GAO Proves VA Blowing Off Veteran Suicide Protocol

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GAO VA Suicide Report

Benjamin KrauseThis week, GAO revealed VA is failing to accurately use its veteran suicide protocol to help the agency respond to the staggering number of suicides. This is par for the course for many whistleblowers calling out VA for neglecting suicidal veterans.

Folks like Brandon Coleman have been proclaiming for some time that VA is flatly failing its suicidal veterans. The Veterans For Common Sense lawsuit apparently failed to accomplish the long range goal of encouraging greater responsiveness to the needs of veterans suffering from PTSD and related suicide. I guess we know what direction VA took in response to the greater public scrutiny from whistleblowers and that lawsuit…

Yeah, VA extended its middle finger and said, “If you don’t like it, sue me… Oh wait, you can’t according to the 9th Circuit or anywhere else.”

The new report summarizes its findings as follows:

Scathing GAO Audit Summary Of VA Suicide Policy

Department of Veterans Affairs (VA) policy states that antidepressant treatment must be consistent with VA’s current clinical practice guideline (CPG) for major depressive disorder (MDD); however, GAO’s recent review of 30 veterans’ medical records found that most contained deviations. For example, although the CPG recommends that veterans’ depressive symptoms be assessed at 4-6 weeks after initiation of antidepressant treatment using a standardized assessment tool, 26 of the 30 veterans were not assessed in this manner within this time frame. Additionally, 10 veterans did not receive follow up within the time frame recommended in the CPG. GAO found that VA (1) does not have a system-wide process in place to identify and fully assess the extent to which veterans with MDD who have been prescribed antidepressants are receiving care as recommended in the CPG and (2) does not know whether appropriate actions are being taken by VA medical centers (VAMC) to mitigate potentially significant risks to veterans. GAO also found that VA’s data may underestimate the prevalence of MDD among veterans being treated through VA as a result of imprecise coding by clinicians, further complicating VA’s ability to know if veterans with MDD are receiving care consistent with the CPG.

GAO’s recent work has found that the demographic and clinical data that VA collects on veteran suicides were not always complete, accurate, or consistent. VA’s Behavioral Health Autopsy Program (BHAP) is a quality initiative to improve VA’s suicide prevention efforts by identifying information that VA can use to develop policy to help prevent future suicides. The BHAP templates are a mechanism by which VA collects suicide data from VAMCs’ review of veteran medical records. GAO’s review of the 63 completed BHAP templates at five VAMCs found that (1) over half of the templates that VAMCs submitted to VA had incomplete or inaccurate data, and (2) VAMCs submitted inconsistent information because they interpreted VA’s guidance differently. Lack of complete, accurate, and consistent data—coupled with GAO’s finding of poor oversight of the review of BHAP templates—can inhibit VA’s ability to identify, evaluate, and improve ways to better inform its suicide prevention efforts.

Source: http://www.gao.gov/products/GAO-15-648T

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namnibor
Seems like “Muppet Labs” has more accountability and protocol than the VA…the further really sad thing is this is not the first time the GAO has found fault with the VA’s handling of Veteran Suicides and Mental Health and following-up with their patients…and one must wonder if this huge fail has been systemic going back to Vietnam War Days or even earlier? I know they just keep throwing darts at my brother with various different antidepressants, all mostly very old school drugs on their Formulary, and what many people may not realize is the fact that MANY antidepressants *can* cause… Read more »
crazyelf
crazyelf

I would like to know, When will something happen to “shake up” the VA? With all the negative press it receives, something has got to give. Veterans deserve better medical care than what their receiving today.
How much longer will it take for the upper crust of the VA to realize they can’t continue to treat veterans/patients in this manner?
Sooner or later, they must be held accountable. I pray it’s not later!!!!

CorpsmanuP! (@Tang1967)
I have come to the conclusion that blogs, forums news reports, reports in general are good for the exposure of problems that have existed and will continue to, if we as a people do not utilize the proper tools to effect change. In a legal scenario, that would be filing injunctions, sanctions and amicus curiae briefings in court. If all of our resources can somehow come together, such as organizing through the State bar, pro bono services, that would give new laywers earned hours in this project to effect change in making and forcing the Congress and the Execitive Branch… Read more »
James

I agree some how a group needs to be formed and monies collected to help pay the pro bono lawyer travel, etc. Maybe I’m wrong but something and someone’s needs to help, all of our veterans stories or facts can’t all be wrong about the way the va is treating us. Doing so with out having to worry about anything being done to them for their failure to assist veterans

crazyelf
crazyelf
Fox 35 news “Pentagon spending $9 million a day to fight ISIS.” Maybe this is where all that VA money is going. The way I see it is, this war has to be paid for somehow. What better way than to cut expenditures from other necessary programs, ie; VA, Social Security, Workers Comp., Medicare and many other federally funded programs. That’s my opinion, folks! According to Congresswoman Roby, the Army is NOT being allowed to use their helicopters. She has a new video is on UTUBE, the title is, “Rep. Roby Floor Speech on FY ’16 Defense Appropriations Bill”. It… Read more »
Jose Co
Jose Co

Is it true that you can’t sue VA staffs for wrong doing? Like intentional or negligence infliction of emotional distress. Any idea?

CorpsmanuP! (@Tang1967)

The Tort Claims Act allows you to sue, but if you negate the acceptance of juriscdiction of the government citing Soveigner authority. Your jurisdiction statement should refer to “common law” and that under the Declaration Of Independence from Sovereign rule, your jurisdiction and venue should state so citing the 11th amendment where the government is not a body, but the individual who represented “The People” in its duty is the subject of controversy, in which you are entitled to a jury trial on demand. They hate these kind of claims.

D.LaRae
Hey Doc, I swear I could spend days sharing “FUN FACTS!” Like did Bush and Cheney break an Amendment? Answer? YES THEY DID. XII AMENDMENT IS PRETTY CLEAR BUT KARL THE HAM ROVE ( John Stewart and Colbert, that was a classic!) BUT ALSO CHENEY PROFITED OF THAT WAR AND GEE BY PASSED THE CLEAN WATER ACT FOR FRACKING? SEND THE WATER TO HIM! JUST FYI-DONALD RUMSFELD MUST FEEL SOME GUILT IF HE CAME OUT OF THE CLOSET AND STATED WE NEVER SGOULD HAVE DONE WHAT WE DID-THAT MAKES THREE. THEY ARE WAR CRIMINALS, PLAIN AND SIMPLE! IF I DIDN’T… Read more »
crazyelf
crazyelf
True… one, as far as has been reported, can not sue the Doctors, nurses, technicians etc. etc. When one files suit against the VA, it goes against the VA as a whole. This is why Doctors, nurses, technicians are transferred to other VA facilities. I know this is wrong. But that’s the way of the VA. Also, when a person(s) receives a settlement, the money is dispersed through somewhere, other than through the monies allocated to the VA for medical and administrative purposes. Of course, many voters and taxpayers are unaware of this! There is websites that have an abundance… Read more »
Ron Nesler
Member

VA is in FACT driving veterans into the sweet embrace of suicide each and EVERY day. And EVERYONE at 810 Vermont Ave KNOWS that.

Dan F
Dan F
The VA is all about studies, and the VAOIG is all about recommendations. This morning I started reading my email from the oldest, which was the post of this blog received at 2:33AM, a couple of emails up was the following email received at 10:07 AM this morning from VA News Releases – Office of Public and Intergovernmental Affairs. (Or, as I call them “The Office of Propaganda”). The Headline read: “Study may help Department of Veterans Affairs find patients with high-risk of suicide.” It can be found at this link: http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2710 For God’s sake, maybe, just maybe, if they… Read more »
Chuck Morse
Chuck Morse

It does appear from the G7 meeting that Global Warming,Educating our enemies,and being Muslim overshadowed the American Veterans current needs !!!

Reuben Castro Acosta

VA HQ IS FEDERAL RICO CRIME RACKET THATS A LEGAL FACT VA DEATHCARE WILL KILL VETS FOR THE BONOUS $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

Reuben Castro Acosta

VA HQ IS A FEDERAL RICO CRIME RACKET THATS A LEGAL FACT

avantdonald

OK…I get it…the VA is REALLY screwed…I’ve been hearing that drumbeat for years..The question is…WHAT CAN BE DONE ABOUT IT? (yes I’m yelling because I’m REALLY REALLY mad)…Scandal, lawsuits, congressional investigations, the VA just keeps rolling merrily along doing the same old stuff in the same old way…Does anyone know of ANYTHING that can be done that will be effective?

crazyelf
crazyelf
I honestly believe nothing will happen until millions of taxpayers, veterans and MANY, and I do mean MANY, converge upon Washington D.C. and let them know, in no uncertain terms, we are feed up with the way they are ruining this country! They need to know one thing: their jobs are on the line….. Do the job they get paid very handsomely to do. Or get the hell out, and let a real representative work out the details! No more lobbyists, large PAC’s (so officials can buy their way into office), etc. etc. etc. How much longer will the American… Read more »
burples
burples

Maybe I’m wrong, but I always assumed SUICIDE was a TOP mission at the VA as the number one cost saver! RIP Veterans.

Sgt - USAF (66-70)
Sgt - USAF (66-70)

I feel the root cause of PTSD IS the VA!!!!!! How many veterans are diagnosed with PTSD before they come home. How many veterans who committed suicide AFTER going to the VA???????????????????

CorpsmanuP! (@Tang1967)

You are right SGT, but it’s called VIP = VA INDUCED PYSCHOSIS 100% RATING through a Tort claim against them for a neglect in standard of care.

Sgt - USAF (66-70)
Sgt - USAF (66-70)

Ever since I started to post to this forum the VA denied a claim and cut my current comp by 10% – no reason they just said there was a ‘serious error’ My VSO claims she has no idea why. Wanna bet!!!

James
Guild lines the only guide lines they use and follow are the ones that will cover their own ass, they break guide lines every day and when the guide lines concerns veterans they are thrown out the! Window, they don’t have to accountable for anything they make their own rules and no one cares, as long as it does not effect them and their money. Other wise it’s a free for all. If they do something wrong they don’t have to worry, higher management will cover it up for them and then that employee owns that manager a favor, you… Read more »
crazyelf
crazyelf

If we were living in the 1770’s, King George would be proud of our elected and appointed officials. It seems many are doing exactly what was written in our “Declaration of Independence”. Y’all remember, that little piece of parchment that spelled out our “grievances” of what Great Britain was committing against us!
I might also add, when those men signed that ‘paper’, they were committing treason.
The penalty, at that time, would have been: hanging, left to rot so all could see, disimboweled, then “Drawn and Quartered”.
Just saying, folks!!!!

D.LaRae
UM YIKES!!! WHAT I FIND VERY INTERESTING ABOUT THAT DOCUMENT ( YES, LOCKED AND LOAD WITH A POCKET SIZE BOOK-TOTALLY NERD OR AS I SAY, JUST ANOTHER INTELLECTUAL BADASS! YOU KNOW WHAT I FIND SO INTERESTING, I WAS IN A STORE I DESPISE BUT THEY CARRY A FEW ITEMS I HAVE NEEDED. I’VE BEEN POLITICALLY ACTIVE FOR YEARS. (MY SPEECH PROFESSOR SWORE HE KNEW ME DURING A TIME “AGAIN” WITH MY BACK, BETWEEN SURGEY TWO AND SUGERY THREE). THIS GUY WALKS UP, SEES MY OBAMA SHIRT AND HE MENTIONED THE WRONG WORDS-READY? “YEAH I JUST MOVED HERE FROM CALIFORNIA BECAUSE… Read more »
Dan F
Dan F

You do know this forum is not about your personal political agenda? The comment you replied to in no way suggested a political stance. The vets on here, regardless of political persuasion, post useful respectful comments or suggestions. Calling people names, incoherent rants and capitalizing random words gets you no where. If this is all you have to offer – find a political forum where you can rant about your point of view. By the way this column was written months ago – we have all moved on.

crazyelf
crazyelf

Thank you DanF. Hats off to you! I’m still trying to ‘post’ the “Constitution” and “Bill of Rights” on here. I feel many Americans have lost the “WHY” America became the country it was meant to be. This is why I have, since i have began posting comments, put ‘Historical Information’ on this site. Maybe then, some might look up the information and become aware of what our “Elected” and “Appointed” officials are supposed to be doing in their ‘political positions’! And, if they get caught committing possible criminal acts, then, under the Laws of Our Nation be prosecuted!!!!

Bob
I agree with Crazyself about the punishment,but these people(and I use that title loosely)that are supposed to care for those who bore the Burden of War as Abraham Lincoln once said have sadly turned their backs on us and why wouldn’t they,it has no ill effect on them or their Families because they still get their 6 figure incomes,outrageous benefits ,unlimited paid sick leave and Tpo of the line unlimited medical care for them and their Families with no waiting for months or more waiting in limbo.So why should Congress and the Senate care about us just because we put… Read more »
crazyelf
crazyelf
Bob, thank you for agreeing with me. I wish I knew how to put the “Declaration of Independence” and the “U.S. Constitution”on here. It might help all who read them to get a better understanding of how we “became a free and independent nation”! For example, did you know Samuel Adams WAS, and IS concidered, the first “TRUE PATRIOT”. He was, and is, considered the Catalyst which started the “Civil War” between England and the Colonies! When any monies were ‘donated’ to the cause, he kept NONE of it. He was a member of the “Sons of Liberty”! Unlike John… Read more »
crazyelf
crazyelf

Bob, on ‘soda head’ yesterday it was reported HUD, with permission from Obama, is changing their ‘rules’. They now want to build low-income housing in high-income areas around the country. How do you think that’s going to go over with the wealthy?
“Obama set to force section 8 housing into wealthy neighborhoods for diversify”, is the title of the article.

crazyelf
crazyelf

I put the “Declaration of Independence” on here. Somehow, it is gone? Why? I believe all peoples should read it, along with the “Constitution of the United States of America”. I also believe reading these ‘documents’ will empower the people with all their knowledge the ‘founding fathers’ gave us to govern a nation. Remember, it is by these documents that insures our freedoms!
Anyone wish to reply????

D.LaRae
HEY GUYS? I WASN’T TRYING TO MAKE IT A POLITICAL FORMAT REGARDING THE TEA PERSON. WHAT I WAS TRYING TO MAKE HIM UNDERSTAND IS YOU NEED TO KNOW MORE THAN “ONE LINERS.” GENERALIZING OR STEREOTYPES OF A WHOLE STATE SOUNDS COMPLETELY OFF ( ARE THEY FOS STATES? HUMOR ALL! YES, BAD AT JOKES BUT I STILL TRY!). JUST FYI THOUGH, TWO. STATES HAVE LARGER STATE CONSTITUTIONS THAN THE COUNTRY. SORRY IT SEEMED TO SOUND POLITICAL, HEY A T-SHIRT I GRABBED IT WASN’T A LET ME GET ALL PERECTIONIST DAY. “WITH AGE COMES WISDOM, AND YOU LEARN WHAT IS IMPORTANT AND… Read more »
crazyelf
crazyelf
Sorry about your pain. I truly am. I live with it 24/7/365. These vets who post on here are Dems, Reps or of other groups. They have one thing in common. That is, being screwed by a government agency. They want it to be fixed. If it can’t be, then do the right thing, dismantle it and start again! I post “Historical Facts” because knowledge is power. The more knowledge a person has his or her power becomes stronger. Do you agree. Read the “Declaration”, “Constitution” and the “Bill of Rights”, then explain to me this, How many of our… Read more »
james hall
james hall

ave, imperaor morituri, te salutant

Sandra Demoruelle
Sandra Demoruelle
Two thoughts – we sued because we were denied access to BVA (see our case HI US Dist Ct CV14-00547 LEK BMK Second Amended Complaint Doc 60 – just filed today so not on PACER YET). It demands that Beneficiary Travel send a Due Process notice for their reimbursement. Our current BT VA EFT deposit w/NO identifying paperwork leaves me wondering what they have paid and what I am waiting for. My guidance – BLESS MR. KRAUSE – say “forget the money just follow your own VA rules and the Fifth Amendment (Due Process of Law).” Our suit was dismissed… Read more »
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