Suicide among service members, veterans, and their families is a public health and national security crisis. Far too many of our nation’s veterans and service members have died at their own hands, an overwhelming majority of them as the result of a firearm. Since 2010, more than 65,000 veterans have died by suicide – more than the total number of deaths from combat during the Vietnam War and the operations in Iraq and Afghanistan combined. These women and men volunteered to serve their country, often in dangerous conditions. We owe them, their families, and their fellow service members and veterans a better, more coordinated response to address the military and veteran suicide crisis.
Suicide is a complex problem, with no single cause and no single solution. But it is preventable. Given the multiple factors that may lead to suicide, preventing suicide requires a comprehensive public health approach that harnesses the full breadth of the federal government.
Today, the Biden-Harris Administration is announcing a series of priority goals and executive actions that will drive suicide prevention efforts moving forward. These goals are outlined in a new national strategy, “Reducing Military and Veteran Suicide: Advancing a Comprehensive, Cross-Sector, Evidence-Informed Approach.”
The key components of this comprehensive strategy include:
Improving Lethal Means Safety
Suicide crises are often brief, and evidence suggests they can be prevented if the individual in crisis lacks immediate access to the means for self-harm. The strategy identifies ways to ensure time and space between a person in crisis and their access to lethal means, including firearms and medications. In implementing this strategy, the Departments of Defense (DOD), Health and Human Services (HHS), Homeland Security (DHS), Justice (DOJ), and Veterans Affairs (VA), as well as the Office of Emergency Medical Services within the Department of Transportation (DOT), will create and implement a coordinated approach for improving Lethal Means Safety. In the coming months, agencies will collaborate to raise awareness among service members, veterans, and their families; educate and train health care providers and crisis responders; and evaluate the effectiveness of existing and new programs that may reduce access to lethal means. This will include designing and launching a campaign to increase the safe storage of firearms and medications, and the use of safety planning interventions by providers.
Enhancing Crisis Care and Facilitating Care Transitions
Individuals at imminent or high risk of suicide need access to high-quality crisis care and follow-on support. The strategy elevates the need for improving care in emergency settings, as well as providing appropriate care and support as individuals transition from crisis care into follow-on settings, including other services that can help to de-escalate the crisis and facilitate access to outpatient care. Emergency care settings (emergency transport, urgent care, and emergency departments) play a critical role in stabilizing patients and connecting them to care, and HHS, VA, DOD, and DOT will collaborate to promote evidence-based risk-assessment and safety-planning are used by providers in these settings throughout the country. Agencies will also expand approaches to help identify service members, veterans and their family members at risk of suicide, enabling early intervention.
Increasing Access to and Delivery of Effective Care
Ensuring access to evidence-based care for mental health greatly reduces suicide risk among those with behavioral health problems, including depression, post-traumatic stress disorder, and addiction. The strategy is focused on reducing barriers to high quality mental health care and to encouraging help-seeking among service members, veterans, and their families. Strategies include eliminating or lowering co-payments for mental health treatment, increasing confidentiality, clarifying fitness for duty standards, and training of providers in evidence-based suicide risk assessment and care. Agencies will also identify and eliminate potentially discriminatory practices related to mental health care.
Addressing Upstream Risk and Protective Factors
Reducing the likelihood that an individual will experience a suicidal crisis requires addressing the factors—such as increased financial strain, lack of housing, food insecurity, unemployment, and legal issues—that may contribute to or increase risk for suicide. Conversely, improving coping and problem-solving skills and supporting connectedness are protective factors that can decrease risk. In driving this priority, HHS, DOD, VA, DHS, ED, and DOL will expand federal, state, territory, Tribal, and local public and private partnerships to address risk and protective factors for suicide. This will include increased emphasis on promoting economic well-being, reducing housing and food insecurity, and supporting service members, veterans, and their families in the transition to civilian life.
Increasing Research Coordination, Data Sharing, and Evaluation Efforts
The federal government invests significant resources in suicide prevention research and the collection of data on suicide risk factors and outcomes. Unfortunately, the data needed to monitor suicide risk and outcomes for service members, veterans, and their family members is not currently shared or integrated among the relevant agencies. The strategy will advance interagency research coordination, ensure integration of data, and encourage adoption of rigorous program evaluation across all prevention programs. These efforts will improve our understanding of the factors that lead to suicide in the military and veteran community, promote early identification of risk so that we can better support individuals and communities, and help ensure the effectiveness of suicide prevention programs. To achieve these goals, VA, HHS, DOD, and the Department of Energy (DOE) will coordinate research activities and program evaluation efforts. Agencies will also continue implementation of the National Research Strategy, improving access to and linkages of data to enable real-time surveillance.
These actions build upon an existing foundation of government programs and public-private partnerships, and will serve to accelerate efforts across the federal government. Moving forward, these federal priorities will be implemented in close coordination with states, territories, Tribes, and local governments, as well as in collaboration with industry, academia, communities and community-based organizations, families, and individuals.
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