Preventing Suicide Among Veterans Not in VA Care Framing the needs, - - PowerPoint PPT Presentation

Preventing Suicide Among Veterans Not in VA Care

Framing the needs, opportunities, and questions

VA Office of Mental Health and Suicide Prevention July 20, 2017

Preventing Veterans Suicides

• VA can’t do it alone

– Veterans who come to VA for health care are part of their communities – Most Veterans do not come to VA for health care

R = 0.81

Veterans Are Parts of Their Communities

Most Veterans do not come to VA for health care

• The total Veteran population is approximately 20 million

– Approximately 9 million are enrolled with VA for health care services – Approximately 6 million use VA health care services over the course of a year

• In 2014, an average of 20 Veterans died from suicide each day

– 6 were current or recent users of VHA health care services – 14 were not

• A. Recent VHA Encounters

31.5%

• B. Recent Non-VA Fee Basis

Care 0.2%

• C. Recent VHA Medication Fills

0.3%

• D. Recent VBA Educational

Support 1.6%

• E. Recent Comp/Pension 3.7%
• F. Recently Applied for

Comp/Pension 0.7%

• G. VHA Encounters in 2000-2012

5.1%

• H. Non-VA Fee Basis Care

in 2000-2012 0.0%

• I. VHA Enrolled

3.3%

• J. VBA Educational Support

in 2000-2012 1.7%

• K. Received Comp/Pension

in 2000-20012 0.0%

• L. Applied for Comp/Pension

in 2000-2012 0.7%

• M. Known to VBA

43.9%

• N. Absent from all

Other Categories 7.4%

Veteran Suicide Decedents in 2014

Currently Identified Points of VA Connection*

* Mutually exclusive groups

Recent: 2013-2014

Other VA and DoD Connections

• The pie chart includes
• Health care from VHA
• Compensation/Pension and Educational programs from VBA
• Other programs to be added include

– Other VBA programs

• Loans
• Vocational services
• Insurance

– Vet Centers – Department of Defense

• Veterans who

– Are active members of National Guard and Reserve units – Who utilize health care services through TRICARE and Military Treatment Facilities

Conceptual Model

• Prevention must target multiple actionable populations
• The impact of the overall strategy is (approximately) the sum of the

impacts of interventions toward actionable populations

• Impact of = P*R*E*S where

– P= actionable population – R= reach into the population – E= real world effectiveness of the preventive intervention – S= suicide rate in the population

Analyze the 20 Per Day

Identify how to make an impact Implement Strategies

Process for Learning and Acting

• Develop models
• Collect required data to

understand the 20 Veteran suicides per day (VBA, Veteran Centers, etc.)

• Identify partnerships and data

resources to support the strategy

• Analyses and reporting

Population

• Identify potential settings and

contexts for outreach and programming

• Coordinate with Federal, State,

Local governments and external stakeholders

• Develop action plans

Impact

• Partnerships regarding

Veteran outreach, messaging, and other strategies

• Push intervention (e.g.,

public service outreach)

Strategies/Intervention

Draft- pre-decisional – not for circulation

Defining Actionable Groups

• Groups may overlap

– Multiple contacts may reinforce each others

• Reach

– Direct to individual identifiable Veterans or indirect, – Through partners – Through public messaging

• They should include:

– States and communities – Health care insurers or providers

• Medicare, Medicaid, and other payers
• Health systems

– Veterans Services Organizations and other community groups – Work place – Interest groups

• Hunting and shooting sports

– Accounts for 2/3 of Veteran suicides

Characterizing Risks and Burdens

• Collaboration with NVDRS to characterize deaths
• Analysis of existing data sets that include Veteran data

– National Survey of Drug Use and Health – National Health Interview Survey – American Community Survey

• Other

Preventing Veterans Suicides

• VA can’t do it alone