In November 2007, CBS News aired a story entitled “Suicide Epidemic Among Veterans” and found that veterans were more than twice as likely to commit suicide in 2005 than non-veterans. The news report showed that veterans aged 20 through 24 had an extremely high proportional rate of suicide compared to civilians the same age. Veterans’ advocates called on the VA to address what they deemed an epidemic of mental health problems.

On December 12, 2007, the House Committee on Veterans’ Affairs held a hearing entitled “Stopping Suicides: Mental Health Challenges within the Department of Veterans Affairs.” At the hearing, Dr. Ira Katz, a representative from the VA, downplayed the CBS News report and stated, “their number for veteran suicides in not, in fact, an accurate reflection of the rates of suicide.” Dr. Katz also stressed a low-rate of veteran suicide, stating that “from the beginning of the war through the end of 2005 there were 144 known suicides among these new veterans.”

At the December hearing, Chairman Filner stated that suicide can be a very difficult public health crisis to gauge. He stressed that perfect statistics were not essential to aggressively responding to this issue and he expressed concern about the lack of an immediate and urgent response from the VA.

Just three days after the hearing, VA’s Under Secretary for Health Dr. Kussman, referred to a newspaper article in an internal e-mail and wrote that “18 veterans kill themselves every day and this is confirmed by the VA’s own statistics. Is that true? Sounds awful but if one is considering 24 million veterans.” That same day, Dr. Katz responded: “There are about 18 suicides per day among America’s 25 million veterans. This follows from CDC findings that 20% of suicides are among veterans it is supported by CBS numbers.”

In February 2008, Dr. Katz sent an e-mail stating “Shh! – Our suicide prevention coordinators are identifying about 1000 suicide attempts per month among the veterans we see in our medical facilities. Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

On April 21, 2008, CBS News aired another story in their series, “VA Hid Suicide Risk, Internal E-Mails Show.” This story exposed the internal e-mails that had been entered as evidence in an ongoing trial.

“Either Dr. Katz knew that the CBS figures were indeed an accurate reflection of the rates of suicide at the December hearing or he had a sudden epiphany just three days later,” exclaimed Chairman Filner. “It angers me that there was data within the VA that seemed to dispute what we were told in the hearing in December. Nearly five months later, we are again holding a hearing on the tragic issue of suicide among our veterans and what the VA is doing to address what is clearly an epidemic.”

The opening statements of all the witnesses and a link to the webcast are available on the Committee website at http://veterans.house.gov/hearings/hearing.aspx?newsid=237. 

Witnesses:

Panel 1
The Honorable James B. Peake, M.D., The Secretary, U.S. Department of Veterans Affairs
Accompanied by
Gerald Cross, M.D., Principal Deputy Under Secretary for Health, Veterans Health Administration
Ira Katz, M.D., Ph.D., Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Administration

Panel 2
Stephen L. Rathbun, Ph.D., Interim Head & Associate Professor of Biostatistics, University of Georgia
M. David Rudd, Ph.D., ABPP, Professor and Chair, Texas Tech University
Ronald William Maris, Ph.D., Distinguished Professor Emeritus, University of South Carolina

Panel 3
Michael Shepherd, M.D., Office of Healthcare Inspections, Office of the Inspector General, U.S. Department of Veterans Affairs

###

Opening Statement of Chairman Filner:

“We should all be angry at what has gone on here, at what looks like posturing before this Committee. Effective oversight can only work with mutual respect for each other. Presumably, we both want to do the best job we can for veterans. We must also respect the facts and the truth – and your staff exhibited neither. If the testimony that Katz gave last December was wrong, why wasn’t this Committee notified? Why didn’t you tell that you found new statistics and you are checking them out?

“What we see is a pattern, Mr. Secretary, that we have seen going back to the days of atomic testing, Agent Orange, depleted uranium, Persian Gulf Illness, traumatic brain injury, post-traumatic stress disorder, suicide, homelessness. The pattern is deny, deny, deny. Then when facts seemingly come to disagree with the denial, you cover-up, cover-up, cover-up. Then, when the cover-up doesn’t work anymore, you admit a little bit and underplay the problem. And then, finally, you admit it’s a problem, and then way after the fact, you try to come to grips with it. We have seen it again and again and again.

“This is not a bureaucratic situation that only concerns numbers – this is a matter of life and death for the veterans that we are responsible for. If we do not admit to the problem or try to understand the problem, then the problem will continue and people will die. If that isn’t criminal negligence, than what is?”

Response of Chairman Filner to the testimony of Secretary Peake and Dr. Katz:

“Today, many Members of this Committee asked you how they can help. Mr. Secretary, you didn’t ask us for one thing. Who is better at outreach than Members of Congress? We know these stories, we are in touch with the veterans in our district everyday.

“Dr. Katz, you are not performing your job in an effective way. You’re not very helpful. You are the expert at the VA and you are not acting in a transparent way. If Congress or the press is not asking the right questions, help us out. You are just sitting there with all this data and only releasing bits and pieces in a secretive manner.

“Mr. Secretary, the data we have discussed here today is a symptom of inadequate mental health treatment. Suicide is the ultimate and tragic symptom of this problem, but other symptoms include domestic violence, homicide, substance use, PTSD, homelessness, marital difficulties. And we have to get at this problem. Right now, we are not doing the job.

“If you have 1,000 suicide attempts per month, and you said it could be more, we have some real serious issues. And you never asked us for anything, acting as if you have everything under control. And Mr. Secretary, you don’t have it under control.

“We are letting tens of thousands out of the service without an adequate or thorough diagnosis. We need mandatory medical evaluations by competent medical personnel. We have to make these evaluations mandatory, as a way to eliminate this stigma. In cooperation with the military, let’s get everyone the support system they need. Right now, we are not giving adequate diagnoses or treatment and that is the problem. Until you tell us what you need to solve this, all this talk about data is meaningless.

“Mr. Secretary, work with the Secretary of Defense and get us a plan to evaluate and diagnose every soldier for post-traumatic stress disorder and traumatic brain injury.”