The Senate has approved legislation to help prevent suicide among veterans
returning from war and those long retired from military service.
The bill (HR 327), titled the Joshua Omvig Veterans Suicide Prevention Act,
passed the Senate unanimously in September; the House passed its version in
The bill requires the VA to develop and implement a comprehensive program
to reduce the incidence of suicide among veterans, including the availability
of 24-hour mental health care for veterans thought to be at risk for suicide.
It also calls for development of an outreach and education program for
veterans and their families to help them recognize readjustment problems and
promote good mental health.
In addition, the legislation would provide mandatory suicide prevention
training for all VA personnel involved in medical care, including how to
recognize the risk factors for suicide and the best practices for suicide
The legislation also would require that each VA medical facility designate
suicide prevention counselors who would work with emergency rooms, police
departments, mental health organizations, and veterans service organizations
on outreach to veterans and improved coordination of veterans' mental health
The bill is named for Joshua Omvig, an Iraq War veteran who suffered from
posttraumatic stress disorder and committed suicide in 2005.
The Senate bill included amendments to address objections raised by Sen.
Tom Coburn (R-Okla.), who had placed a hold on the bill over provisions that
would have allowed the Department of Veterans Affairs (VA) to track veterans
who have been screened and identified as mental health risks through the
bill's suicide prevention system. He derided the tracking provision as a
violation of veterans' civil liberties and a danger to future job
"If, in fact, you have encountered the VA and because you were
screened, not of your choice and not because you had signs or symptoms,..
.that becomes a part of your record," Coburn said in a written
statement. "You automatically are limited in lots of things that you
cannot do in this country."
That provision and another that would have mandated a VA peer-counseling
program—criticized by Coburn as ineffective—were removed by
amendment. The VA can choose to offer the peer-counseling program but not
Some of the provisions in the bill mirror initiatives undertaken
administratively by the VA in recent years, including the placement of suicide
prevention coordinators in every VA medical center and establishment of a
veterans-focused, 24-hour, suicide prevention hotline.
APA had lobbied for a provision to require that all returnees receive a
mental health screening instead of only a mental health status exam, which
does little to detect mental illness or risk for suicide, said Lizbet
Boroughs, deputy director of APA's Department of Government Relations.
However, despite the limitations imposed by the Senate amendments, the bill's
supporters recognize that overall the legislation offers tremendous
"This is bipartisan legislation that will help ensure that our
veterans receive the mental health care that they need," said Jerry
Reed, executive director of the Suicide Prevention Action Network (SPAN USA),
in a written statement. "Research shows us that male U.S. veterans are
twice as likely to die by suicide than those without military service, making
passage of the Joshua Omvig Veterans Suicide Prevention Act all the more
The legislation also aims to destigmatize mental health care. Many veterans
have expressed fear about problems that might stem from their voicing concerns
about their psychiatric problems, including whether receiving mental health
care would damage future job prospects in the military or in civilian jobs,
especially those related to law enforcement.
Veterans advocates have maintained that better coordination of health and
criminal-justice services is needed to ensure that veterans with mental
illness who have been released from local jails are referred to the VA system
for help before they descend into homelessness or suicide.
Frederick Frese, Ph.D., a member of the NAMI board of directors, said at a
September congressional briefing on veterans' mental health that coordination
with local government agencies could keep many veterans with mental illness
from going for years without treatment (see Too Few Clinicians Complicate Care
in VA, Military Systems).
Yet another part of the bill requires the VA to make outpatient mental
health care for veterans considered at risk for suicide available on a 24-hour
basis. Many veterans and their survivors have testified before congress about
extended treatment waiting times they endured after reporting suicidal
thoughts and requesting mental health care.
The bill also requires a toll-free hotline for veterans, staffed by"
appropriately trained mental health personnel" and available at
all times, in addition to the 24-hour care requirement.
The measures are needed, said Sen. Tom Harkin (D-Iowa), sponsor of the
Senate version, to reduce the more than 5,000 veteran suicides each year. The
need is clear from statistics showing that the suicide rate for Iraq veterans
is 35 percent higher than that for the general population, he said.
"This is a genuine crisis, and it requires an urgent, stepped-up
response from the VA, which is exactly the purpose of my bill," Harkin
The bill was endorsed by the American Legion, Veterans of Foreign Wars,
Disabled Veterans of America, and other veterans groups.
"The American Legion receives contact from veterans themselves who
openly admit they need immediate help because of thoughts of harming
themselves," said Shannon Middleton, deputy director for Health at the
American Legion, in congressional testimony about the bill. "When the
family and the veteran know what services are available, it is easier to seek
The bill, after being amended in the Senate, was returned to the House in
September for final passage.
The Joshua Omvig Veterans Suicide Prevention Act can be accessed at<http://thomas.loc.gov>
by searching on the bill number, HR 327. ▪