On Monday, Dr. Thomas Insel, director of the National Institute of Mental Health, told reporters at an annual meeting of the American Psychiatric Association in Washington that it was possible that "suicides and psychiatric mortality…could trump combat deaths." Insel said he based this assessment in part on figures from a recent RAND Corp. study as well as suicide rates for patients who have substance abuse problems and other complications of post-traumatic stress disorder as a result of combat.
Insel's comments were put in context on Tuesday during a House Veterans Affairs Committee hearing, when Dr. James Peake, secretary of VA, said that the number of suicide attempts by all veterans under treatment by the department could exceed an earlier official estimate of 1,000 a month.
The Defense Department estimates that slightly more than 4,500 troops have been killed in combat in Afghanistan and Iraq. The RAND study determined that up to 300,000 returning U.S. troops from those wars suffer from post-traumatic stress disorder. The same study concluded that 320,000 troops returning from Afghanistan and Iraq have suffered traumatic brain injury, with only half of those veterans seeking treatment.
During Tuesday's hearing, Peake told lawmakers that the number of suicide attempts could be more than 1,000 a month because of "underreporting" within the VA. Dr. Ira Katz, deputy chief patient care services officer for mental health at the Veterans Health Administration, testified that his earlier estimate of 1,000 suicide attempts per was based on only three months of data from the department's mental health co-coordinators.
Laurie Tranter, a VA spokeswoman, told Government Executive that the data Katz based his earlier estimate on was derived from a suicide tracking system and suicide prevention program. She said both are at various stages of deployment throughout the Veterans Health Administration.
Rep. Bob Filner, D-Calif, chairman of the House Veterans Affairs Committee accused Peake Tuesday of "criminal negligence" in trying to cover up the number of suicide attempts by veterans. He said the VA's actions fit a pattern of trying to cover up or deny serious medical problems suffered by veterans from the Korean, Vietnam and Gulf Wars.
Peake said that all veterans from Afghanistan and Iraq receive a mental health screening by a general practitioner. Filner said he wants VA and Defense to provide a mandatory, one-hour mental health check-up conducted by a psychiatrist for all combat veterans.