re continuing to work on ways to hire more mental health providers and then use telemental health (treating mental health issues remotely, by phone or other communications platform) to reach veterans who live in more remote areas. We will make to make sure we are putting our resources into research programs on things that are strongly connected to suicide. And, finally, we will collaborate with our partners on all of this. Our military partners, the community partners, and other interested parties—we need to share our processes and data so we can continue the mission of preventing suicide among veterans. It’s the only way to move forward.
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