Veteran Suicide Prevention

Veteran Suicide Prevention

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Updated June 28, 2024
Veteran Suicide Prevention
Background
specified amounts for mental health care and suicide
Suicide was the 13th leading cause of death in the United
prevention. Report language accompanying appropriations
States among veterans in 2021, the most recent reporting
measures is not considered binding in the same manner as
year. Although suicide rates have increased among the U.S.
language in statute, but rather explains provisions of a
general population over the past two decades, according to
measure and/or communicates legislative intent.
the U.S. Department of Veterans Affairs (VA), veterans are
In congressional budget submissions, VA provides more
disproportionately affected by suicide. Based on VA data,
granular information about mental health care obligations.
in 2021, the suicide rate for veterans was 71.8% greater
Suicide prevention treatment and outreach, respectively, are
than for nonveteran U.S. adults, adjusting for age and sex
a subset of mental health care obligations. Table 1 provides
(see Figure 1), and an average of 17.5 veterans died by
obligations—the total sum of funding available—for such
suicide per day.
activities for FY2022 through FY2025.
Figure 1. Veteran and Nonveteran Suicide Rate per
100,000 Population, 2006–2021
Table 1. VA Mental Health Care and Suicide
Prevention Obligations, FY2022-FY2025
(Rates adjusted for age and sex)
(in millions of dol ars)
Rate per 100,000
Age- and Sex-Adjusted
FY2024 FY2025

FY2022 FY2023
(est.)
(req.)
30
Mental Health $13,017.7 $14,423.5 $15,968.8 $17,053.7
Veteran
Care
20
Suicide
$2,152.7 $2,414.6 $2,544.8 $2,667.7
Prevention
Non-Veteran
10
Treatment
Suicide
$522.8
$517.0
$571.0
$582.6
0
Prevention
Outreach
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Veterans Crisis
$169.7
$230.4
$300.5
$306.7

Line
Source: Prepared by CRS using VA 2006-2021 National Suicide Data
National
$193.5
$47.5
$46.8
$48.8
Appendix accompanying the 2023 National Veteran Suicide Prevention
Suicide
Annual Report.
Prevention
VA data suggest that use of Veterans Health Administration
Strategy
(VHA) services by specific veteran populations can reduce
Implementation
suicide. VA has named suicide as its top clinical priority for
Governors
$0
$0
$10.0
$10.0
FY2018 to FY2024. As a result, the department has funded
Challenge
and implemented numerous suicide prevention programs
Program
largely administered through VHA. Congress has also
Centers of
$9.9
$9.0
$6.0
$6.0
expressed interest in reducing veteran suicide through
Excellence
appropriations and authorizing legislation.
Demonstration
$7.0
$11.7
$7.7
$7.7
Projects
VA Suicide Prevention Appropriations
Local Facility
$0.6
$0.7
$0.8
$0.8
and Obligations
and Community
Generally, VA is funded through annual Military
Outreach
Construction, Veterans Affairs, and Related Agencies
Activities
(MILCON-VA) appropriations acts. The VA budget is
Suicide
$41.8
$77.0
$58.2
$58.9
comprised of mandatory and discretionary funding. The
Prevention 2.0
medical services account, which includes suicide
Initiative
prevention, is funded solely with discretionary funds.
PREVENTS
$29.5
$21
$0
$0
Mental health care and suicide prevention treatment and
Staff Sergeant
$4.2
$57.3
$55.6
$54.8
outreach are funded through medical services
Parker Gordon
appropriations, specified in MILCON-VA appropriations
(SSG)
acts, but a more specific allocation of funds for those
Fox Suicide
services is not typically provided in the statutory text of
Prevention
these acts. Rather, report language accompanying the
Grant Program
MILCON-VA appropriations act generally provides
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Veteran Suicide Prevention
FY2024 FY2025
related adverse outcomes. Using a statistical algorithm,

FY2022 FY2023
(est.)
(req.)
REACH VET analyzes existing data (e.g., use of VHA
Suicide
$66.6
$83.4
$85.4
$88.8
services) to identify veterans at the highest suicide risk in
Prevention
the next month.
Coordinators
SSG Fox Grant Program
and Teams
VA provides grants to community (non-VA) suicide
prevention programs. The program was established to reach
Source: Prepared by CRS based on FY2024-FY2025 VA
veterans who do not receive care from or interact with VA.
Congressional Budget Submissions, Volume II.
VA awards grants of up to $750,000 to organizations to
Notes: Italics = activities within Suicide Prevention Outreach. Suicide
provide/coordinate suicide prevention activities.
prevention outreach activities may not add to the suicide prevention
outreach total due to rounding. PREVENTS = The President’s
Congressional Activity and Legislation
Roadmap to Empower Veterans and End a National Tragedy of
Previous Congresses have passed several bills to address
Suicide. Actual obligations are provided for FY2022-FY2203.
veteran suicide. Significant pieces of legislation enacted
Estimated obligations based on appropriated funding are provided for
into law during the 110th-118th (1st session) Congresses are
FY2024; obligations based on requested funding are provided for
highlighted below, focusing on key provisions of those acts.
FY2025. Suicide prevention treatment and outreach do not to add to
the mental health care total, which encompasses other activities not
The Support the Resilience of Our Nation’s Great
listed in the table.
(STRONG) Veterans Act (DIVISION V of Consolidated
Selected VA Suicide Prevention
Appropriations Act, 2023); (P.L. 117-328). This bill
Outreach Programs
improved training of VA’s mental health workforce,
improved the VCL, required suicide prevention outreach to
Suicide prevention outreach focuses on all at-risk veterans,
traditionally underserved veteran populations, and
including those who are not eligible, enrolled, or currently
expanded eligibility for readjustment counseling.
receiving VHA services. Selected VA programs
(https://www.mentalhealth.va.gov/suicide_prevention/
Veterans Comprehensive Prevention, Access to Care,
index.asp) are described in further detail below.
and Treatment (COMPACT) Act of 2020 (P.L. 116-214).
A significant provision in this bill is the authorization of
National Strategy for Preventing Veteran Suicide
VA to provide emergent suicide care to eligible veterans
The National Strategy is VA’s 10-year strategic plan (2018-
without requiring payment. This new requirement expands
2028) for reducing veteran suicide that guides VA’s suicide
upon existing VHA policy that allowed for emergent mental
prevention efforts (see https://www.mentalhealth.va.gov/
health care; such care was limited to certain individuals and
suicide_prevention/docs/Office-of-Mental-Health-and-
may have required payment under some circumstances.
Suicide-Prevention-National-Strategy-for-Preventing-
Veterans-Suicide.pdf). The plan identifies 14 goals within 4
Commander John Scott Hannon Veterans Mental
strategic directions. To address these goals, the plan
Health Care Improvement Act of 2019 (Hannon Act);
discusses, among other things, implementation of
(P.L. 116-171). A significant provision in this bill is the
interventions to reach all veterans.
authorization of the SSG Fox grant program.
Veterans Crisis Line (VCL)
Clay Hunt Suicide Prevention for American Veterans
The VCL is a confidential toll-free hotline, online chat, and
(SAV) Act (P.L. 114-2). Among other things, this required
text messaging service that provides 24/7 crisis intervention
VA to arrange for independent, annual evaluations of VHA
services. Launched in 2007, it is free and available to all
mental health care and suicide prevention programs and to
veterans, including those not enrolled in VHA services. The
undertake a pilot program to repay the education loans of
VCL can be accessed through the national 988 Suicide &
eligible psychiatrists (or certain psychiatric residents) in
Crisis Lifeline, which transitioned to the 3-digit 9-8-8
exchange for additional obligated service.
number in July 2022. As of April 2024, the VCL responded
Joshua Omvig Veterans Suicide Prevention Act (P.L.
to more than 7.7 million calls, 941,000 chats, 377,000 texts,
110-110). This bill codified a comprehensive program for
and has referred more than 1.5 million veterans to suicide
suicide prevention among veterans (38 U.S.C. §1720F).
prevention coordinators.
Among other things, the program must include an SPC at
Suicide Prevention Coordinators (SPCs)
each VAMC and a toll-free hotline (the VCL).
SPCs are VHA employees who coordinate care for veterans
For more information about recent applicable legislation,
at high risk for suicide who are receiving care within VHA.
see CRS Report R46848, Commander John Scott Hannon
SPCs can be assigned referrals from the VCL to ensure care
Veterans Mental Health Care Improvement Act of 2019
continuity with a veteran’s local VHA provider. As of June
(P.L. 116-171) and Veterans COMPACT Act of 2020 (P.L.
2020, VA employed approximately 540 SPCs, at 135
116-214)).
medical facilities.
Recovery Engagement and Coordination for
Michele L. Malloy, Senior Research Librarian
Health—Veterans Enhanced Treatment
Jared S. Sussman, Analyst in Health Policy
(REACH VET)
IF11886
REACH VET was launched across VA Medical Centers
(VAMCs) in April 2017 and is used within VHA to predict
which veterans may be at highest risk for suicide or other
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Veteran Suicide Prevention

Disclaimer
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