WASHINGTON — With veterans now accounting for one of every five suicides in the nation, the Department of Veterans Affairs is under pressure from the courts and Congress to fix its mental health services in an attempt to curb the death toll.
"The suicide rate is out of control. It's epidemic proportions right now," said Paul Rieckhoff, the executive director of the Iraq and Afghanistan Veterans of America. "There are very few programs that are effective, and there's a serious lack of national awareness."
While the government keeps no official tally of veteran suicides, the VA said last year that veterans account for roughly 20 percent of the estimated 30,000 suicides annually in the United States.
The latest attack on the VA came two weeks ago from the 9th U.S. Circuit Court of Appeals in San Francisco, which ordered a major overhaul of the agency. The court said that with an average of 18 veterans killing themselves each day, "the VA's unchecked incompetence has gone on long enough; no more veterans should be compelled to agonize or perish while the government fails to perform its obligations."
Suicides among active-duty troops are also a cause of concern: In April, 25 soldiers killed themselves, equal to about half the deaths in Afghanistan during the month.
Officials cite a number of possible reasons to explain the increase, including multiple deployments and more financial and family problems linked to the time away from home.
On Capitol Hill, when the Senate Veterans' Affairs Committee took up the issue Wednesday, senators made it clear that they expect the VA to improve its performance.
"We do not need the courts to tell us that much more can and should be done to relieve the invisible wounds of war," said Democratic Sen. Patty Murray of Washington state, the chairwoman of the committee. "Although some steps have been taken, the stigma against mental health issues continues within the military and VA care is still often too difficult to access. This has had a tragic impact."
In at least 13 cases, Murray said, veterans committed suicide or died from drug overdoses while waiting to receive help from the VA.
Two veterans — one from the Iraq War, one from the Afghanistan War — appeared before the committee, testifying about their long waits before receiving any services from the VA.
One of them, Steven Bohn, 24, of Peabody, Mass., served in Afghanistan until he was injured in November 2008. He was hurt when a suicide bomber with 2,000 pounds of explosives drove a dump truck into a building, detonating it. Bohn said he was in the hospital for six months with severe internal and spinal injuries.
His transition from military service to the VA has been less than smooth, he told senators.
"I still have two herniated discs, which are pinching nerves in my neck and causing great pain, but I am uncertain what additional treatment might still be possible," Bohn said. "At this point, many months after becoming a veteran, I have yet to be assigned a VA primary care doctor."
Murray said that service members and veterans alike "continue to take their own lives at an alarming rate." She noted that in April, the VA's suicide hotline fielded more than 14,000 calls, or more than 450 a day, the most ever for a single month.
"While it's heartening to know that these calls for help are being answered, it is a sad sign of the desperation and difficulties our veterans face that there are so many in need of a lifeline," she said.
Antonette Zeiss, the acting deputy chief officer of mental health services with the VA's Office of Patient Care Services, said the department's call center had received more than 400,000 calls since it began nearly four years ago. Of those, she said, more than 55,000 were referred to local VA suicide prevention coordinators for same-day or next-day service.
George Taylor, the deputy assistant secretary of defense for force health protection and readiness, told the panel that "maintaining and enhancing the psychological health" of service members is a top priority for the Defense Department. And he said the department was "very concerned" about the number of suicides in the military over the past 10 years.
But he said progress was being made: Last year, 293 service members died by suicide while on active duty, down from 310 the year before. Taylor said the department had succeeded in slowing the steady increases in suicides that began in 2006.
MORE FROM MCCLATCHY
4 years after scandal, senators say care of wounded vets still lags
VA will pay more family members to care for wounded soldiers
National campaign aims to give military families a hand
Commentary: Veterans' caregivers deserve services Congress promised
Families of severely wounded veterans still waiting for help