Report: Veterans at risk for suicide not getting follow-ups

By Leo Shane III

Source: Stars and Stripes
Published: Thursday 02 May, 2013

WASHINGTON — Health workers failed to check up on almost a third of veterans at risk for suicide, raising serious questions about the department’s mental health care.

But in a report released this week, the VA inspector general’s office said that 30 percent high-risk mental health cases they reviewed did not receive all of the follow-ups promised by the department. Among lower-risk patients, 28 percent did not receive the promised check ups.

Under existing policies, the Veterans Health Administration requires staff to conduct follow-up calls or appointments for any veteran discharged from an acute mental health treatment program.

Those deemed high-risk for self injury are supposed to have four follow-ups within a month. Others are required to get at least one follow-up visit or call within a week.

In a statement, VA officials acknowledged the problems listed in the report and said they remain committed to providing the best care possible for veterans.

"VA will improve post-discharge follow-up for mental health patients, particularly those who were identified as high risk for suicide by creating a local patient registry for follow-up on all patients discharged from their inpatient mental health units," the statement said. "VA will also require three attempts be made to contact a Veteran who has missed a mental health appointment and document these attempts in the medical record.”

The report marks the third year in a row the inspector general has faulted the Veterans Health Administration for substandard follow-up care, and comes despite repeated promises by department leaders that they’re making every effort to stamp out veterans suicides.

The latest VA data indicates about 22 veterans nationwide commit suicide each day, a steady rise in recent years.

The department has expanded its mental health crisis line operations and anti-suicide public campaigns in recent years, as well as bulked up the number of mental health specialists in the VHA.

Still, the Inspector General report notes that follow-up care for unstable patients can be one of the most critical steps to ensuring their health and safety.

“Considerable numbers of discharged mental health patients who lacked significant suicidal ideation during hospitalization later developed suicidal ideation during the outpatient treatment period,” the report states.

“Research studies have concluded that increased engagement in follow-up care is beneficial. Additionally, lack of follow-up can be a factor in psychiatric readmissions.”

In response to the report, VHA officials told the inspector general that they will issue a memo charging all health care facilities to create patient follow-up registries, to ensure those calls are being made.

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