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Veterans secretary promises better healthcare for Native and rural veterans

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United States Secretary of Veterans Affairs Robert Leon Wilkie Jr. met with Native American veterans, tribal leaders and members of The Retired Enlisted Association (TREA) in South Dakota on Wednesday to discuss efforts to help Native American military veterans, specifically in the field of healthcare.

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Native American Veterans - Photo Vincent Schilling

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Navajo Code Talkers at the U.S. Department of Interior in Washington D.C. on Wednesday, Dec. 5, 2012.

Sec. Wilkie met with Native veterans to share that the Veterans Administration is working to increase tribal outreach virtually in cooperation with Indian Health Services

United States Secretary of Veterans Affairs Robert Leon Wilkie Jr. met with Native American veterans, tribal leaders and members of The Retired Enlisted Association in South Dakota on Wednesday to discuss efforts to help Native American military veterans, specifically in the field of healthcare.

Sec. Wilkie told Indian Country Today in an interview that he wished to “shorten the distance between people” in need of veterans services.

“In speaking with the tribal representatives today, I talked about increasing Veteran Administration's reach into tribal communities with things like telehealth, visits from VA representatives and closer cooperation between the VA and Indian Health (Services).”

Wilkie explained that Veterans Affairs — an organization responsible for nearly three-quarters of a billion dollars worth of services offered by Indian Health Services — would be effectively “opening the aperture” on giving support to tribal governments and urban area localities.

He also explained that the methodologies for outreach needed to be updated in conjunction with the growth of technology and cited that veterans in rural areas that takes his or her life likely had none or limited access to healthcare services.

“Of the 20 veterans a day who commit suicide, who take their lives, we don't have contact with 14 of those twenty,” he said.

Wilkie also described efforts to connect Native veterans to healthcare officials using virtual technologies.

“Let me give you an example of what's happening here in South Dakota on the Standing Rock reservation and in the Cheyenne lands. We've now distributed tablets and computers that allow veterans in those communities to virtually gain access to doctors, nurses, and benefits officers. This allows us to schedule appointments for them and it brings VA a little closer to home. We've started here in South Dakota and we'll expand it. I was up in North Dakota talking to the governor yesterday and we're going to expand it there and to Montana, as well as Wyoming. So those are the kinds of things that we are doing on a national level to change the true trajectory of where Native veterans should be in relation to their VA.”

Wilkie told Indian Country Today how the Mission Act of 2018—which gives more flexibility in the health care facility used by veterans — can be an advantage when choosing a facility. He also talked about family benefits.

“If a veteran has to travel a long distance to a VA facility and that veteran passes community hospitals, urgent care clinics, individual doctors or specialty clinics, we want to make sure that that veteran knows that he or she can use those facilities and that we're not forcing them to travel those hundreds of miles if there's something along the way for them to use. The other thing that is absolutely vital, and I speak of this as the son of a gravely wounded combat soldier from Vietnam, we finally close the last circle from Vietnam by allowing the families who take care of Vietnam veterans to get financial support and material support to take care of those veterans,” explained Wilkie.

“Vietnam veterans represent the largest portion of our 9.5 million veterans who use veterans' health. I can tell you that we still have a lot of catching up to do. I can remember when my father was a senior officer in the 82nd airborne division of all units and he wasn't even allowed to wear his uniform off the post. So recognizing caregivers, family caregivers for Vietnam veterans is the very least that we can do to finally close some of the circles that opened up.”

Wilkie also stated health professionals are lauding the practice of virtual efforts or telehealth.

“I'm not a medical professional. My experience is military and department of defense, but the medical professionals tell me that this is the future in mental health because you're not forcing someone to expose himself or herself in large settings with strangers. You can have them talk to a person in the comfort of a home or familiar setting, a VSO veteran service organization, or a hall. Now, there are some people who will want that direct human contact. But if we provide that kind of variety in those options, I think we will all be better off.”

Additional efforts by the Veterans Administration

In an email to Indian Country Today, the U.S. Department of Veterans Affairs Office of Public Affairs provided a substantial list of efforts currently underway to benefit military veterans and families of veterans. Some of the efforts submitted to Indian Country Today were written as follows below:

Greater access to care through “The Mission Act of 2018”

Secretary Wilkie worked with Congress to create the MISSION Act, which streamlines VA’s community care programs, strengthens health care options for our nation’s Veterans, whether in the VA or in the community and, most importantly, centers those decisions on what is best for our Veterans.

More information about the Act can also be found at https://www.missionact.va.gov/.

Connecting virtually via “Telehealth”

As acting VA secretary, Secretary Wilkie announced that VA is adopting a joint electronic health record integrated across all DoD and VA components, using the same system as the Department of Defense. This will ultimately result in all patient data residing in one common system and enable seamless care between the VA and DoD.

Suicide Prevention

According to the latest VA data, the number of Veteran suicides decreased from 2015 to 2016, and on average, about 20 current or former service members die by suicide each day. Of those 20, six have been in VA health care and 14 were not.

As the Joint Commission explains: “The US Department of Veterans Affairs (VA) has been able to reduce the number of in-hospital suicides from 4.2 per 100,000 admissions to 0.74 per 100,000 admissions on mental health units, an 82.4% reduction, suggesting that well-designed quality improvement initiatives can lead to a reduction in the occurrence of these tragic events.”

Studies show that suicides occur less frequently on VA campuses than on non-VA campuses.

Also, according to the latest VA data:

  • The number of Veteran suicides decreased from 2015 to 2016.
  • The Veteran unadjusted suicide rate decreased from 30.5/100,000 to 30.1/100,000 from 2015 to 2016.

Additionally, since the department in 2017 began tracking suicides at VA facilities there have been more than 260 suicide attempts, 240 of which have been interrupted.

Suicide prevention is VA’s highest clinical priority. One life lost to suicide is one too many.

That’s why VA is implementing a wide range of prevention activities to address many different risk factors. We are working alongside dozens of partners, including DoD, to deploy suicide prevention programming that supports all current and former service members – even those who do not come to VA for care. Examples of joint efforts to prevent Veteran suicide include the Mayor’s Challenge and our work under Executive Order 13822.

Our approach is summarized in the National Strategy for Preventing Veteran Suicide, which provides a framework for identifying priorities, organizing efforts, and contributing to a national focus on Veteran suicide prevention.

We encourage any Veteran, family member or friend concerned about a Veteran’s mental health to contact the Veterans Crisis Line at 1-800-273-8255 and press 1 or text 838255. Trained professionals are also available to chat at www.veteranscrisisline.net. The lines are available 24 hours a day, 7 days a week.

All VA facilities provide same-day urgent primary and mental health care services to Veterans who need them, and any time an unexpected death occurs at a VA facility, the department conducts a comprehensive review of the case to see if changes in policies and procedures are warranted.

For more info on VA suicide prevention programs, including the Veterans Crisis Line, see below and here:

https://www.mentalhealth.va.gov/suicide_prevention/docs/VA_Suicide_Prevention_Program_Fact_Sheet_508.pdf

VA Suicide Prevention by the Numbers

  • VA spent $12.2 million on suicide prevention outreach in the fiscal year 2018, including $1.5 million on paid media. During the fiscal year 2019, our total budget for suicide prevention is approximately $47.5 million, and we plan to spend $20 million of that budget on outreach.
  • VA suicide prevention coordinators are managing care for almost 11,000 Veterans who are clinically at high-risk for suicide.
  • Under VA’s new universal screening for suicidal intent, almost 900,000 Veterans have received a standardized risk screen since October 1, 2018.
    • More than 30,000 of these Veterans have received more complex screening based on a positive initial screen and more than 3,000 have received a full clinical assessment after screening positive.
  • VA Suicide Prevention Coordinators conducted more than 20,000 outreach events in FY18, reaching almost 2 million people.
  • In FY18, the Veterans Crisis Line:
    • Dispatched emergency services for callers in immediate danger an average of 80 times per day
    • Received an average of 1,766 calls per day
    • Received an average of 203 chats per day
    • Received an average of 74 texts per day
  • VA has achieved its goal of hiring 1,000 more mental health providers – adding 1,045 as of January 31, 2019.
  • VA made the commitment to hire additional mental health providers in June 2017 as part of VA’s top clinical priority of eliminating Veteran suicide. 

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