Harkin Vows to Break VA’s Silence on Veterans’ Suicide Crisis

In light of the adage “Truth is the first casualty of war,” the U.S. Department of Veterans Affairs (VA) is under fire for allegedly covering up the suicide crisis among our nation’s veterans in November.

The veterans’ rights group, Veterans for Common Sense, filed a class-action suit against the VA, and a federal court in San Francisco began hearing the case last Monday. The case, backed by internal e-mails written by Dr. Ira Katz, the VA’s head of mental health, and procured by CBS News, alleges that the VA is deliberately concealing the risk of suicide among veterans.

“The system is in crisis and unfortunately the VA is in denial,” veterans' rights attorney Gordon Erspamer told CBS last Monday.

Congress took up the issue Thursday, when U.S. Sens. Tom Harkin, D-Iowa, and Russ Feingold, D-Wis., introduced a bill, the Veterans Suicide Study Act, which would require the VA to track veterans’ suicide rates annually and report its findings to Congress. Moreover, the bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since Jan. 1, 1997.

“We are looking at a real crisis among our veterans and it is high time the VA recognizes it,” Harkin said in a statement. “Tracking the number of suicides among our veterans will help us to better understand the true depths of this crisis so we may ensure we are doing everything we can to address their mental health needs. It is shameful to lose those who have served our country to suicide simply because they do not have the support they need.”

Katz told CBS in November that “there is no epidemic in suicide in VA,” but changed his story a few months ago. In a letter written to his top media adviser, Katz wrote: "Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our medical facilities."

However, an e-mail labeled “Not for the CBS News Interview Request” that was sent in November indicates Katz may have been trying to conceal the actual numbers.

The e-mail drew the ire of Rep. Bob Filner, D-Calif., who chairs the House Committee on Veterans Affairs, last week. "This is disgraceful. This is a crime against our nation, our nation's veterans," Filner told CBS News. "They do not want to come to grips with the reality, with the truth."

In an e-mail late Monday to CBS News, Katz wrote that the reason the numbers were not released was due to questions about the consistency and reliability of the findings -- and that there was no public cover-up involved.

Nonetheless, Katz has drawn attention from congressional members, some of whom are calling for Katz to step down, including members of the Senate Veterans Affairs Committee: Sens. Daniel Akaka of Hawaii and Patty Murray of Washington.

"Dr. Katz's irresponsible actions have been a disservice to our veterans, and it is time for him to go," Murray told the Washington Post. "The No. 1 priority of the VA should be caring for our veterans, not covering up the truth."

Moreover, the Washington Post reported that Akaka, the committee's chairman, said in a letter to the VA that Katz's "personal conduct and professional judgment" had been called into question by his response to veteran suicides. Veterans, and the VA itself, "would be best served by his immediate resignation," Akaka said.

In the meantime, Feingold, the bill’s coauthor, is concerned about the mental health of veterans returning from Iraq and Afghanistan. “The fact that the VA has no real data on the suicide rate among veterans shows how much needs to be done to address the mental health needs of veterans,” Feingold said in a statement. “With ongoing reports showing that service members are returning from combat with alarming rates of mental health problems, understanding and responding to these problems is critical to preventing deaths.”

The Veterans Suicide Study Act is a companion to the Joshua Omvig Suicide Prevention Act introduced in the House by Rep. Leonard Boswell, D-Iowa, and pushed through the Senate by Harkin, despite a procedural move by Sen. Tom Coburn, R-Okla., that temporarily stalled the bill.

Similar to the bill introduced last week, a component of the suicide prevention legislation was to put more pressure on the VA and hold it more accountable by implementing mandates and deadlines that would implement suicide-prevention programs in a timely fashion and expedite the process for returning veterans.

Boswell’s bill was designed to help address post-traumatic stress disorder (PTSD) among veterans by requiring mental health training for Veterans Affairs staff; a suicide prevention counselor at each VA medical facility; and mental-health screening and treatment for veterans who receive VA care. It also supports outreach and education for veterans and their families, peer support counseling and research into suicide prevention.

1 in 5 current vets suffer, study shows

Congressional pressure on the VA was prompted, in part, by a RAND Corporation study released April 17. The study indicates that nearly 20 percent of military service members who have returned from Iraq and Afghanistan -- 300,000 in all -- report symptoms of PTSD or major depression, yet only slightly more than half have sought treatment.

The RAND study also found that many service members said they do not seek treatment for psychological illnesses because they fear it will harm their careers. But even among those who do seek help for PTSD or major depression, only about half receive treatment that researchers consider "minimally adequate" for their illnesses.

In the first analysis of its kind, researchers estimate that PTSD and depression among returning service members will cost the nation as much as $6.2 billion in the two years following deployment — an amount that includes both direct medical care and costs for lost productivity and suicide. Investing in more high-quality treatment could save close to $2 billion within two years by substantially reducing those indirect costs, the 500-page study concludes.

"There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," Terri Tanielian, the project's co-leader and a researcher at RAND, said in a statement. "Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need."

Service members report many reasons for not seeking treatment. Many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional. Even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities.

"We need to remove the institutional cultural barriers that discourage soldiers from seeking care," Tanielian said. "Just because someone is getting mental health care does not mean that they are not able to do their job. Seeking mental health treatment should be seen as a sign of strength and interest in getting better, not a weakness. People need to get help as early as possible, not only once their symptoms become severe and disabling."

Researchers concluded that a major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans. The effort must include the military, veteran and civilian health care systems, and should focus on training more providers to use high-quality, evidence-based treatment methods and encouraging service members and veterans to seek needed care.

Since October 2001, about 1.6 million U.S. troops have deployed to the wars in Iraq and Afghanistan, with many exposed to prolonged periods of combat-related stress or traumatic events. Early evidence suggests that the psychological toll of the deployments may be disproportionately high compared with physical injuries.

Another side effect of treating PTSD is the costs associated with diagnosis and treatment. The RAND study estimates the societal costs of PTSD and major depression for two years after deployment range from about $6,000 to more than $25,000 per case. Depending whether the economic cost of suicide is included, the RAND study estimates the total society costs of the conditions for two years range from $4 billion to $6.2 billion.