Despite numerous public mental health and suicide prevention programs, suicide persists as a serious public health problem. Currently, about one person in the United States dies by suicide every 11 minutes.
For Veterans, the suicide rate was 57.3 percent higher than that of non-Veteran adults in 2020, according to a 2022 suicide prevention report by the U.S. Department of Veterans Affairs (VA). The report found suicide to be the second leading cause of death among Veterans under age 45 in 2020 and the 13th leading cause of death among Veterans overall.
To better address Veteran suicide in particular, the federal government called for a thorough review of VA mental health and suicide prevention programs and their success and new, improved ways to tackle the problem. VA partnered with Aptive Resources, a government consulting firm, to achieve these objectives through two key programs:
- The Clay Hunt Suicide Prevention for American Veterans Act, which requires yearly, independent, third-party evaluations of the impact of VA mental health care and suicide prevention programs
- A 2019 White House executive order calling for a unified public approach to end Veteran suicide through the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS).
Collecting and Analyzing Data
Aptive developed and maintained a centralized database to track suicide prevention-related activities, metrics, and outcomes. Using quantitative and statistical data analysis and program evaluation tools, the Aptive team reviewed and evaluated PREVENTS initiatives.
In support of the Clay Hunt Act, Aptive tested data sets for quality, integrity, and statistical validity; conducted statistical analyses of program effectiveness; and evaluated cost effectiveness and patient satisfaction. Using quantitative data analysis methodologies and software, Aptive’s research team uncovered deep, evidence-based insights and developed common themes to accurately portray the current state of VA’s suicide prevention programs.
Analyzing both quantitative and qualitative data, Aptive creates a variety of reports each year that evaluate most VA mental health programs; detail Veteran beneficiary demographics and clinical effectiveness; and align interventions, programs, and outcomes. The team analyzed research data and generated findings and recommendations for VA and Congress about reorganizing VA’s mental health structure.
“Our team conducts the nation’s largest mental health program evaluation for the largest integrated health care system in the country — the Veterans Health Administration,” said Kay Bagchi, director of Aptive’s Mental Health and Special Populations Capability Group. “We collect and analyze data for inpatient and outpatient mental health services, support services, patient satisfaction, opioid and pain management prescribing, outcomes and best practices to produce cost/benefit analyses for nine different VA mental health programs with millions of datasets, including clinical records.”
Engaging Communities
PREVENTS called for the federal government to work with partners from both private and nonprofit groups, including state, local, territorial, and tribal governments, to address suicide from many different perspectives.
All told, the Aptive team worked closely with over 150 subject matter experts from more than 15 federal agencies and many nongovernment organizations, including Veterans Service Organizations and Military Service Organizations, to create the PREVENTS roadmap. The team developed, implemented, and evaluated programs, research, and policies that yielded 10 general and 154 specific recommendations with 46 federal agency actions. The recommendations include providing and promoting comprehensive suicide prevention training across professions and promoting foundational changes in how research is conducted, including improving the speed and accuracy with which research is translated into practice.
Identifying and Addressing Policy Gaps
With the necessary data and input from partners, policymakers can more effectively address policy gaps, redundancies, and deficiencies, which are major obstacles to mental health care service delivery. Among these gaps are lack of care for Veterans at risk for suicide who are outside the VA system or living in rural areas where mental health services may be minimal or unavailable; and limited and uncoordinated state, local, and community-based suicide prevention efforts for Veterans.
Aptive helps enable this work by identifying important policy issues and trends, including but not limited to, local, state, national, and international substance abuse and mental health policy.
Looking Ahead
New national initiatives continue to emerge to address Veteran suicide. In addition to various bipartisan bills introduced in Congress, VA and the Biden Administration have a number of efforts underway.
For example, VA recently announced 10 winners of Mission Daybreak, a $20 million challenge to reduce Veteran suicide that focuses on the best innovations inspired by Veterans, universities and other groups external to VA. Innovators receive financial awards to develop their suicide prevention solutions. The challenge is part of VA’s 10-year National Strategy for Preventing Veteran Suicide and aligns with the Biden Administration’s plan for Reducing Military and Veteran Suicide.
The Biden Administration is also advancing its Unity Agenda, which includes actions to partner with states and territories to reduce suicide, increase Lethal Means Safety (LMS), and expand access to legal support services and outreach to justice-involved Veterans. The plan includes a strategy to improve mental health for children and teens, health care workers, and other Americans struggling with anxiety, depression, substance use, and related mental health issues.
The U.S. Substance Abuse and Mental Health Services Administration’s (SAMHSA) four-year plan also advances the Administration’s Unity Agenda, as well as Congressional and Department of Health and Human Services mental health initiatives.
With a continued focus on evidence-based solutions identified through data collection and analysis, community and partner outreach and engagement, and policy changes that address gaps in the mental health system, we can get closer to achieving our goal of improving mental health for all Americans.
The opinions expressed in this blog post are the author's own and do not necessarily reflect the view of AcademyHealth.
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