May 1, 2008 – Veterans are suffering and dying because of a broken-down mental health system at the Department of Veterans Affairs, and the only remedy is a court-ordered overhaul, a lawyer for advocacy groups told a federal judge Wednesday in final arguments in a lawsuit.
“More of these veterans are dying in the United States than out in combat,” attorney Arturo Gonzalez said. “There is only one person on Earth who can do anything to help these men and women, and that’s you,” he told U.S. District Judge Samuel Conti, who presided over the seven-day nonjury trial in San Francisco.
A government lawyer called the assertions in the lawsuit “extreme and outrageous” and said the plaintiffs had failed to show the VA is neglecting or mistreating veterans.
“The VA is providing world-class health care in the mental health area,” Justice Department attorney Daniel Bensing told Conti. He said some delays are inevitable in a system that receives 840,000 claims for benefits a year, but that the agency is substantially increasing its staff and implementing measures to screen returning troops for mental trauma and the risk of suicide.
The suit was filed last year by two groups, Veterans for Common Sense and Veterans United for Truth. They accused the VA of making mental health care virtually unavailable to thousands of discharged soldiers through perfunctory exams, long waits for referrals and treatment, and a prolonged and complex system of awarding medical benefits.
The plaintiffs want Conti to order the VA to carry out its own plan to improve suicide prevention and overall mental health care – issued in 2004, but still mostly at the pilot-program stage – and to direct the agency to set timetables for benefits and allow veterans to be represented by lawyers. Gonzalez said the judge should appoint a representative, known as a special master, to make sure the agency complies.
The plaintiffs’ most striking evidence came from internal VA e-mails, released in response to the suit. They reported 18 suicides a day among all veterans and 1,000 suicide attempts a month among those under VA care.
There are 24 million veterans in the United States, and about 30 percent receive VA care.
The agency has not disclosed what proportion of suicidal veterans served in Iraq and Afghanistan. But the plaintiffs’ witnesses and lawyers said there was evidence that returning troops are taking their own lives in greater numbers. They said there has been a steady increase in the veterans’ suicide rate since 2001, and a comparatively high rate among veterans ages 20 to 24.
Witnesses testified the veterans’ suicide rate was anywhere from two to 7.5 times the rate among the general population.
The suicide figures have caught congressional attention. Two senators have demanded the resignation of Ira Katz, the VA official who wrote “Shh” at the top of the e-mail dealing with suicide attempts and disputed the statistics in public testimony while confirming them in internal documents. A House committee has scheduled a hearing on veterans’ suicides next week.
In Wednesday’s arguments, Bensing, the government lawyer, described the congressional dispute as a “political distraction” irrelevant to the court case.
“We don’t dispute that suicide is a major, serious problem” and that prevention “has to be a major priority,” he said. But he said the VA is regularly screening returning veterans for the risk of suicide and has set up a toll-free suicide hot line, “an exceptional step, which in all likelihood has saved many lives.”
But Gonzalez, the plaintiffs’ lawyer, said a May 2007 report by the VA’s inspector general found that 70 percent of the agency’s facilities had no system to track veterans with suicidal tendencies, and more than 60 percent lacked any suicide-prevention strategy.
He said government reports also showed that half the veterans referred to mental health specialists had to wait more than 30 days for appointments, and that the VA board that hears appeals from veterans who are denied benefits takes an average of four years to issue decisions.
“The system, your honor, has crashed,” Gonzalez said. Veterans, he said, are “dying literally every day because they are not receiving proper care.”