Most new veterans aren't getting screened for suicide risk and may be missing mental health treatment in the crucial first years of transitioning to civilian life, despite a presidential order that the military provide the service, the Defense Department inspector general found in a new report released Friday.
The Pentagon screened only about one-third -- 34% in 2020 and 30% in 2019 -- of transitioning troops, who face an overall risk of suicide that's three times higher than active-duty service members, the IG reported.
It was supposed to screen 100% by the end of 2018, according to a joint plan with the Veterans Affairs Department.
As the military grapples with a persistent suicide epidemic, the lack of transition screenings for those at higher risk of taking their lives may have impaired the Pentagon and the VA's ability to predict health care needs and dole out benefits at discharge, and may have jeopardized the safety of veterans, according to the IG.
"The overall DoD approaches and services for arranging continuity of mental health care are not resulting in uninterrupted care for all service members," the watchdog said in the report.
In 2018, former President Donald Trump directed the Pentagon and the VA to ensure veterans receive "seamless access to high-quality mental healthcare and suicide prevention resources as they transition, with an emphasis on the 1-year period following separation." About four months later, the DoD and the VA issued the joint action plan for creating screenings and continual care.
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Veteran suicide rates have been rising for two decades, and since 2005 have climbed faster than non-veteran suicide rates in the U.S., according to Rand Corp. The grim metrics abound and have remained steady despite years of discussion in Congress, and pledges from successive presidential administrations and the military.
Many more veterans and active-duty troops have committed suicide over the past 20 years -- 30,177 -- than were killed in post-9/11 wars -- 7,057, according to research by Brown University's Costs of War Project.
"Getting this right is personal for all of us at the department. Yet, prevention can be complex," Maj. Gen. Clement Coward, acting executive director of the Office of Force Resiliency, said last month in a press statement as the Pentagon released its annual report on active-duty suicides. "As the scientific research about suicide prevention continues to evolve, we continue to do everything possible to stop these tragedies."
The VA in September reported a drop in suicides among veterans during 2019, the most recent data available. There were 6,261 suicides, 399 fewer than the previous year, it said..
"Suicide prevention remains a top priority for VA, with the most significant amount of resources ever appropriated and apportioned to VA suicide prevention," VA Secretary Denis McDonough said in a released statement. "Suicide is preventable, and everyone has a role to play in saving lives."
The IG report released Friday found the Defense Health Agency and military services didn't include suicide risk screenings and mental health assessments in the Separation History and Physical Exam, the only medical exam required when troops transition out.
The DoD didn't put an office in charge of overseeing mental health assessments, and it had no comprehensive system to ensure transitioning service members who already were receiving mental health care did not have a break in that care, the IG found.
The department is instead reliant on troops themselves and automated systems to shift care from the military health system to the VA health system.
In a response to the IG, Gil Cisneros, the undersecretary of defense for personnel and readiness, said the department and the VA are working together to revise the military exit exam into a "single baseline examination" that can be used by both.
That work is to be completed by October 2022, Cisneros wrote in the letter.
New mental health screening questionnaires given to troops during separation will assess risks of suicide and violence, and include queries about post-traumatic stress disorder, depression and alcohol use, he said.
If you or a veteran you know is in crisis, you can call the Veterans Crisis Line, dial 1-800-273-8255 and Press 1; chat online; or send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year.
-- Travis Tritten can be reached at travis.tritten@military.com. Follow him on Twitter @Travis_Tritten.
