Underwood Urges the Department of Veterans Affairs To Improve Trainings for Veteran Suicide Prevention
WASHINGTON— Today, Congresswoman Lauren Underwood (IL-14) wrote the U.S. Department of Veterans Affairs (VA) Under Secretary for Benefits Paul Lawrence requesting additional information on the level of training Veterans Benefit Administration (VBA) contractors receive for suicide prevention. Currently, VA contracted examiners are required to complete a "general competency" training package within 180 days of joining the VA, including just one single module dedicated to suicide prevention.
Additionally, Underwood expressed concern about the VA's current sole reliance on the Veterans Crisis Line (VCL) for at-risk veterans during vulnerable times. In the letter, Underwood inquired into VA's plans to expand or update suicide prevention training and protocols for both VA and contracted clinicians and examiners.
"Despite the effectiveness of the VCL, I am concerned that sole reliance on the hotline may leave veterans vulnerable to potential wait times, technical difficulties, and other issues that may arise while waiting for assistance. I encourage you to work with medical and mental health providers—including VA contracted providers and examiners—to ensure that appropriate training is designed and implemented," wrote Underwood.
As a member of the Committee on Veterans' Affairs, Underwood has made addressing the veteran suicide crisis a top priority. Last year, Underwood introduced the Veterans' Care Quality Transparency Act to ensure both the VA and outside providers are offering veterans high-quality mental health and suicide prevention services. The legislation passed the House of Representatives with unanimous support and is awaiting consideration by the Senate. Additionally, Underwood introduced the Post-9/11 Veteran Suicide Prevention Counseling Act to improve veterans' health by improving access to contraceptives and preventing veteran suicide by offering proactive screening and counseling to address the unique needs of post-9/11 veterans.
Full text of the letter can be found here and below.
January 23, 2019
The Honorable Paul Lawrence
Under Secretary for Benefits
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
Under Secretary Lawrence,
I am writing to request additional information on the suicide prevention training required for Veterans Benefit Administration (VBA) contractors. While I greatly appreciate the Department of Veterans Affairs' (VA) timely responses to my previous requests for information on this topic, additional questions remain to be answered.
A November 22, 2019, response from VA detailed that contracted examiners are required to complete a "general competency" training package within 180 days of joining VA's network. This "general" training includes a single module dedicated to suicide prevention. Per VA, these contracted examiners are sometimes afforded additional training opportunities through their professional licensing and continuing education programs, although these additional trainings are not required.
In the same response, VA outlined that the Disability Benefits Questionnaires (DBQs) assess for suicidality and that examiners have a protocol to follow if a veteran presents with significant risk. "This protocol involves calling the Veterans Crisis Line (VCL) and/or the appropriate law enforcement authorities based on the laws and regulations of each state in order to ensure a warm handoff for appropriate care. The VCL will then provide follow-up to the individual often offering local VA treatment resources. The contractors are currently required to give the claimant the VCL info when suicide risk (not just imminent risk) is found during the exams and to note such action was taken in the exam report. The VCL is then the centralized referral mechanism to VHA, as the VCL's role is to then assist the individual with local VA resources."[1]
I am concerned that the current guidelines place sole reliance on a telephone as the focal point for suicide prevention. Despite the effectiveness of the VCL, this may leave the veteran vulnerable to potential wait times, technical difficulties, and other issues that may arise while waiting for assistance. I encourage you to work with medical and mental health providers—including VA contracted providers and examiners—to ensure that appropriate training is designed and implemented. I also ask that you provide answers in writing to the questions below:
- How are contract examiners trained to call emergency services or to help provide support to the veteran if they are in crisis? Please provide a copy of the training materials used.
- What, if any, plans do you have to expand or update suicide prevention training and protocols for both VA and contracted clinicians and examiners?
Thank you for your prompt attention to this matter.
Sincerely,
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