Caring for Veterans in Crisis: Ensuring a Comprehensive Veterans Health System Approach

Chairman Takano, Ranking Member Roe, and distinguished members of the Committee, on behalf of National Commander James Oxford and the nearly two million members of The American Legion, we thank you for the opportunity to address the important issue of caring for veterans in crisis. As the largest veterans service organization in the United States, we stand ready to assist this committee and the Department of Veterans Affairs to ensure that America’s veterans are provided with the highest level of support and healthcare.

The Comprehensive Approach

Veteran suicide is a national issue and far exceeds the ability of any one organization to handle alone. The American Legion stands behind the Department of Veterans Affairs (VA) in its efforts to collaborate with partners and communities nationwide to assist veterans in crisis. The public health approach looks beyond the individual to involve peers, family members, and the community in preventing suicide. Preventing veteran suicide is a top priority for VA, but they need help from dedicated partners to reach veterans who are in crisis.

On April 24, 2019, National Commander Brett Reistad teamed up with Dr. Keita Franklin, VA’s previous Executive Director of Suicide Prevention, and penned a letter emailed to nearly 850,000 American Legion members, family, and friends, to let them know that we are working together to adopt a public health approach to suicide prevention.

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It is imperative that the entire extended veteran network is involved in assisting veterans in crisis. Equally as essential is the need to centrally coordinate all efforts to ensure valuable resources are not squandered in duplicative efforts, as well meaning as they may be.     

In an effort to increase collaboration with partners and communities nationwide, The American Legion’s TBI/PTSD Committee developed a Mental Health Survey. The target audience was veterans and caregivers, of which 13,648 responded. The data collected indicated 82.47% of survey participants never received any form of suicide prevention training, and 67.39% of survey participants were somewhat likely, likely, or very likely to take suicide prevention training if offered. Survey participants identified training as a critical area and are ready to participate if the opportunity is made available.

VHA Staffing Issues

The American Legion remains deeply concerned by the trend of suicides reported at VA facilities. One contributing factor to the increase in suicide on VA campuses may be traced to staffing shortages experienced by VA hospitals and clinics. Data released in September 30, 2019, as mandated by the VA Choice and Quality Employment Act of 2017, reported 2,500 occupational staffing shortages across the VHA system. Of note, 60%  of the facilities noted severe occupational shortages for Psychiatry, making it the most cited clinical occupational shortage.

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The high rate of employee turnover, insufficient recruitment, non-competitive salary, geographical recruitment challenges, private sector competition, and drawn-out hiring processes attribute to shortages in VA personnel. These factors inherently lend themselves to overworked staff, poor patient experiences, and lower quality of care.

In keeping with The American Legion Resolution No. 115, Department of Veterans Affairs Recruitment and Retention, we urge Congress to pass legislation to improve VA’s tedious hiring process and increase VA’s recruitment, retention and relocation budget.

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  It will allow VA to retain quality mental health providers, incentivize exemplary performance, and increase employee morale. Improvements in these areas will lead to increased customer satisfaction and overall quality of care for veterans.

Access to Care for Rural Veterans

Connecting those who served to the medical resources they deserve is a top priority for The American Legion.

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Many veterans live in remote areas and are unable to access care in a timely manner which can create major issues in a time of crisis. The VA has taken action to address this issue by expanding its Telehealth capabilities, and has teamed up with The American Legion and Philips to bring VA healthcare to veterans in a familiar setting – their local posts. Through Project ATLAS (Accessing Telehealth through Local Area Stations), Philips will install video communication technologies and medical devices in selected American Legion and VFW posts to enable remote examinations through a secure, high-speed internet line. Veterans will be examined and advised in real time through face-to-face video sessions with VA medical professionals, who may be located hundreds or thousands of miles away. Project ATLAS aims to increase the convenience and accessibility of care which will prove to be essential to veterans in crisis.   

Conclusion

Chairman Takano, Ranking Member Roe, and distinguished members of this committee, The American Legion thanks you for holding this important hearing and for the opportunity to explain the views of the nearly 2 million members of this organization. The American Legion is committed to working with the Department of Veterans Affairs and this committee to ensure that America’s veterans are provided with the highest level of support. For additional information regarding this testimony, please contact Mr. Jeffrey Steele, Senior Legislative Associate of The American Legion’s Legislative Division at (202) 263-2993 or JSteele@legion.org