Answering Email

I received this via email from a kindly Congressional staffer who wanted to make sure I had seen it. I do not know this staffer personally, but he read my post trashing the proposed Veterans Mental Health Treatment First Act. I appreciate that he sent this along, given that I have also written on Veterans Suicide Prevention (for which I took a lot of drubbing from those who think this is a "bash the military" meme… but who need to be reminded that Veterans – like non-Veterans -- commit suicide – most not because of their service, but in spite of it… and are worth saving one person at a time.) I think I might have scared the staffer off as I haven't had a response… yet.

Hi Carla –

I read your blog post on veterans' mental health, and thought you might be interested in this story.

Best,
K

FOR IMMEDIATE RELEASE

Contact: (Veterans' Affairs)

May 15, 2008

AKAKA USES OVERSIGHT AUTHORITY TO FORMALLY REQUEST SUICIDE DATA FROM DEPARTMENT OF VETERANS AFFAIRS

WASHINGTON, D.C. – Today U.S. Senator Daniel K. Akaka (D-HI) invoked his oversight authority as Chairman of the Veterans' Affairs Committee to formally request data from VA on veterans' suicides that is not otherwise available to the Congress. In a letter to Veterans Affairs Secretary James Peake, Akaka stressed the need for full and accurate data on the issue.

"We will not know the true cost of war until we know the true rate of suicides among veterans," said Akaka. "Until the VA mental health care system meets the needs of those who have served, we will continue to see the tragic consequence of veteran suicides."

In his letter, Akaka specifically requested the following from Secretary Peake:

• The total number of veterans who have committed suicide or attempted to commit suicide

• The number of veterans who have committed suicide or attempted to commit suicide while receiving care from VA
• Information on VA's efforts to improve outreach and assistance for veterans between the ages of 30 and 64
• All of VA's health care quality assurance reviews related to suicides and suicide attempts over the past three years

As Chairman of the Senate Veterans' Affairs Committee, Akaka is empowered by federal law to review medical quality assurance records that are otherwise not provided outside of the Department.

Akaka's request follows heightened concerns from Congress and others regarding veteran suicides. Last week, Secretary Peake testified that both male and female veterans are more likely than non-veterans to commit suicide. In recent weeks Akaka has sought action on veteran mental health issues, meeting with Secretary Peake, and working with the Senate Majority Leader to bring up S. 2162, the bipartisan Veterans' Mental Health and Other Improvements Act of 2008. According to a recent RAND study, nearly one in five Iraq and Afghanistan veterans – roughly 300,000 so far – report symptoms of PTSD or major depression, and fewer than half receive mental health care. [ed. Emphasis added.]

-END-

K,

Thank you for thinking of me. I admire and am deeply appreciative of the [legislator]'s work on behalf of Veterans. However, I have concerns about straight statistics and the twisting (the magic of bad statistics) that occurs when released (and used inappropriately as in the past.) By that I mean that data is used to promote political bashing rather than reflecting a true and sincere attempt to analyze why and how [fill in the blank] is occurring -- including how to "fix" the problem -- if, in fact, there is a problem and if it is fixable at all.

For example, I'd note that previously released data on the number of suicides within the active military (including Reserve and Guard) looked shocking; however, when compared historically and compared to the rate of suicide within the general populace (soldiers coming from the general population), the rates in every age, gender and ethnicity were the same as or lower than the general population (see, here for just one discussion and quasi-analysis). I suspect that the same might be evidenced in the veterans' suicide numbers.

The last statement of [this] press release also illustrates the "magic of poor statistics": the Rand study actually says (page 1 of the Rand Press Release; more on p. 3 of the Research Highlights) that "slightly more than half seek treatment"... and, we assume, all received treatment. Therefore, slightly more than half (53%) actually sought and received treatment. So it is not true that "fewer than half received treatment"; the correct statement is that just less than half did not seek treatment -- they never asked for it. Of course, the assumption being that if the 47% who also had "symptoms" had sought or would seek treatment, they, too, would receive it. I know these don't spin well into shocking headlines, but it is a disservice [to connect suicides and misquoted statistics] and undermines legitimate arguments for meeting the needs of the military and veterans' communities.

You can understand my reservation that data (on veterans' suicides) served up in a vacuum is not particularly relevant unless it is also tested in a broader sense. In order to determine whether the suicides are "relevant" to the Veterans' Affairs Committee's work, the focus should not be simply on the empirical number of suicides by veterans (and its use as evidence of some "failure" on the part of the VA) but the legitimate investigation must also include whether the suicides have some connection to the veteran's military service (for instance had service-connected PTSD), whether the veteran served in combat, whether they suffered some detectable mental health condition prior to their suicide, and whether they sought or were offered treatment, etc.

This same slant is evident in the headlines about homeless veterans: are they homeless for some reason unrelated to their military service and just happen to be veterans, or are they homeless because they are veterans?? That there are homeless veterans is not in dispute. WHY they are homeless and SHOULD that be a concern are the questions that should also be asked and answered. Military service is not always the cause of veterans' misfortune-- homelessness or suicide. Tragic and sad? Absolutely. Of course, if all the relevant data indicates that the VA could be doing something (or should be doing something) in this regard, we should all stand on our chairs and DEMAND that it be done (and demand appropriate funding with reasonable timetables!) But we all know that resources are finite and that there are things that can and should be "fixed" in the DoD and VA systems (see my posts HERE and HERE).

As for the "Veterans' Mental Health and Other Improvements Act of 2008", it certainly is terrific on its face (and in its intent certainly), but some of its provisions are so over broad -- requiring treatment for substance abuse, etc. whether or not such abuse/addiction is a result of or connected in any way to military service and extending to individuals who have been out of the military for decades?? I reiterate that resources are finite and question whether this is the best use of those resources to serve the largest group of veterans with needs (in other words, will veterans get the biggest bang for the bucks?) Has there been an identified need for such services (I have seen no such study or conclusions)? Is there a larger population of veterans with a need that will not be met by diverting such funding? I also might question the paternal attitude of trying to "fix" every problem of every veteran (or every citizen).

Finally, I find it notable that Senator Akaka is also seeking information on "outreach" efforts to older veterans, but know it's a hollow pursuit unless funding is restored to open up enrollment again in ALL VA health care priority groups that would permit such services to be offered to ALL veterans. And, it goes without saying that Congress must be willing to FUND and commit resources to the VA in order to do something about anything. There certainly is enough legislation [already] languishing in various Defense and Veterans Committees (e.g., legislation addressing the comprehensive Dole/Shalala recommendations) that sits simply because these proposed bills have become partisan in an election year -- Democrats hesitant to support a Republican-sponsored bill (and vice versa) for fear the "credit" for such legislation will inure to the "other" party -- all while Veterans and service members suffer and die while waiting for services and compensation. No one asked them what political party they were when they took their oaths and party shouldn't matter to do what's right on their behalf.

Thank you again for forwarding this. Please don't think this a rant against [the legislator] -- it isn't and it isn't meant to be. It's the result of frustration with a system that puts election year politics (hell, any year politics) ahead of the needs of those who protect and defend. As the wife a retired career Navy officer, and the mom to a serving US Sailor, a Navy vet and a disabled Army veteran, I know of what I speak.

Best regards,

Carla

Some Soldier's Mom