Improved services might not help prevent veteran suicides, if the victims are not under VA care, according to VA Secretary Eric Shinseki. Speaking at the conference, he said that aggressive outreach to veterans and their families must be part of VA’s prevention efforts.

“Most veterans who commit suicide, perhaps as many as two out of three, are not enrolled in the VA healthcare system. So, as good as we think our programs are, we don’t even get a shot at these veterans,” Shinseki noted.

Leadership Key for Prevention

In outlining DoD’s suicide prevention efforts at the conference, Panetta said leadership has a key role in suicide prevention.

“All those in command and leadership positions, particularly junior officers and NCOs who have day-to-day responsibility for troops, need to be sensitive, need to be aware, need to be open to signs of stress in the ranks, and they need to be aggressive, aggressive, in encouraging those who serve under them to seek help if needed,” Panetta said. “They also must set an example by seeking help themselves, if necessary.”

Secondly, he said quality and access to healthcare must be improved.  DoD has more than 9,000 psychiatrists, psychologists, social workers, mental health nurses and counselors working in military hospitals and in military clinics. Now, “behavioral-health experts are now being embedded into line units, and the department has worked to place mental-health providers in primary-care clinics in order to facilitate access.”

Still, he pointed out that guardsmen and reservists often do not have ready access to the same support network as the active-duty force.

Panetta also said DoD is working to better identify mental-health conditions and noted that he had recently ordered a militarywide review of behavioral-health diagnoses. The Army already had initiated an investigation into the accuracy of mental-health diagnoses after a controversy at Madigan Army Medical Center in Tacoma, WA, where hundreds of soldiers with PTSD may have had their diagnoses changed.

“We’ve got to do everything we can to make sure that the system itself is working to help soldiers, not to hide this issue, not to make the wrong judgments about this issue, but to face facts and deal with the problems upfront and make sure that we provide the right diagnosis and that we follow up on that kind of diagnosis,” Panetta told the conference audience.

He cited other suicide-prevention initiatives, including efforts to elevate mental fitness to the same level of importance as physical fitness and increasing research in suicide prevention. 

Panetta said his long-term goal for DoD “is to be a game-changing innovator in this field.” 

“Just as we helped foster the jet age, the space race and the Internet, I want us to break new ground in understanding the human mind and human emotion,” he said.

More Mental Health Staff 

Shinseki told the conference that the VA has hired more than 4,000 mental-health professionals in the past four years and plans to hire another 1,600 professionals this year, raising the total mental health clinical staff to nearly 22,000 professionals.

Outside of programs to reach veterans, Shinseki said the VA must take a close look at out how substance abuse contributes to suicides, asking, “If substance abuse is the leading cause of homelessness, and homelessness, substance abuse and suicides are all related, do we address substance abuse sufficiently in our consideration of suicides? Are we courageous enough to ask whether our medication policies contribute to homelessness and suicides, as well?”

He also emphasized it is important that DoD and VA strengthen their collaboration to help troops move from one care location to another. “We simply must transition them better,” he said.

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