Presentation on theme: "VA Programs for Suicide Prevention"— Presentation transcript:
1 VA Programs for Suicide Prevention Fuad Issa, MD, FAPAMedical DirectorVA Community Resource and Referral Center1500 Franklin Street, NEWashington, DC 20018(202)
2 Facts about Veteran Suicide ~30,000-32,000 US deaths from suicide/ year.Centers for Disease Control and Prevention~20% are Veterans (=~18 suicide/day).National Violent Death Reporting System~ 5 deaths from suicide/day among Veterans receiving care in VHA.VA Serious Mental Illness Treatment, Research and Evaluation Center
3 Facts about Veteran Suicide More than 60% of suicides among utilizers of VHA services are among patients with a known diagnosis of a mental health conditionSerious Mental Illness Treatment Research and Education CenterVeterans are more likely to use firearms as a means.National Violent Death Reporting System~1000 attempts/month among Veterans receiving care in VHA as reported by suicide prevention coordinators.
4 Facts about Veteran Suicide ~8 % repeat attempts with an average of 3 months follow-up~0.45% deaths from suicide in attempters with an average of 3 months follow-up~30% of recent suicides have a history of previous attemptsVA National Suicide Prevention Coordinator
5 Suicide Prevention: Basic Strategy Suicide prevention requires ready access to high quality mental health (and other health care) services supplemented by programs designed to help individuals and families engage in care to address suicide prevention in high risk patients.
6 Specific Initiatives Established for Suicide Prevention National programs for education and awarenessOperation S.A.V.E 2009Suicide Risk Management Training for CliniciansTBI and SuicideWomen Veterans and Suicide (in development)24/7 Veterans Crisis Line 2007(www.veteranscrisisline.net)Veterans Crisis Line TALK (8255 ), press 1Veterans ChatVeterans TextSuicide Prevention Coordinators (SPC) 2007
7 Operation S.A.V.E VA Guide Training/Gatekeeper Training Operation SAVE trains non-clinicians to recognize SIGNS of suicidal thinking: ASK Veterans questions about suicidal thoughts, VALIDATE the Veteran’s experience, and ENCOURAGE the Veteran to seek treatment.Currently working with the Student Veterans of America to revise the training to be used on campus with students and faculty.
9 Background July 25, 2007 – Hotline went live First call received was at 11: 20 AMBased in Canandaigua VA Medical Center in upstate New YorkBegan with 4 phone lines and 14 responders, currently has 19 lines and 151 respondersPartnership with SAMHSA / LIFELINE
10 Current Hotline (2010)15 phone lines1 warm transfer line151 FTEE
11 Current Hotline Staff (2010) 123 Hotline Responders17 Health Technicians6 Shift Supervisors1 Clinical Care Coordinator/Psychologist3 Administrative Staff1 Supervising Program Specialist
12 Va National Suicide Hotline Call Report YearVetsFamily & FriendsReferralsRescuesActive DutyTotalFY 072918739139933889FY 082987945176264174978043189FY 09639347553139603709158990745FY 1081805992519970573217441191761785362199540933113294206256999
13 Veterans ChatVeterans Chat enables Veterans, their families and friends to go online where they can anonymously chat with a trained VA counselor. If the chats are determined to be a crisis, the counselor can take immediate steps to transfer the visitor to the VA Suicide Prevention Hotline, where further counseling and referral services are provided and crisis intervention steps can be taken.The online feature is intended to reach out to all Veterans who may or may not be enrolled in the VA health care system and provide them with online access to the Suicide Prevention Lifeline and provides Veterans with an anonymous way to access VA’s suicide prevention services.Veterans (and family members or friends) can access Veterans Chat through the Lifeline suicide prevention website.
14 Chat Access Started in July 2009 Capability to “chat” one to one with counselorAccess to care mechanism for those who would prefer internet communicationCrisis chatters referred to hotline for serviceContinues partnership with Lifeline Crisis NetworkTo date over 4000 chats have been logged in.
15 National Mental Health Director for Suicide Prevention Works with Deputy Chief Mental Health to implement the Suicide Prevention Strategic PlanOperates the Hotline Call CenterLeads local Suicide Prevention Coordinators or TeamsSubject matter expert for public information campaignCoordinates inpatient Environment of Care processMaintains and evaluates data on attempts and current deaths from suicideLiaison with other Federal agencies and programsDevelops and implements new strategies for outreach and intervention with high risk Veterans
16 Local Suicide Prevention Coordinators StaffingCoordinator at each medical center & largest CBOCs0.5 FTE support staff at medical centers1.0 care manager for each 20,000 uniques beyond the first 20,000ResponsibilitiesReceive referrals from Hotline and facility staffCoordinates enhancement of care for high risk patientsCare management for those at highest riskMaintaining category II flagging systemReporting of attempts and deaths from suicideEducation and training for facility staffOutreach and education to the communityParticipation in inpatient Environment of Care evaluationsFacilitating development of means restriction programsOther programs responsive to local needs and opportunities
17 Other Training Initiatives Regular Suicide Prevention Staff meetings and conferencesRisk Assessment for Clinicians – on line programPendingWeb based training on women’s issuesPrimary Care provider train the trainer program
18 High Risk Patients Chart notification system – “flag” Safety Plan Treatment Plan modificationsMeans restrictionFamily / friend involvementFollow-up for missed appointments
19 Safety PlanningA written plan. The plan is included in the Veteran’s medical record. The Veteran also receives a copy of the plan.The plan includes 6 steps:Step 1: Warning SignsStep 2: Internal Coping StrategiesStep 3: Social Contacts Who May Distract from the CrisisStep 4: Family Members or FriendsStep 5: Professionals and Agencies to Contact for HelpStep 6: Making the Environment SafeStanley, B. & Brown, G. K. (2008). Safety Plan Treatment Manual to Reduce Suicide Risk: Veteran Version
20 Outreach/ Media Media campaign Gary Sinise – portrayed a suicidal Veteran that is saved in the movie Forest GumpDeborah Norvill – to reach family members of VeteransVA has expanded the advertising campaign that debuted in the metropolitan Washington, D.C., area. The campaign is now active in 124 cities, with advertisements on local buses. The ads are designed to make Veterans and their family members aware of the VA Suicide Prevention Lifeline TALK (8255), which is available around-the-clock, seven days a week.VA also has been distributing brochures, wallet cards, bumper magnets, key chains and stress balls to Veterans, their families and VA employees to promote awareness of the Lifeline number and educate its employees, the community and Veterans about how to identify and help those who may be at risk.