Veterans Affairs Medical Centers Dreadfully Under Staffed to Help Prevent Suicide Among Our Returning Iraq and Afghanistan War Veterans

Victor Montgomery is the author of Healing Suicidal Veterans, Recognizing, Supporting and Answering Their Pleas for Help! (New Horizon Press, October 2009).

November 20, 2009 - Hundreds of thousands of war zone veterans and their loved ones are looking for answers to the complex questions about the devastating effects of 'combat trauma' and mental health. The studies show a large percentage of men and women combat veterans are disoriented, confused and disillusioned by the ravages of war trauma and the psychological wounds and mental health disabilities that dominate their very being when they returned home from the war zones, forever changed. A recent RAND study (2008) found that nearly three out of four veterans in need of mental health care receive inadequate care or no care at all.

The savagery and horror experienced ‘in country’ by warriors, a shortage of mental health workers on the ground and the lack of commitment and strategic plan for Afghanistan, by President Obama, account for only one part of the decline in morale and mental breakdown epidemic. Other components just as devastating that lead to lower morale and mental distress, at home and abroad, include multiple and extended deployments, financial and family trouble, homelessness, unemployment, alcohol and drug abuse and increased domestic stress, have caused an epidemic of mass depression among our nations honorable warriors.

A McClatchy Newspaper article by Nancy Youssef‘s investigative reporting uncovered “An Army task force has found that a growing number of soldiers serving in Afghanistan are suffering from some kind of mental stress and is urging the military to double the number of mental health professionals deployed there. The study, conducted by the Army Mental Health Advisory Team, found that soldiers' morale in Afghanistan is "significantly lower" than it was in

2005 and 2007 studies, as soldiers face a resurgent Taliban and the highest levels of violence of the war. In 2009, 21.4 percent of the soldiers in Afghanistan were suffering from depression, anxiety and post-traumatic stress, compared with 10.4 percent in 2005. (McClatchy Newspapers, 2009)

It is troubling to this writer how the bicameral legislature of the federal government and the present Cabinet-level administration can sit back and knowingly underfund our Veterans Health Administration’s ability to sufficiently train and staff our 153 VA Medical Centers for suicide prevention.

The rhetoric continues…Washington- on Veterans Day, Nov. 11, 2009 Secretary of Veterans Affairs Eric K. Shinseki called on Americans to honor the 48 million men and women – including America’s 23 million living Veterans – who have served our Nation in uniform. “Americans come together today to honor and thank those who have safeguarded our Nation both in peace and war,” said Secretary Shinseki.  “Veterans Day is a time to renew our national resolve to care for those who have borne the battle.  Our character as a country is revealed through the honor we accord them and measured by the respect with which we care for them.

President Obama has called for a Department of Veterans Affairs that is Veteran-centric, results-oriented, and forward-looking,” said Shinseki. And President Barack Obama proclaimed: “We have a sacred trust with those who wear the uniform of the United States of America. We reflect upon the invaluable contributions of our country’s Veterans and reaffirm our commitment to provide them and their families with the essential support they were promised and have earned.”  Yet, Mr. President, where are our troop reinforcements and mental health workers?

The lack of sufficient troops on the ground, unrelenting multiple (2,3,4,5,) deployments, extended deployments away from families, short turn around times and military redeploying soldiers to Iraq and Afghanistan despite mental health concerns is unconscionable.

The following article was posted on February 18th, 2009, in the New Times - Volume 23, Issue 29…by Aaron Glantz- Cover Story- New Times- The long, lonely road home. "A local recruit's tragic death (suicide) illustrates how the military has redeployed soldiers to Iraq and Afghanistan despite mental health concerns." Paul Sullivan, Executive Director of Veterans for Common Sense says... "The Army failed to follow their own rules when the Army deployed an unfit soldier," he said. "Until there is accountability, the Army will continue to send unfit soldiers back to war with fatal consequences." (2009)

Meanwhile back on the home front, during this reporter’s investigation the following data was discovered…“VA has hired more than 3,900 new mental health employees since 2005 – bringing the total number to more than 17,000. Of these, 400 are devoted to preventing suicide among veterans.” (United States Department of Veterans Affairs, 2009)

If this is the case, as reported by the VA this year, let’s do the math. There are 153 VA Medical Centers in the US and territories. The 400 workers devoted to suicide prevention would equate to 2.6 mental health employees, at each VA Medical Center, devoted to veteran suicide prevention, intervention and rescues.  

The normal ‘manageable’ civilian case loads in the US, for clinical therapists and certified counselors, are generally between 25 and 35 patient/clients per clinician/counselor; most in outpatient clinics are seen weekly in groups and at least once per month for individual counseling. So, taking a closer look at these numbers as they relate to veteran suicide prevention healthcare management at the VA, equate to: 35x2.6x153 or 13,923 current VA patients/client case load capability. That is 14,000 current war zone veteran patients/clients (not taking into consideration former wars and conflicts) could actually be seen, face to face monthly by VA clinicians and counselors employed specifically for preventing suicide among veterans, throughout the entire VA Healthcare System.

What is wrong with this picture? According to many statistical reports and investigative reporting including the VA, approximately 30% of 1,700,000 returning veterans from Iraq and Afghanistan war zones have been diagnosed with Post Traumatic Stress Disorder (PTSD) and or Traumatic Brain Injury (TBI). These two disorders alone, which most often result in depression, confusion and anxiety, are found to be triggers and symptoms resulting in suicide ideation…and completed suicides.

If this is the case, as reported, then approximately 510,000 current war veterans are in dire need of suicide prevention, intervention and rescues. Under the present VA staffing this would mean that every VA employee devoted to suicide prevention would have to carry a case load of 1,275 patient/clients.

The mental health director for the VA, Ira Katz, said in an e-mail last December that of the 18 veterans who commit suicide each day, four to five of them are under VA care, and 12,000 veterans under VA care are attempting suicide each year. (CBS News, 2008)

What is the answer? Take even a miniscule portion of the trillion dollars of bail out and stimulus money and disperse it immediately to the Veteran Affairs to help prevent our men and women from killing themselves due to the present looming ‘mental health epidemic’. The VA mental health teams across America are under trained and under staffed to handle the enormity of this mental breakdown epidemic. Suicides among soldiers in 2008 rose for the fourth year in a row and continue to increase reaching the highest level in nearly three decades. (New York Times, 2009)  Let’s wake up America. Call your Congress person, Today!

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Victor Montgomery
P.O. Box 281
Honeoye Gardens, NY 14471
Phone: 949-355-3160
Website: www.healingsuicidalveterans.com

Victor Montgomery III is an expert in Crisis Intervention and Addiction Therapy. A Vietnam Era Marine Corps veteran, he has worked with countless veteran callers and their families through crisis hotlines and out-patient clinics. He has a Master of Arts in Education degree from the University of Phoenix in Phoenix , Arizona , Graduate Studies in Clinical Psychology and a Bachelor of Arts in Psychology from Vanguard University of Southern California in Costa Mesa, California,. Vic received specialized training by the VA for Veteran Suicide Crisis Rescues. He is a Certified and Registered Addiction Specialist (RAS) and Certified Master Addiction Counselor (CMAC). Vic Montgomery has counseled men and women in crisis for over twenty years. He is an ordained minister and served in Chaplain services for 8 years. Mr. Montgomery resides with his family in upstate New York . He and his wife Diane also have children and grandchildren residing in California, Texas, Colorado and Oregon. Vic and Diane can be found camping and kayaking in the Adirondacks and the Finger Lake Region of Western Upstate New York.