Veterans for Common Sense

Iraq War veteran Timothy Juneman went to the VA for help, was diagnosed with Traumatic Brain Injury and Post Traumatic Stress Disorder and was receiving help. This last fall Juneman started attending Washington State University but within months, he learned he would be sent back into active service when his National Guard unit was alerted for mobilization for a combat tour in Iraq. 

April 28, 2008, Spokane, Washington — They served their country honorably but after risking their life in combat abroad, coping with coming home was too much. In the last three months seven servicemen being treated by Spokane’s VA Hospital have committed suicide.

Of the seven suicides since January 1st, two had served in the National Guard, one was in the Navy, one from the Army Reserves and one was a Marine. Four of the seven had served in combat operations in Iraq.

 For some veterans, the trauma of war never goes away. One of them was 25-year-old Timothy Juneman, whose life ended in a dark, lonely place. His mother, Jacqueline Hergert, is demanding answers as to what happened.

“In the 20 days he was dead, before he was found, he was on suicide watch and no one checked on him,” Hergert said.

“What he really needed was for the VA to be an advocate for him and that didn’t happen.”

The growing number of suicides among military veterans is an issue that continues to gain national attention as hundreds of veterans take their lives every year. According to Jacqueline Hergert, her son’s problems began in 2005 when her son, Specialist Timothy Juneman, returned home after a year-long combat tour in Iraq where he served with 1st Brigade, 25th Infantry Division (Stryker Brigade Combat Team), which was based out of Ft. Lewis.

Before Iraq, Juneman was known as a lover of the outdoors. He achieved Eagle Scout by the time he was 16 and after graduating from high school and a year of community college he enlisted in the Army in 2002. His first overseas tour was in South Korea. His second tour of duty was in Iraq and he came home a changed man.

“He went into a dark, deep depression,” she said. “I think he was doing a lot of self-medicating.  Maybe drinking a little, but very depressed.”

“After returning home from his tour of duty in Iraq, Tim was given the following choice — either commit to a two-year enlistment in the Washington National Guard and receive a stability from deployment for that amount of time or be stop-lossed and face certain redeployment within a year,” Hergert wrote in a letter to Sen. Patty Murray, a member of the Senate’s Veterans Affairs committee. “Tim chose to enlist in the Washington National Guard unit and was assigned to Spokane, Wa(shington).”

Juneman went to the VA for help, was diagnosed with Traumatic Brain Injury and Post Traumatic Stress Disorder and was receiving help. This last fall Juneman started attending Washington State University but within months, he learned he would be sent back into active service when his National Guard unit was alerted for mobilization for a combat tour in Iraq.

 For a man battling paranoia and depression, it was too much.

“Mom, I don’t think I can go back to Iraq,” Jacqueline Hergert recalls her son’s words.

Last month, Juneman was found hanging in his Pullman apartment.

“My son hanged himself in his apartment on March 5, 2008. He was not discovered for 20 days, and then only because he didn’t pay his rent for the month,” Hergert continued in her letter to Sen. Murray. “He missed numerous scheduled medical appointments at the VA hospital. He missed his weekend duty with the National Guard unit. Yet, no one came to check on him, not even the doctors or counselors who were seeing him for his injuries and trauma.”

Juneman survived Iraq only to become an unfortunately often overlooked statistic: He is one of four veterans, seven in all, that were being treated by the Spokane VA Hospital that committed suicide in the last three months.

“It’s been cause for a lot of soul-searching here,” Gregory Winter, M.D., Chief of Mental Health at the Spokane VA Hospital said.

The deaths come despite last year’s introduction of a suicide prevention program that provided better outreach, more education and more care and a suicide prevention hotline, 1-800-273-TALK.

“We’re very, very concerned about this group in particular. We’re concerned about all of our veterans, but this is a risky group,” Dr. Winter said, referring to veterans who have recently returned from Iraq and Afghanistan.

Specialist Timothy Juneman was in that group and now it’s his mother doing the coping.

“I have to live with the knowledge that he died alone and in despair and feeling without hope,” Hergert said.

April 27, 2008 – Shh,” began the e-mail referring to 12,000 veterans who attempt suicide each year while the Department of Veterans Affairs tries to provide for their care. It continued with a question: “Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

The writer: Dr. Ira Katz, the VA’s mental-health director.

Another e-mail from a VA official in December confirmed that U.S. veterans are committing suicide at the rate of 18 per day.

The reason? The VA has been unable to keep pace with the growing number of veterans who fought in Afghanistan and Iraq and returned home in need of mental-health care.

Suing to get care

Both e-mails were revealed Monday in San Francisco during the opening arguments of a class-action suit against the VA, being heard in U.S. District Court. The plaintiffs — Veterans for Common Sense in Washington, D.C., and the Santa Barbara-based Veterans United for Truth — want the judge to order the VA to provide immediate treatment for suicidal veterans and prompt care for those suffering from post-traumatic stress disorder.

A Department of Justice attorney, however, argued that the VA provides “world-class” medical care and urged the District Court judge to dismiss the lawsuit.

Sorry, the Justice Department attorney misses the point. All indications show veterans are not getting the “world-class” care they deserve and, as a result, are dying as they wait.

The need for swift treatment was underscored by the RAND Corp. in a study released April 17. It indicated that as many as 300,000 troops returning from Afghanistan or Iraq suffer from major depression or PTSD. That represents 18.5 percent of all troops who served in the two war zones.

Having depression or PTSD increases the chances of suicidal tendencies. As the veterans advocates told the District Court, 120 veterans from Iraq and Afghanistan commit suicide each week while the government drags its feet in granting mental-health-care benefits.

Trying to keep pace

The Justice Department attorney told the judge the VA has tried to keep up, adding 20 percent more mental-health employees and 25 percent more in claims processing.

That might help, but it is not enough by half. Already, it takes the VA six months to decide a claim, and the backlog of disability claims has reached 650,000, an increase of 200,000 since the 2003 start of the Iraq war. That is too long a wait and too large a backlog.

And what happens if the claim is denied? The veteran who seeks benefits through the VA’s grievance system has no right to an attorney or to demand records or to question opposing witnesses.

How utterly contemptible that those who put their lives on the line for this nation and come home in need of urgent care are treated as if they were trying to scam the government. Such petty bureaucratic red tape demeans the valor this nation’s veterans have exhibited.

The VA should be pulling out all the stops so veterans, especially those who are suicidal, get immediate help.

Already, some are alleging the e-mail by Dr. Katz suggests the VA mental-health division wanted to cover up this dirty little secret. If so, swift discipline is needed. Sen. Patty Murray, D-Wash., called for Dr. Katz’s resignation last week.

Government needs to act

Cleaning house is not enough. The very people responsible for putting troops in harm’s way — the Bush administration and Congress — need to act. President Bush must ask for and Congress must allocate the funding the VA needs to care for the burgeoning number of veterans returning from battle.

People expect death on the battlefield. And too many young men and women have already died, especially in the government’s war of expediency in Iraq. However, we do not expect veterans to die of neglect at home and we must not stand for it.

In nearly seven years of war, five of those in Iraq alone, civilians have been chanting a simple mantra: “Support the troops.” They have done just that, including sending troops upgraded body armor the government had been slow to provide.

It is time now for the government to provide returning veterans the care and dignity they deserve.

April 28, 2008 – A friend of mine who’s a librarian was recently reviewing job applicants. Asked his qualifications in library skills, one man put “machine gunner.” He was a vet who’d served in Falluja. The library is in a state school here in the United States that, last fall, had 650 such vets enrolled. The young man got the job but soon became irked by what he saw as the trivial preoccupations of his colleagues. He applied for a job at a nearby police department. All over the country, police departments are advertising for Iraq vets. Three-quarters of the way through the hiring process, the PD signaled to him that things looked good. Then, in rapid succession, three Iraq vets in the area were involved in lethal episodes: two murders and one suicide. The PD immediately called the young man in for a second psychological evaluation, then nixed him for the job. He’s 24. He can’t find anything satisfying to do and is thinking of re-enlisting. He’s against the war.

Those violent episodes are just part of bringing the war home. It’ll be active on the home front for years to come. Just fewer than one in three — 31 percent — of those who’ve been deployed in Iraq and Afghanistan suffer from a brain injury or stress disorder or a mix of both these conditions.

On April 17, the RAND Corporation released a study of service members and veterans back home from Iraq and Afghanistan. The 500-page study was titled Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. It was sponsored by a grant from the California Community Foundation and done by twenty-five researchers from RAND Health and the RAND National Security Research Division. From last August to January, the team conducted a phone survey with 1,965 service members, reservists and veterans in twenty-four areas across the country with high concentrations of those people. Some had done more than one tour.

The Associated Press and major newspapers outlined the RAND report’s astounding numbers and then the story slid from view, which is a very bad thing, since the report disclosed in compelling numbers that the wars in Iraq and Afghanistan are steadily filling every American community with psychologically and physically mutilated victims of war. Many of them will endure lives saturated with physical pain and mental turmoil or confusion. A proportion will be prone to alcoholism, drug use and violence, sometimes deadly. Their partners and their children will suffer all measure of scarring.

Pentagon data show that more than 1.6 million military personnel have deployed to the conflicts since the war in Afghanistan began in late 2001.
The RAND study put the percentage of those suffering from PTSD and depression at 18.5 percent, thus calculating that approximately 300,000 current and former service members were suffering from those problems at the time of its survey.

Some 320,000 service members, about 19 percent, according to RAND, may have experienced a possible traumatic brain injury while in a war zone. These injuries have ranged from concussions to severe head wounds. Julian Barnes, in the Los Angeles Times, pointed out in his April 18 story that “a chief difference is that in Iraq and Afghanistan all service members, not just combat infantry, are exposed to roadside bombs and civilian deaths. That distinction subjects a much wider swath of military personnel to the stresses of war.”

“We call it ‘360-365’ combat,” Paul Sullivan, executive director of Veterans for Common Sense, told Barnes. “What that means is veterans are completely surrounded by combat for one year. Nearly all of our soldiers are under fire, or being subjected to mortar rounds or roadside bombs, or witnessing the deaths of civilians or fellow soldiers.”

The RAND report says that about 7 percent suffered from both a probable brain injury and current PTSD or major depression. Only 43 percent reported ever being evaluated by a physician for their head injuries. Only 53 percent of service members with PTSD or depression sought help over the past year. Various reasons were offered to RAND researchers for not getting help, including worries about the side effects of medication, reliance on family and friends to help them with the problem and fear that seeking care might damage career prospects.

The news stories tended to lay stress on the fact that almost half of those with brain injuries or suffering from depression and stress disorder were seeking help. Missing amid the brief stir aroused by this devastating report was any adequate editorial commentary, or inquiry to political candidates, about the obvious fact that every month that U.S. troops remain deployed in Iraq and Afghanistan adds inexorably to this terrible total. But discretion is the order of the day, exemplified by Dr. Ira Katz, top mental health official at the Department of Veterans Affairs, who, as CBS News reported on Feb. 13, e-mailed an aide, “Shh! Our suicide prevention coordinators are identifying about 1000 suicide attempts per month among veterans we see in our medical facilities.”

Here’s how the figures add up, just for Americans. The wars in Afghanistan and Iraq have thus far produced 300,000 psychological casualties, 320,000 brain injury casualties, plus 35,000 (probably understated) officially reported “normal” casualties. This adds up to 655,000 US casualties in Iraq and Afghanistan, an average of just under 101,000 Americans killed or wounded every year since the wars began. If the idea of 101,000 casualties for every extra year in Iraq and Afghanistan gets out and infects the voting public, imagine the effect on the currently torpid national debate over leaving in five years versus 15 years!

April 26, 2008 – Fort Riley, Kan — When Specialist Jeremy Hall held a meeting last July for atheists and freethinkers at Camp Speicher in Iraq, he was excited, he said, to see an officer attending.

But minutes into the talk, the officer, Maj. Freddy J. Welborn, began to berate Specialist Hall and another soldier about atheism, Specialist Hall wrote in a sworn statement. “People like you are not holding up the Constitution and are going against what the founding fathers, who were Christians, wanted for America!” Major Welborn said, according to the statement.

Major Welborn told the soldiers he might bar them from re-enlistment and bring charges against them, according to the statement.

Last month, Specialist Hall and the Military Religious Freedom Foundation, an advocacy group, filed suit in federal court in Kansas, alleging that Specialist Hall’s right to be free from state endorsement of religion under the First Amendment had been violated and that he had faced retaliation for his views. In November, he was sent home early from Iraq because of threats from fellow soldiers.

Eileen Lainez, a spokeswoman for the Defense Department, declined to comment on the case, saying, “The department does not discuss pending litigation.”

Specialist Hall’s lawsuit is the latest incident to raise questions about the military’s religion guidelines. In 2005, the Air Force issued new regulations in response to complaints from cadets at the Air Force Academy that evangelical Christian officers used their positions to proselytize. In general, the armed forces have regulations, Ms. Lainez said, that respect “the rights of others to their own religious beliefs, including the right to hold no beliefs.”

To Specialist Hall and other critics of the military, the guidelines have done little to change a culture they say tilts heavily toward evangelical Christianity. Controversies have continued to flare, largely over tactics used by evangelicals to promote their faith. Perhaps the most high-profile incident involved seven officers, including four generals, who appeared, in uniform and in violation of military regulations, in a 2006 fund-raising video for the Christian Embassy, an evangelical Bible study group.

“They don’t trust you because they think you are unreliable and might break, since you don’t have God to rely on,” Specialist Hall said of those who proselytize in the military. “The message is, ‘It’s a Christian nation, and you need to recognize that.’ ”

Soft-spoken and younger looking than his 23 years, Specialist Hall began a chapter of the Military Association of Atheists and Freethinkers at Camp Speicher, near Tikrit, to support others like him.

At the July meeting, Major Welborn told the soldiers they had disgraced those who had died for the Constitution, Specialist Hall said. When he finished, Major Welborn said, according to the statement: “I love you guys; I just want the best for you. One day you will see the truth and know what I mean.”

Major Welborn declined to comment beyond saying, “I’d love to tell my side of the story because it’s such a false story.”

But Timothy Feary, the other soldier at the meeting, said in an e-mail message: “Jeremy is telling the truth. I was there and witnessed everything.”

It is unclear how widespread religious discrimination or proselytizing is in the armed forces, constitutional law experts and leaders of veterans’ groups said. No one has independently studied the issue, and service members are reluctant to come forward because of possible backlash, those experts said.

There are 1.36 million active duty service members, according to the Pentagon, and since 2005, it has received 50 formal complaints of religious discrimination, Ms. Lainez said.

In an e-mail statement, Bill Carr, the Defense Department’s deputy under secretary for military personnel policy, said he “saw near universal compliance with the department’s policy.”

But Mikey Weinstein, a retired Air Force judge advocate general and founder of the Military Religious Freedom Foundation, said the official statistics masked the great number of those who do not report violations for fear of retribution. Since the Air Force Academy scandal began in 2004, Mr. Weinstein said, he has been contacted by more than 5,500 service members and, occasionally, military families about incidents of religious discrimination. He said 96 percent of the complainants were Christians, and the majority of those were Protestants.

Complaints include prayers “in Jesus’ name” at mandatory functions, which violates military regulations, and officers proselytizing subordinates to be “born again.” After getting the complainants’ unit and command information, Mr. Weinstein said, he calls his contacts in the military to try to correct the situation.

“Religion is inextricably intertwined with their jobs,” Mr. Weinstein said. “You’re promoted by who you pray with.”

Specialist Hall came to atheism after years as a Christian. He was raised Baptist by his grandmother in Richlands, N.C., a town of fewer than 1,000 people. She read the Bible to him every night, and he said he joined the Army “to make something of myself.”

“I thought going to Iraq was right because we had God on our side,” he said in an interview near Fort Riley.

In the summer of 2005, after his first deployment to Iraq, Specialist Hall became friends with soldiers with atheist leanings. Their questions about faith prompted him to read the Bible more closely, which bred doubts that deepened over time.

“There are so many religions in the world,” he said. “Everyone thinks he’s right. Who is right? Even people who are Christians think other Christians are wrong.”

Specialist Hall said he did not advertise his atheism. But his views became apparent during his second deployment in 2006. At a Thanksgiving meal, someone at his table asked everyone to pray. Specialist Hall did not join in, explaining to a sergeant that he did not believe in God. The sergeant got angry, he said, and told him to go to another table.

After his run-in with Major Welborn, Specialist Hall did not file a complaint with the Army’s Equal Opportunity Office because, he said, he was mistrustful of his superior officers. Instead, he told leaders of the Military Association of Atheists and Freethinkers, who put him in touch with Mr. Weinstein. In November 2007, Specialist Hall was sent home early from Iraq after being repeatedly threatened by other soldiers. “I caution you that although your ‘legal’ issues are yours and yours alone, I have heard many people disagree with you, and this may be a cause for some of the perceived threats,” wrote Sgt. Maj. Kevin Nolan in Specialist Hall’s counseling for his departure.

Though with a different unit now at Fort Riley, Specialist Hall said the backlash had continued. He has a no-contact order with a sergeant who, without provocation, threatened to “bust him in the mouth.” Another sergeant allegedly told Specialist Hall that as an atheist, he was not entitled to religious freedom because he had no religion.

Responding to questions about Specialist Hall’s experience at Fort Riley, the staff judge advocate, Col. Arnold Scott, said in an e-mail message, “In accordance with Army policy, Fort Riley is committed to ensuring the rights of all its soldiers are protected, including those of Specialist Hall.”

Civilian courts in the past have been reluctant to take on military cases, and the Justice Department has yet to respond to Specialist Hall’s lawsuit.

“Even if it doesn’t go through, I stood up,” Specialist Hall said. “I don’t think it is futile.”

April 24, 2008 – San Francisco, CA — The number of Iraq war veterans contacting a suicide hotline soared last month, according to information revealed Thursday during a federal trial in San Francisco.

Dr. Michael Kussman, Undersecretary for the Department of Veterans Affairs, was called to the stand by plaintiffs who are suing the government for failing to implement its own Mental health Strategic plan.

Kussman testified that the suicide hotline recieved 5,000 calls from veterans last month. That makes March the busiest month for the hotline since it was established in July of 2007.

“It’s a failure to implement the programs to deal with these veterans. This is an epidemic of suicides with veterans coming back from the war, and there’s a lot of trouble with Vietnam vets,” said attorney Gordon Erspamer, who represents the plaintiffs.

War veterans are returning with severe brain injuries and suffer from post traumatic stress disorder. Under intense questioning, Dr. Kussman agreed that access to mental health care is among the top complaints, but that the V.A. is ideally poised to care for veterans as they transition out of the military.

Kussman admitted 16{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of V.A. facilities have no referral system for vets at risk of suicide.

April 27, 2008 – The Justice Department has told Congress that American intelligence operatives attempting to thwart terrorist attacks can legally use interrogation methods that might otherwise be prohibited under international law.

The legal interpretation, outlined in recent letters, sheds new light on the still-secret rules for interrogations by the Central Intelligence Agency. It shows that the administration is arguing that the boundaries for interrogations should be subject to some latitude, even under an executive order issued last summer that President Bush said meant that the C.I.A. would comply with international strictures against harsh treatment of detainees.

While the Geneva Conventions prohibit “outrages upon personal dignity,” a letter sent by the Justice Department to Congress on March 5 makes clear that the administration has not drawn a precise line in deciding which interrogation methods would violate that standard, and is reserving the right to make case-by-case judgments.

“The fact that an act is undertaken to prevent a threatened terrorist attack, rather than for the purpose of humiliation or abuse, would be relevant to a reasonable observer in measuring the outrageousness of the act,” said Brian A. Benczkowski, a deputy assistant attorney general, in the letter, which had not previously been made public.

Mr. Bush issued the executive order last summer to comply with restrictions imposed by the Supreme Court and Congress. The order spelled out new standards for interrogation techniques, requiring that they comply with international standards for humane treatment, but it did not identify any approved techniques.

It has been clear that the order preserved at least some of the latitude that Mr. Bush has permitted the C.I.A. in using harsher interrogation techniques than those permitted by the military or other agencies. But the new documents provide more details about how the administration intends to determine whether a specific technique would be legal, depending on the circumstances involved.

The letters from the Justice Department to Congress were provided by the staff of Senator Ron Wyden, an Oregon Democrat who is a member of the Intelligence Committee and had sought more information from the department.

Some legal experts critical of the Justice Department interpretation said the department seemed to be arguing that the prospect of thwarting a terror attack could be used to justify interrogation methods that would otherwise be illegal.

“What they are saying is that if my intent is to defend the United States rather than to humiliate you, than I have not committed an offense,” said Scott L. Silliman, who teaches national security law at Duke University.

But a senior Justice Department official strongly challenged this interpretation on Friday, saying that the purpose of the interrogation would be just one among many factors weighed in determining whether a specific procedure could be used.

“I certainly don’t want to suggest that if there’s a good purpose you can head off and humiliate and degrade someone,” said the official, speaking on the condition of anonymity because he was describing some legal judgments that remain classified.

“The fact that you are doing something for a legitimate security purpose would be relevant, but there are things that a reasonable observer would deem to be outrageous,” he said.

At the same time, the official said, “there are certainly things that can be insulting that would not raise to the level of an outrage on personal dignity.”

The humiliating and degrading treatment of prisoners is prohibited by Common Article 3 of the Geneva Conventions.

Determining the legal boundaries for interrogating terrorism suspects has been a struggle for the Bush administration. Some of those captured in the first two years after the Sept. 11, 2001, attacks were subjected to particularly severe methods, including waterboarding, which induces a feeling of drowning.

But the rules for interrogations became more restrictive beginning in 2004, when the Justice Department rescinded a number of classified legal opinions, including a memorandum written in August 2002 that argued that nothing short of the pain associated with organ failure constituted illegal torture. The executive order that Mr. Bush issued in July 2007 was a further restriction, in response to a Supreme Court ruling in 2006 that holding that all prisoners in American captivity must be treated in accordance with Common Article 3.

Mr. Benczkowski’s letters were in response to questions from Mr. Wyden, whose committee had received classified briefings about the executive order.

That order specifies some conduct that it says would be prohibited in any interrogation, including forcing an individual to perform sexual acts, or threatening an individual with sexual mutilation. But it does not say which techniques could still be permitted.

Legislation that was approved this year by the House and the Senate would have imposed further on C.I.A. interrogations, by requiring that they conform to rules spelled out in the Army handbook for military interrogations that bans coercive procedures. But Mr. Bush vetoed that bill, saying that the use of harsh interrogation methods had been effective in preventing terrorist attacks.

The legal reasoning included in the latest Justice Department letters is less expansive than what department lawyers offered as recently as 2005 in defending the use of aggressive techniques. But they show that the Bush administration lawyers are citing the sometimes vague language of the Geneva Conventions to support the idea that interrogators should not be bound by ironclad rules.

In one letter written Sept. 27, 2007, Mr. Benczkowski argued that “to rise to the level of an outrage” and thus be prohibited under the Geneva Conventions, conduct “must be so deplorable that the reasonable observer would recognize it as something that should be universally condemned.”

Mr. Wyden said he was concerned that, under the new rules, the Bush administration had put Geneva Convention restrictions on a “sliding scale.”

If the United States used subjective standards in applying its interrogation rules, he said, then potential enemies might adopt different standards of treatment for American detainees based on an officer’s rank or other factors.

“The cumulative effect in my interpretation is to put American troops at risk,” Mr. Wyden said.

April 25, 2008 – That would seem like a really good idea after news broke last week that nearly 1,000 troops a month have attempted suicide after returning from service in Iraq and Afghanistan, according to internal VA e-mails, even though the department publicly acknowledged only 790 suicide attempts in all of 2007.

VA rolled out a pilot tracking system and suicide prevention database in 2005 to hospitals and clinicians in Colorado, Montana, Wyoming and Utah. But Dr. Michael Kussman, VA’s undersecretary for health, testified that the tracking system had not been deployed throughout the department as of the end of 2007. Kussman testified at a trial on a class action lawsuit alleging VA had covered up an “epidemic” of suicides.

The VA inspector general reported in May 2007 that this system was used on a limited basis and recommended its use throughout the department nationwide. Kussman, under questioning by Gordon Erspamer, an attorney representing the veterans groups suing VA, said as of 2007, 70 percent of the department’s medical facilities had not deployed the suicide tracking system. But, Kussman said, these facilities were told they needed to “move rapidly” to install the system.

Erspamer asked Kussman if he sent out a memo or directive that said, “Hey guys, 70 percent are not tracking, you have to start tracking now?”

Kussman answered, “I don’t recall if there is a specific memo to that effect.”

I have asked VA to provide me with details on the status of the tracking system, but have not received a reply.

A Hill staffer told me he believed that development of the suicide tracking system was still in its infancy, and he doubted it was in use throughout VA. This staffer said the status of the suicide tracking system will be a topic that the House Veterans Affairs Committee will address at a hearing it will hold on the “Truth About Veterans Suicides” on May 6.

Tracking Key to Suicide Prevention

That’s the view of Paul Sullivan, executive director of Veterans for Common Sense, which, along with Veterans United for Truth, filed the class action lawsuit now at trial in the U.S. District Court in San Francisco. Sullivan told me that such a system used nationwide would help VA better identify veterans who have symptoms and conditions that make them suicide risks, including –post-traumatic stress disorder and traumatic brain injury.

Based on the VA inspector general report, it seems widespread use of a suicide registry would definitely help identify veterans in need of immediate attention. The suicide registry piloted by VA in its facilities in the Rocky Mountain states showed that 20 percent of the veterans in the registry who attempted suicide had not been treated for mental health issues.

The suicide registry, the inspector general reported, is linked to the VA electronic health record system and can alert clinicians to put patients on heightened monitoring, but as of 2007, only veterans in a few states had the benefit of this increased monitoring.

Systemic Problems

Sullivan, a Gulf War veteran, said the slow and unresponsive VA system contributes to the despair that leads to suicide attempts. A veteran who has PTSD and traumatic brain injury, who also has lost his wife, children, home and job, and is living on the street, needs speedy help from VA, not a bureaucratic response that says wait in line for six months for a hospital or clinic appointment and years for your benefits.

I’m a Marine Corps Vietnam veteran and this whole scenario is sadly familiar, and I wonder why my fellow veterans from the current wars in Afghanistan and Iraq now have to suffer from the kind of neglect visited on Vietnam veterans.

Sullivan said that’s why he filed the lawsuit: He wants to ensure that all veterans receive the care and attention their service demands.

How About Using the Army/Defense System

The Army Behavioral Health Technology Office at the Madigan Army Medical Center in Tacoma, Wash., developed a couple of years ago the Army Suicide Event Report, a Web-based system that provides one location on the Internet for behavioral health providers to document detailed information relating to a suicide event.

This system has been adopted for use throughout the Defense Department, and maybe VA could use it. But that would probably require a multiyear, megamillion-dollar retooling effort by a contractor.

Madigan also developed the Automated Behavioral Health Clinic, another Web application that provides patients with touchscreen kiosks to answer questions on behavioral health issues that could help sound the alarm on potential suicides. VA might want to check this one out, too.

Health Data Repository Location Not a Big Secret

When I started covering Defense health IT five years ago, I was requested to never, ever disclose the location of the facility, which stores the health records of 9.2 million active-duty and retired service members and their families.

I have honored that request, even when contractors speaking at public forums give out the location. They need some open source intelligence education.

We have met the enemy, and he is us.

April 25, 2008 – It almost always happens this way, doesn’t it? Some government official or agency gets mired in a scandal or foul-up and then turns cartwheels trying to hide the news. Ultimately, the attempted cover-up gets them in more trouble than the initial problem itself. (See: Richard M. Nixon and Watergate cover-up vs. Watergate burglary, 1972-1974.)

This pathetic dynamic is at play again this week with the U.S. Department of Veterans Affairs, which misled Congress about the suicide rate of U.S. troops who served in Afghanistan and Iraq. Appropriately, Sen. Patty Murray, D-Wash., a member of the Veterans Affairs Committee, and committee chairman Sen. Daniel Akaka, D-Hawaii, have called for the resignation of Ira Katz, the VA’s director of mental health.

As the result of a class-action suit in San Francisco against the VA, internal VA e-mails surfaced this week showing Katz and others attempting to hide the magnitude of the veterans’ suicide problem.

This e-mail, dated Feb. 13 this year from Katz to VA Communications Director Ev Chasen, came in connection with a request by CBS News for an interview: “Shh! Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among the veterans we see in our medical facilities. Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

Chasen answered: “I think this is something we should discuss among ourselves, before issuing a release.”

Sen. Tom Harkin, D-Iowa, who also has been looking into the suicide issue, called the cover-up “completely outrageous” and said the VA had previously reported that only 790 veterans under VA care had attempted suicide since 2007.

On April 3, Murray, who has long been looking out for veterans in numerous ways, was given the “Silver Helmet Award” by AMVETs for her work to help veterans in Washington and across the country. It was well deserved.

It would be nice if Murray and others in Congress could concentrate on dealing with veteran-related problems without having first to fight their way through cover-ups of those problems.

Michael Kussman, the VA’s Under Secretary For Health, Denied Any Wrong Doing During VA Lawsuit

April 25, 2008, The head of health care at the Department of Veteran Affairs (VA) denied any wrong doing by the agency on Thursday as more internal emails surfaced showing VA officials discussed withholding suicide information from the public.

While on the stand in California federal court, where the VA is facing a lawsuit filed by veteran advocates who are demanding better health care, Dr. Michael Kussman, the VA’s Under Secretary for Health, said, “I disagree with the premise that there was some effort to cover up something.”

On March 10 of this year, Everett Chasen, the chief communications officer for the VA’s Veterans Health Administration (VHA) sent an e-mail message to several top agency officials including Kussman. At the time, CBS News was preparing a report about attempted suicides among VA patients. Chasen wrote, “I don’t want to give CBS any more numbers on veteran suicides or attempts than they already have – it will only lead to more questions.”

In response, Kussman said he did not “recall” the message. He said, “Obviously I’m [copied] on the e-mail but I get [copied] on a huge number of e-mails everyday.”

In another e-mail – dated December 15, 2007 – Dr. Ira Katz, who oversees mental health at the VA, informed Kussman that “there are 18 suicides per day” among all vets and “4-5 suicides per day” among those being treated by the VA. When asked by lawyers in court if these figures raised any concerns, Kussman said, “Any suicide is cause for concern.” However, despite repeated requests by media and members of Congress, the VA has never made these figures publicly known.

Two other e-mails presented in court on Thursday show VA officials calling a CBS News investigative report on veteran suicides “defensible” with a methodology that “appears to be correct.”

CBS News spent five months compiling nationwide suicide data based on state death records after the VA said they did not collect this kind of information. The report was broadcast last November and heavily criticized by VA officials.

Kussman was asked if the VA ever told Congressman Steve Buyer, R-Ind, who questioned the accuracy of the CBS News report, that the report was “defensible.” Kussman said, “I don’t know if that was specifically communicated to the congressman.”

April 25, 2008 – Yountville, CA — A state audit has found that the nation’s oldest veterans home is suffering from chronic staff shortages and poor maintenance of medical equipment.
The 124-year-old veterans home in Yountville houses about 1,100 veterans.

The Northern California facility was audited after residents complained to state Sen. Patricia Wiggins, a Democrat from Santa Rosa. Among the problems they cited were dirty floors and a resident who had to wait in bed for two hours before a nurse came to clean him.

Auditors said the home has trouble filling vacancies because of low salaries, forcing some nurses to work substantial overtime.

The audit also said the state Department of Veterans Affairs needs to improve its oversight.

Department spokesman J.P. Tremblay said the audit uncovered no problems with the quality of care at the home. He said the department is working to solve staffing and budget problems.