What The Veteran Suicide Prevention Bill Would Mean For San Diego

Our top story on Midday Edition a bill now on its way to the President’s desk is aimed to giving veterans another life line in dealing with mental health issues. The Clay Hunt Suicide Prevention for American Veterans Act was passed by the senate yesterday. The previsions of the bill strengthen and add mental health services offered by the veterans administration A new analysis reveals that the rate of suicide among the Veterans of the Iraq and Afghanistan war era is fifty percent higher than among civilians. Joining me is Dr. David Eisenberg he is a psychotherapist and suicide prevention coordinator at the VA San Diego health care system. -- Dr. Eisenberg -- David Isenberg thank you for joining us welcome. Thanks Scott things for inviting me. Their son, Daniel Summers took his life in June Daniel Summers took his life in June 2013. Howard in Gene welcome to the show. How are you and gene -- Howard it -- Howard again -- can you tell me what the Clay hunt suicide prevention act will add to the mental health services question Mark That's a very interesting for shimmery. There is some actual controversy which is going to add a lot to the suicide prevention to the VA. We have talked to a lot of people both here in San Diego and nationally that the VA is actually trying very hard and has actually improved on a national level there suicide prevention efforts. But we think this bill does more than anything else, is ring new light to the issue. We get more into the forefront. The fact that it was held up during the last session, the senator from Oklahoma, we think it was a positive to the they were impetus to the bill and make people more aware of the bill. Some of the things that is going to do that we already do here in San Diego is for example, then data per support effort nationwide. We have a very active support network and we have found that veterans in general are somewhat reluctant to seek treatment to seek care to go someplace that they are not comfortable. And if somebody who has been through a process and was a veteran has gone through it and has been successful at it, the new veteran, the other veteran will then volunteer. This is where the. Support program so helpful. Right, in addition, with this Clay hunt suicide prevention act does is create a one-stop website for veterans mental health care services. It asked the BAA and mandates them to evaluate their mental health programs work a variety of smaller things including the peer support pilot program that you were talking about which was apparently already ongoing here in San Diego. David Isenberg do have any idea how these expanded services may be used here in San Diego? I don't have an idea. But I can echo the echo the peer support specialist aspect. We appear support specialist operating here connected to mental health. I was speaking to a site is sidled up this morning who was as you described cut in the limbo between the super unhappy past and the difficulty with entering into the treatment. Treatment can be challenging.. Support specialist going out to provide direct support, especially someone who has had their own trouble with PS TST -- PTSD. India April fill impact. David, where would you say there are weaklings now in the VA suicide prevention efforts here in San Diego question Mark Ethic were always hoping for more providers. One of the issues is, how fast people get access to treatment. Which is a major concern to our very fine leader, Jeff Gehring, he is really pushing the importance of seeing that seemed pick having access to the providers is very important. Reaching out, running ways, finding ways to increase ways for about. Gene, when your son Daniel was trying to reach out for the can help we are talking about what would the main problem see was facing question or Unfortunately, he was in Phoenix. We know what the axis problems were in Phoenix. We actually felt that his letter, when we releases suicide letter, actually was the first whistleblowing on Phoenix in terms of the problems they had there. Daniel was not afraid to seek care, he knew he needed care. What is first problems that ran into was actually going to the VA and the VA saying, it is addressed as with the National Guard yet to be seen at a military DOD hospital. It took him three months to get that squirt away. So three months off the back is lost. And his mental health professional that we don't know if it was a psychiatrist or psychologist actually left the VA and when he left he said this was about a third able to treatment. He went to the VA in my inside by provider was leaving and asked who his provider was going to be. They said they had no provider. They were using the [Indiscernible] to notify veterans. They with cinema postcard when he was assigned a new provider. And in the five years between that time and is that he did not receive a postcard from the VA. So is forced out of the VA system. He had a seat treatment in the community. Howard and gene, was an obvious to you that your son was experiencing deep psychological trouble? Or did he try to hide it from you? Well, as many, if not all of the instances that we have been aware of, the better and tries to hide things from his family. One of the major issues and profits we had is that Daniel was married. And because he was married we became very secondary with regards to receiving any information about his condition. That brings up a whole other issue. The HEPA issue which we find is very a barrier, a huge barrier to treatment. We don't have nearly enough time to discuss the issue but people in Congress are aware of that and there are efforts being made to make it more reasonable to allow people who have invested interest in a particular patient be informed as to the condition of the patient. And be able to help. We know that there is an initiative here in town, I think Laura's law. It is being proposed that would be in some help to situations such as Daniels. Did you become advocates and you decide before Congress have you heard similar stories, the the story of Daniel come back to you, Jean, over and over again from other parents question Mark Actually because we cannot have some sort of a national presence at this point, and we have an event that we put on, so it has a Facebook site. We have been content by multiple people about individual problems that they had most recently, the sister of a better husband died knows as schizophrenia, we reached out to Dr. Göring to help us to reach out to his VA on East Coast. To see if they couldn't help the sister try to help get guardianship and work with him to make sure that he really had all plan. We went to a conference at the taps organization put on which is a wonderful organization. [Indiscernible]. You don't have to be a suicide survivor or family member of a suicide victim, basically, anyone who has a relative who is been in the services and that relative as pastor you could join us organization. The press is going portions organization is a suicide provide all -- suicidal division. We've met with parents and every one of them had a similar story. People approach us and thanked us. For publicizing Daniels letter because they had no idea what their child was going through, what his thoughts were, I say his but it's his and hers. We know suicide is big issue in the female population as well. This was eye-opening to us. Let me pose a question to you, David Isenberg, recent analysis from Iraq and Afghanistan found that their suicide rate was 50% higher rate than the civilian population with the same demographics. Are you seeing many patients who say they are thinking about committing suicide? Yes. I don't have a number cop it we do see too many patients who are hurting with suicide [Indiscernible]. Just to give you some data in California and 2012 there were [Indiscernible] suicide. The rate was 10.2 per 100,000. That was all folks not just for vets. The San Diego is 60 per hundred thousand. So right away we have something going on, a cluster in San Diego. Of the VAT rate nationally is 35 per hundred thousand. In San Diego, is 54 per hundred thousand. Part of that may be an artifact of the high cooperation between the medical examiner here in our own data analysis. We have a good relationship. Our suicide prevention program actually collects data from them each month. For that might be a fact of reporting. But this is really way too high. One is too high. Is suicide ideation linked with posts traumatic stress disorder? Is not necessarily linked to it. There are risk factors for suicide and there are protective factors for suicide. I brought a little handout for you Maureen. Ms. doctors could include the diagnosis, a mental health diagnosis, but substance abuse disorder, having retractable grommet illness, chronic pain, there are a variety of reasons why someone might be burdened with suicide ideation. I wanted to bake to this bill, Maureen can I have 30 seconds to this question Mark Certainly. We screen for this so when of that comes to the VA to begin his career as a patient. We use formal screening methods, even if they're coming for something not related to mental health, if someone comes for a mental health or emotional issue we do a formal comprehensive suicidal risk assessment. [Indiscernible] for all of our providers. Thank you for that. Gino's can ask you now we have the house to it side prevention act. The president will was a great sign it. What other problems in the system still need to be fixed question Mark We have shortly after Daniel past, we sat down with his wife was a nurse and his mother liked with a psychiatrist. We came up with 19 pages of problems that we felt Daniel, barriers Daniel had hit in the Phoenix VA we have to remember that were talking about a single be a that has been identified as being a problem in the system. But there are still some issues that we think are broad. Probably one of the most important that we see right now is that only 20% of our veterans are being seen in the VA. That means 80% of her but trends are being seen of the community. There was a recent RAND study that indicated out of those providers outside of the VA only 13% were really confident in terms of knowing about military culture and knowing about that evidence-based treatments that are effective with mental health problems. Only 30% were really confident to treat veterans. So that is scary to us. To us, that's a huge issue right now. Educating the community first off, the mental health providers, but then the normal pubic is not all people will go to a normal -- mental health. But the other primary care physician. OB/GYN. Pediatrics. The education problem is really really big. Even the VA itself, and something were working on with the VA, as a resident you rotate through the VA, you're not given any special training before that. To understand what the military culture is and what known issues these people could have. I have very little time Howard. I'm sorry. U. S. for of issues at the VA, which David sent of course is static or one of the proposals within the clay hunt act is the loan for business proposal. We don't think it goes nearly far enough, 30,000 years for only 10 people. That's $30,000 per year that you've given back the only obligated to give back two years. Which we think is very very minimal. Mental health is a huge issue in the terror country and we think there needs to be a little forgiveness program for mental providers for the entire country for the entire population. The other issue that event into the VA formula -- the drug formula needs is lacking in anything coordinated and mess with the DOD formula. Okay. I know I need to leave it there. I know you appreciate all you three coming on at its peak but Jean and Howard Summers and David Hyatt Isenberg of the San Diego healthcare system. Thank you very much. Thank you.