Testimony of The Independence Fund at the House Veterans Affairs Committee Hearing on April 29, 2019
Tragic Trends: Suicide Prevention Among Veterans
Chairman Takano, Representative Roe, Members of the Committee:
Thank you for the opportunity to provide this testimony to the Committee on Suicide Prevention.
The Independence Fund recently embarked on one of the most ambitious suicide prevention programs, in partnership with the VA. Called, “Operation RESILIENCY”, this program brings together tactical combat units who suffered high casualty rates during those deployments, and then suffered high suicide rates upon redeployment. The concept is to bring the company or battalion sized units together in reunion retreats, build upon the strong unit cohesion borne of battle, and leverage that cohesion to renew a sense of belonging amongst the military veterans, as well as to build accountability amongst the unit members.
The Independence Fund recently hosted the first of these retreats April 4-7, 2019, in Charlotte, NC, with members of Bravo Company, 2nd Battalion, 508th Parachute Infantry Regiment (B Co., 2/508 PIR), from their 2009-2010 combat deployment to Afghanistan. Of the 115 surviving members of the Company, 95 participated, some of them still active duty or reserve component, but most discharged or retired veterans. This unit suffered more than a 50% Purple Heart award rate, lost three members Killed in Action, and dozens Wounded in Action. Equally troubling, since returning home, B Co. has had two members from that deployment take their own lives. Also of note, during the Resiliency Retreat with the members of Bravo Company, we learned of about two dozen suicide attempts among members of that Company.
During this four-day reunion, while members of B Co. enjoyed unit building activities such as white-water rafting, Top Golf outings, unit physical training, and bonfires, they also participated in clinical group and individual therapy sessions facilitated by mental health professionals from the VA’s Office of Suicide Prevention, and led by Dr. Keita Franklin. The clinical therapy sessions focused on connectiveness and reigniting the bonds these Paratroopers have. On the final day, after more unit physical training, a Resource Fair was held with representatives from local Congressional offices, Veteran and Military Service Organizations, mental health providers, and various Veterans Benefits Administration, Veterans Health Administration, and other federal government agencies, as well as local governments, to provide a “whole of society” approach to addressing the panoply of contributors to veteran behavioral health and suicide prevention.
In addition to the representatives of the VA’s Suicide Prevention Office, local VA medical facility and VISN officials, as well as representatives of various benefits offices, participated in the weekend. Members of the North Carolina Congressional delegation, the Afghan Ambassador to the United States, and VA and Independence Fund officials all participated in various programs with the unit members.
Post Reunion Retreat Engagement
Together with the VA, the participants of the retreat complete a VA designed pre-retreat, post-retreat, and 30-day follow-on post-retreat survey, a copy of which is attached. This survey is used to measure individual changes in participants’ individual Resilience Score, using the Connor-Davidson Resiliency Scale (CD-RISC). The VA conducts these surveys and collects this data as this program is a pilot program for the VA, in large part to determine the efficacy of this approach in improving individual resilience.
Furthermore, the VA is conducting follow-on engagement calls for all participants, with the initial contact completed by May 3, 2019. The participants will also receive a post-retreat survey via e-mail by May 8, 2019, as well as additional follow-on calls at 60- and 90-day points after the retreat, and at six and 12 months. The calls will be used to determine if the participants connected to resources identified during the retreat weekend, and if The Independence Fund and the VA can provide them additional support obtaining these resources. An additional purpose of the calls is to remind them of the connection with their accountability partners within the unit, and possibly identify those in or approaching crisis who may need immediate intervention.
Another key goal of the retreat is to get those participants who need it into therapy with the Department of Defense or VA, as appropriate. Since the retreat, three participants started therapy, and another three presented themselves as in crisis, where The Independence Fund and the VA were able to get them into immediate care.
For those present, the impact on the participants was palpable. The reconnection with battle buddies, assurance from unit leadership that seeking behavioral health assistance was normal and acceptable, and resiliency training all appeared to have a visible and quick impact on the participants. As one participant stated post-retreat, “This retreat saved lives. Maybe not today or tomorrow, but lives will be saved because of what happened here.”
Additional Reunion Retreats
The Independence Fund will host at least two additional retreats in 2019 and plans to host four to six retreats per year moving forward. From May 8-11, 2019, the Independence Fund will host the 3rd Battalion of the 67th Armored Regiment, who deployed to Fallujah, Iraq, at a reunion retreat in Houston, TX. From September 26-29, 2019, the Independence Fund will host a retreat for Bravo Company, 2nd Battalion, 504th Parachute Infantry Regiment, in Nashville, TN.
Members of this Committee and both Committee and personal office staff are more than welcome to join us at these retreats. Local Congressional offices are also invited to set up booths at the retreats’ Resource Fairs on the last day to advise constituent participants on the services those Congressional offices can provide active duty, reserve component, and veteran participants. Further, if Members of the Committee know of other military units, active or reserve component, who fit these criteria and might benefit from an Operation RESILIENCY retreat, please contact us and we will work with you to support those units.
Operation RESILIENCY Summits
Building on the “whole of community” approach championed by the VA through their Governors’ Challenge and Mayors’ Challenge, The Independence Fund is also hosting a series of regional Operation RESILIENCE Summits to support the local community planning to execute these veteran suicide prevention efforts. The Independence Fund hosted the first Summit April 23, 2019 in Charlotte, NC supporting Mecklenburg County, and focusing on student veteran suicide. In addition to the support of national leadership of Student Veterans of America, representatives of eight regional colleges and universities joined local government officials and The Independence Fund with workshops and panel discussions such as “Pre/Post Military Stress for Student Veterans”, “Invitation to a Tribe: Connecting in the Community”, “Student Veteran with Healthcare Needs – Navigating and Collaborating with VA and Community Resources”, and “Working Through Obstacles and Creating Support for Veteran Resiliency & Success”. The Independence Fund will work with SVA, Mecklenburg County and other participants to continue to engage Student Veterans in the weeks and months following.
In July 2019, the Independence Fund will host a second Summit in Houston, TX, which will focus on older veteran suicide. Specific goals of these summits are to “Invitation to a Tribe: Connecting in the Community”, “Senior Veteran with Healthcare Needs – Navigating and Collaborating with VA and Community Resources”, and “Working Through Obstacles and Creating Support for Veteran Resiliency & Success”. We are currently reviewing other communities in which to host further Summits this year and following years. The Independence Fund plans to host four to six of these Summits per year. If Members of this Committee know of suitable partner communities where we could host future Summits, we would very much appreciate the opportunity to work with your offices to coordinate that.
Legislative & Policy Proposals
The Independence Fund fully supports the whole of community approach presented in the President’s PREVENT Executive Order, and believe including non-governmental community organizations, along with State and local governments, in such veteran suicide prevention programs is the only way to fully address the issue of veteran suicide. As both this Committee, the Senate Veterans Affairs Committee, and the Administration are all proceeding with similar community engagement grant programs, The Independence Fund would appreciate the opportunity to present what we believe should be governing principles as these legislative, regulatory, and Executive Branch actions move forward.
Keep a Behavioral Health Focus: While many factors can contribute to an individual’s death by suicide, it is ultimately a behavioral health issue. Factors such as employment, finances, housing, and personal relationships can all contribute to suicide and suicidal ideation. But many other veterans suffer setbacks in all those areas without looking at suicide as a response. The decisions which lead to suicide are cognitive and are best treated by proper behavioral health. The Independence Fund is concerned government grant and community engagement programs will be diluted below a level of minimum capability if these programs attempt to address too many non-behavioral health issues.
Strengthen the Behavioral Health Capabilities of Community Care Providers: With most veterans dying by suicide not enrolled in the VA system, it is doubtful expanding VA behavioral health capabilities alone will adequately address veteran suicide rates. Government to community engagement programs and grants should seek to broaden, strengthen, and deepen the capabilities of community care behavioral health capabilities to reach as many veterans as possible. This Committee should also remain aware there is still deep mistrust of the VA within many parts of the veterans community, which will require exorbitant levels of marketing and engagement to overcome. The Independence Fund believes those funds would better be spent on community care programs where those issues of mistrust are not as prevalent.
Grants Should Provide Sufficient Funds to Run a Meaningful Programs: Too often government grant programs seek to meet broad demographic, policy, and geographic diversity goals, which then may lower the amount awarded in individual grants below a level where the program can be efficiently executed and unnecessarily raising per capita costs. The Independence Fund believes it is better to award a smaller number of larger grants than a larger number of smaller grants in order to prevent funds provided will be consumed by overhead and administrative expenses and not address the key behavioral health issues.
Maximize Community Partner Engagement in the Government Processes: Current regulations allow grant making agencies to have stakeholders serve on grant selection committees. This Committee should encourage the VA and the PREVENT Task Force to bring such veteran suicide prevention stakeholders into the process for determining the grant criteria and to have such stakeholders serve on the grant-making committees. Further, this Committee should encourage the Administration to establish an advisory subcommittee of the PREVENT Task Force where veteran suicide prevention stakeholders and community partners can effectively serve.
The Independence Fund appreciates this opportunity to testify before the Committee and looks forward to the opportunity to work with you further in preventing veteran suicide.
The hearing can be viewed live at: https://www.youtube.com/watch?v=Rj1gmfEZ__E