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VA Leadership Turnover Hindered Campaign to Curb Veterans Suicides

Watchdog finds weak metrics in prevention awareness outreach campaign.

Frequent changes at the top echelons of the Veterans Affairs Department contributed to a decline in outreach to veterans at risk of suicide, the Government Accountability Office reported.

Citing both “leadership turnover and reorganization,” auditors of the crisis hotline for veterans run by the Veterans Health Administration’s Office of Mental Health and Suicide Prevention found a decline in outreach on social media, public service announcements and the department’s website in 2017-2018 after four previous years of growth.

“The VHA did not assign key leadership responsibilities or establish clear lines of reporting, and as a result, its ability to oversee the outreach campaign was hindered,” said the report prepared in November and released on Dec. 17.

The current programs, launched in 2010 but articulated as the department’s highest priority in 2018, are aimed at tackling the persistent problem of veterans taking their own lives. The veteran suicide rate averages about 20 per day, twice the rate of those who haven’t served in the military.

But VA’s contractor engaged to develop metrics, such as the number of veterans visiting the crisis line website, had not established targets for the majority of the metrics, said the report addressed to Rep. Tim Walz, D-Minn., ranking member of the Veterans’ Affairs Committee.

 “Without established targets for its metrics, VHA is missing an opportunity to better evaluate the effectiveness of its suicide prevention media outreach campaign,” GAO wrote after interviewing officials and examining outreach materials. Auditors also spoke to officials in VA’s Office of Acquisitions, Logistics and Construction and VHA’s Office of Communications.

VA recently renewed the contract with the content developer, which previously had produced materials for both the suicide prevention and mental health campaigns within the Office of Suicide Prevention and Mental Health. Beginning in 2019, the department will separate the contracts.

GAO recommended that VA’s undersecretary for health establish an approach to oversee the department’s suicide prevention media outreach campaign that includes clear delineation of roles and responsibilities, and establish a target for its metrics to improve evaluation efforts.

VA agreed, and outlined steps it is taking.

On Wednesday, Veterans Affairs Secretary Robert Wilkie was grilled on the report at a bicameral hearing. He said preventing suicide was his "top clinical priority,” but lawmakers asked why the VA had not expended all of its resources for the priority and what he was going to do to make improvements. Wilkie said only that he would do his best, but declined to provide any specific goals.

"We’ll never be able to judge against that. ‘Do our best,’ what does that mean?," said Rep. Beto O'Rourke, D-Texas.

Asked to react to the report, Ryan Gallucci, director of the National Veterans Service for the Veterans of Foreign Wars, told Government Executive the “VA must do everything in its power to reduce suicide in the veterans’ community, to include using the resources it is given to do so. Far too many veterans who choose suicide never connect with VA. As a community-based veterans’ organization with resources of our own to help our fellow veterans, the VFW stands ready to help VA spread the word to those who otherwise may not know that help is out there.”

Eric Katz contributed to this report.