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Mental Health Challenges Within the Us Department of Veterans Affairs

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Mental Health Challenges Within the Us Department of Veterans Affairs STOPPING SUICIDES: MENTAL HEALTH CHALLENGES WITHIN THE U.S. DEPARTMENT OF VETERANS AFFAIRS HEARING BEFORE THE COMMITTEE ON VETERANS’ AFFAIRS U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED TENTH CONGRESS FIRST SESSION DECEMBER 12, 2007 Serial No. 110–61 Printed for the use of the Committee on Veterans’ Affairs ( U.S. GOVERNMENT PRINTING OFFICE 39–647 WASHINGTON : 2008 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Aug 31 2005 00:08 Oct 15, 2008 Jkt 039647 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 E:\HR\OC\39647.XXX 39647 jbell on PROD1PC69 with HEARING COMMITTEE ON VETERANS’ AFFAIRS BOB FILNER, California, Chairman CORRINE BROWN, Florida STEVE BUYER, Indiana, Ranking VIC SNYDER, Arkansas CLIFF STEARNS, Florida MICHAEL H. MICHAUD, Maine JERRY MORAN, Kansas STEPHANIE HERSETH SANDLIN, South RICHARD H. BAKER, Louisiana Dakota HENRY E. BROWN, JR., South Carolina HARRY E. MITCHELL, Arizona JEFF MILLER, Florida JOHN J. HALL, New York JOHN BOOZMAN, Arkansas PHIL HARE, Illinois GINNY BROWN-WAITE, Florida MICHAEL F. DOYLE, Pennsylvania MICHAEL R. TURNER, Ohio SHELLEY BERKLEY, Nevada BRIAN P. BILBRAY, California JOHN T. SALAZAR, Colorado DOUG LAMBORN, Colorado CIRO D. RODRIGUEZ, Texas GUS M. BILIRAKIS, Florida JOE DONNELLY, Indiana VERN BUCHANAN, Florida JERRY MCNERNEY, California ZACHARY T. SPACE, Ohio TIMOTHY J. WALZ, Minnesota MALCOM A. SHORTER, Staff Director Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans’ Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occur- rences are inherent in the current publication process and should diminish as the process is further refined. ii VerDate Aug 31 2005 00:08 Oct 15, 2008 Jkt 039647 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 E:\HR\OC\39647.XXX 39647 jbell on PROD1PC69 with HEARING C O N T E N T S December 12, 2007 Page Stopping Suicides: Mental Health Challenges Within the U.S. Department of Veterans Affairs ............................................................................................... 1 OPENING STATEMENTS Chairman Bob Filner ............................................................................................... 1 Prepared statement of Chairman Filner ........................................................ 66 Hon. Steve Buyer, Ranking Republican Member .................................................. 3 Hon. Stephanie Herseth Sandlin, prepared statement of .................................... 66 Hon. Harry E. Mitchell, prepared statement of .................................................... 67 Hon. Cliff Stearns, prepared statement of ............................................................. 67 Hon. Leonard L. Boswell ......................................................................................... 5 Hon. Donald A. Manzullo ........................................................................................ 6 WITNESSES U.S. Department of Veterans Affairs, Ira Katz, M.D., Ph.D., Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Adminis- tration ................................................................................................................... 48 Prepared statement of Dr. Katz ...................................................................... 84 Bowman, Mike and Kim, Forreston, IL ................................................................. 6 Prepared statement of Mike and Kim Bowman ............................................. 68 Coleman, Penny, Rosendale, NY, Author, Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War ......................................................... 33 Prepared statement of Ms. Coleman ............................................................... 69 Meagher, Ilona, Caledonia, IL, Author, Moving a Nation to Care: Post-Trau- matic Stress Disorder and America’s Returning Troops ................................... 35 Prepared statement of Ms. Meagher ............................................................... 76 Zivin, Kara, Ph.D., Research Health Scientist, Health Services Research and Development, Veterans Health Administration, U.S. Department of Vet- erans Affairs ......................................................................................................... 54 Prepared statement of Dr. Zivin ..................................................................... 86 SUBMISSIONS FOR THE RECORD U.S. Department of Veterans Affairs, Michael Shepherd, M.D., Physician, Office of Healthcare Inspections, Office of Inspector General, statement ....... 87 American Legion, Joseph L. Wilson, Deputy Director, Veterans Affairs and Rehabilitation Commission, statement .............................................................. 91 Disabled American Veterans, Joy J. Ilem, Assistant National Legislative Di- rector, statement .................................................................................................. 93 Iraq and Afghanistan Veterans of America, Todd Bowers, Director of Govern- ment Relations, statement .................................................................................. 98 National Coalition for Homeless Veterans, statement ......................................... 99 Vietnam Veterans of America, Richard F. Weidman, Executive Director for Policy and Government Affairs, statement ........................................................ 103 iii VerDate Aug 31 2005 04:11 Oct 15, 2008 Jkt 039647 PO 00000 Frm 00003 Fmt 0486 Sfmt 0486 E:\HR\OC\39647.XXX 39647 jbell on PROD1PC69 with HEARING Page MATERIAL SUBMITTED FOR THE RECORD Additional Hearing Material: Hon. Michael J. Kussman, M.D., M.S., MACP, Under Secretary for Health, U.S. Department of Veterans Affairs, sample of letter sent to veterans, informing veterans of the National Suicide Prevention toll-free hotline number, 1–800–273–TALK (8255), and pocket-sized card with VA Suicide Crisis Hotline phone number/information, as well as a Crisis Response Plan .................................................................... 107 U.S. Department of Veterans Affairs Pamphlet, entitled ‘‘Suicide Preven- tion, Men and Women Veterans, Knowing the Warning Signs of Sui- cide,’’ dated September 2007 ........................................................................ 108 Post-Hearing Questions and Responses for the Record: Hon. Bob Filner, Chairman, Committee on Veterans’ Affairs, to Hon. Gordon H. Mansfield, Acting Secretary, U.S. Department of Veterans Affairs, letter dated December 14, 2007, and VA responses ..................... 110 Hon. Harry E. Mitchell, Member of Congress, U.S. House of Representa- tives, to Hon. James B. Peake, M.D., Secretary, U.S. Department of Veterans Affairs, letter dated February 8, 2008, and response letter dated February 27, 2008, following up to request additional information not supplied in earlier VA responses to questions for the record ............. 115 Hon. Bob Filner, Chairman, Committee on Veterans’ Affairs, to John D. Daigh, Jr., M.D., CPA, Assistant Inspector General, Office of Health- care Inspections, U.S. Department of Veterans Affairs, letter dated December 14, 2007, and response letter dated January 24, 2008 ............ 117 Hon. Bob Filner, Chairman, and Hon. Steve Buyer, Ranking Republican Member, Committee on Veterans’ Affairs, to Hon. James B. Peake, M.D., Secretary, U.S. Department of Veterans Affairs, letter dated December 21, 2007, and response letter dated February 5, 2008, re- questing additional data on suicide rates among veterans ....................... 121 Hon. Bob Filner, Chairman, and Hon. Steve Buyer, Ranking Republican Member, Committee on Veterans’ Affairs, to Rick Kaplan, Executive Producer, CBS Evening News With Katie Couric, letter dated December 21, 2007, and response letter dated May 16, 2008, from Linda Mason, Senior Vice President, Standards and Special Projects, CBS News ......... 128 iv VerDate Aug 31 2005 00:08 Oct 15, 2008 Jkt 039647 PO 00000 Frm 00004 Fmt 0486 Sfmt 0486 E:\HR\OC\39647.XXX 39647 jbell on PROD1PC69 with HEARING STOPPING SUICIDES: MENTAL HEALTH CHALLENGES WITHIN THE U.S. DEPARTMENT OF VETERANS AFFAIRS WEDNESDAY, DECEMBER 12, 2007 U.S. HOUSE OF REPRESENTATIVES, COMMITTEE ON VETERANS’ AFFAIRS, Washington, DC. The Committee met, pursuant to notice, at 10:10 a.m., in Room 345, Cannon House Office Building, Hon. Bob Filner [Chairman of the Committee] presiding. Present: Representatives Filner, Snyder, Michaud, Herseth Sand- lin, Mitchell, Hall, Hare, Berkley, Rodriguez, McNerney, Space, Walz, Buyer, Stearns, Boozman, Brown-Waite, Bilirakis, and Buchanan. Also Present: Representatives Boswell, Manzullo, and Kennedy. OPENING STATEMENT OF CHAIRMAN FILNER The CHAIRMAN. This meeting of the House Committee on Vet- erans’ Affairs is called to order. I appreciate your attendance, and I appreciate your interest in this very important issue of mental illness, particularly of the sui- cides that have occurred in our veterans’ population, especially those involved in combat situations. So this is going to be a very tough hearing, an emotional hearing. It is an issue the military,
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