Military suicides have been a serious problem for decades, but in the last few years, the crisis has taken a new turn as despairing veterans express their frustration at substandard care in a striking way: by committing suicide in the parking lots of VA hospitals. Literally referred to as “parking lot suicides” by the VA, these tragic deaths are veterans’ way of testifying to the system’s many failures. Though the VA contends that veterans have access to same-day mental health services, recent tragedies are forcing the federal government to take a closer look at what’s happening at the VA.
Waiting Room Suicide Shakes Community
While the parking lot suicides were shocking – there were 19 between October 2017 and November 2018 – it was a waiting room suicide that took place at an Austin VA hospital that shook the nation. Referred from another VA clinic, Terry O’Hearn had attempted suicide previously in 2016, and was just 30 when he died in a crowded VA hospital waiting room. Over 100 people witnessed his suicide, which took place days after O’Hearn was discharged from the psychiatric ward against his mother’s recommendation.
O’Hearn’s suicide was one of three that took place in a span of just five days; there were two others at VA clinics in Georgia that same week, but because it took place in a waiting room rather than a parking lot, the community expressed greater shock, and was itself traumatized. And while parking lot suicides are typically meant to subtly attract community attention, O’Hearn’s actions were far more desperate.
The Scope Of The Problem
In order to understand how the VA found itself surveilling its grounds for potential suicides – staff members intervened in about 220 potential suicides during the same October 2017 to November 2018 period mentioned above – it’s important to consider two key factors. First, there is the stigma veterans face in addressing mental illness. Second, is the underlying staffing problems facing the military and the VA alike.
When it comes to stigma, members of the military may struggle to discuss mental health issues such as trauma, depression, and anxiety because, as warriors, they are expected to be strong and stoic. And public perception is that mental illness is a sign of weakness. It may also be an indicator that one is unfit to serve – even if only in the same way that a broken leg would make a person unfit. While this shouldn’t be the case, the stigma persists.
As for the staffing issue, too few soldiers means that those who are experiencing mental illness aren’t able to take enough time off to address the issue. And when they return home for treatment, they find a veteran’s health system with over 40,000 vacancies. It’s no surprise that veterans can’t access appropriate mental health services; there just aren’t enough professionals to treat them.
In light of the current problems, VA officials must consider what they can do to meet user needs. Hiring increases haven’t substantially changed the vacancy numbers and veteran suicides continue apace. One solution may be to emphasize efficiency using new technology. AI featuring machine learning could be used to analyze calendars within the VA system to make the best use of available treatment slots. Similar software could also be used to identify patterns of missed appointments and identify the highest risk patients and fast track them into treatment.
Undertaking A Review
The large number of parking lot suicides had put the VA under pressure to examine its treatment of veterans with mental health issues, as well as its operating procedures, but Terry O’Hearn’s suicide has sent the system into crisis mode. Joe Chenelly, executive director of American Veterans, an advocacy group, recently wrote to a number of federal bodies involved in veterans affairs demanding action on the suicide epidemic. Despite enormous spending efforts, he says, there has been no reduction in the number of veteran suicides and the actions of those affected are increasingly desperate.
Of course, VA spending may be high, but that doesn’t matter if that spending isn’t appropriately targeted. A 2018 GAO report revealed significant shortcomings in the VA’s suicide prevention programming, including a lack of clear goals for suicide prevention outreach, no consistent leadership, and a drop off in outreach content production. Though the VA’s public message suggests that they are doing everything possible to reach veterans in need, their work on the issue demonstrates a lack of commitment in this area.
The onus is now on the VA to improve its suicide prevention efforts, but they will require more consistent leadership to do so, as well as a more stringent commitment to existing policies. This includes ensuring proper follow-through on the January 2018 Executive Order requiring automatic enrollment of all veterans in VA mental health services.
The VA might also consider implementing new deep learning technology to help predict which veterans are at the highest risk of committing suicide. Already the Department of Energy is partnering with a number of independent labs to study suicide patterns in high risk populations. This could allow the VA to identify precipitating factors and intervene more effectively to prevent suicide among those at the greatest risk. Only with the advent of highly advanced AI tools has this approach become possible, but it could be transformative. While veteran suicide rates are high, the VA also has a strong record in terms of intervention. With more information, care providers could improve further.