In his job here as suicide prevention coordinator at the VA Central Western Massachusetts Healthcare System, James S. Bastien works daily with the mental health needs of veterans. He is on duty Monday through Friday, 8 a.m. to 4:30 p.m., to take crisis calls and coordinate care. He feels the system’s nationwide protocols are among the best for mental health treatment, but he also feels recent congressional action to improve such treatment is a recognition that the country “should be doing a lot more” for its veterans.
“What the VA and congress and the president have come to understand,” Bastien said, ” is something we have never witnessed before, and that is veterans having trouble adjusting over prolonged periods of time. The inability to keep up with this demand has been part of the issue. I am encouraged by this legislation. Resources are a significant issue and we need to be doing a lot more.”
On Tuesday, the Senate, joining earlier similar action by the House, unanimously approved the Clay Hunt Suicide Prevention for American Veterans Act. President Obama has indicated he will sign the legislation into law. Its provisions include incentives to help expand mental health staff at the VA’s 800 hospitals and clinics, outside evaluations of its mental health programs to target best practices and areas for improvement, and creation of a one-stop website of related resources.
Last year, the VA health system underwent an audit, and change of leadership, after its backlog of cases, coverups of those backlogs and allegations that veterans died waiting for care, became public knowledge. Congress passed the Veterans Access, Choice, and Accountability Act to address some of the issues. A recent meeting of veterans with representatives from the Leeds-based system, as well as from the VA benefits Boston office, indicated coordination of services, years-long backlog in paperwork, and need for more medical personnel and flexible hours in outpatient clinics, as well as specialty care closer to home, as among issues of concern for area veterans.
The recent suicide prevention legislation seeks to address statistics that show some 22 veterans a day take their own lives. Government data is said to show fewer suicides among male veterans who seek VA help, but more recent data shows suicide rates for male veterans, ages 18 to 24, have increased even among those seeking such help.
The suicide prevention legislation is named after a Marine Corps sergeant who served in Iraq and Afghanistan and later took his own life in 2011. Its provisions extend the eligibility period for VA healthcare for some veterans from those area of service.
Bastien says the provisions of the Clay Hunt act highlight a “national tragedy” that has been occurring since the 9/11 terror attacks in New York and Washington, D.C. sent Americans to fight in the Middle East and elsewhere.
“Young men and women have been at war for the United States for 14 years, and they have been coming home, fighting for their lives, even though the wars have ended,” said Bastien, referring to veterans coping with traumatic brain injury, substance abuse and post traumatic stress disorder from multiple deployments to war zones. “It is a national tragedy that 20 percent of the individuals who daily take their own lives are veterans.”
Bastien added the veterans he sees for post traumatic stress syndrome, said to be the third most common psychiatric diagnosis at the VA, are “split between two groups.”
“One group is the Vietnam veterans. Many have led productive, busy lives that kept post traumatic stress at bay, but now that they are getting older and have retired, they have time on their hands. A lot of these memories are coming back,” Bastien said. “The others are the veterans of the most recent wars of Operation Iraqi Freedom and Operation Enduring Freedom. Wars with 360-degree battlefields where everybody’s life is at risk. There has been a dramatic rise in post traumatic stress syndrome, which was not even a diagnosis until 1980, from these wars.”
Bastien said the VA has “invested heavily” in suicide prevention during the last several years. Some three dozen factors are considered in assessing someone’s suicide risk, and there are protocols in place for treatment following any hospitalization,he said. He said risk factors may include a marriage break up, death of a battle buddy, loss of a job. He added the VA clinic in Worcester is piloting a program that looks more closely at environmental and psychological factors and how they can be assessed collaboratively as triggers.
He also said Leeds already has a program similar to the one suggested in the Clay Hunt act where veterans are able to talk, in confidence, to other veterans about mental health issues.
“Veterans helping other veterans, I think, that has been an important addition to our service. Things that happen in a war zone become part of a veterans experience, but are very hard to talk about to civilians when they get back,” Bastien said. “We have six hired staff who have done an outstanding job. Veterans trust them and will come to talk with them in a way they do not talk to a mental health professional. It is very positive and a much needed component in the overall approach to helping vets.”