Earlier this fall, a friend challenged me to do 22 push-ups a day for 22 days to raise awareness of veteran suicide.
The request puzzled me. How, given the attention that this issue has received, do people not know that veterans commit suicide in troubling numbers? And, how will 484 push-ups help address this crisis? Then, in September, USA Today printed an editorial that highlighted the staggering fact that “a veteran is choosing death every 72 minutes.”
Like many editorials on this issue, the culprit was clear: The Veterans Administration was a hidebound bureaucracy that refused to offer cutting-edge treatments or effectively manage its crisis line.
To be sure, the VA deserves a fair amount of criticism. Its failure to deliver quality care to every veteran, the malfeasance that occurs in some facilities, and the lack of transparency with which the department operates are all deeply problematic. Nonetheless, it has had important successes. The 22-a-day figure itself emerged from the VA’s ambitious state-by-state review of death certificates, the first to calculate veteran suicide on a national scale.
In 2010, Veterans’ Crisis Line operators referred nearly 20,000 veterans, or about 55 per day, to VA mental health care. Between October, 2010, and April, 2011, the crisis line provided 3,658 immediate rescues and arranged for nearly 1,800 veterans to be admitted to their local VA hospital. And many of those patients were provided with evidence-based treatments.
Pillorying the VA is politically expedient, but insufficient. What we must do is develop a nuanced understanding of the structural issues in U.S. culture that contribute to the high suicide rate, issues that could be addressed through political will and public commitment.
First, access to quality mental health care is a national problem. Despite increased hiring, the VA identified psychologists as one of “five occupations with [the] largest staffing shortages” in 2015. As well, many veterans, particularly those in rural states, must travel great distances to access VA healthcare.
However, the VA is not unique in this regard. According to the U.S. Health Resources and Services Administration, there is a shortfall of about 2,800 psychiatrists in the United States, while the Washington Post found that “more than half of U.S. counties have no mental health professionals.”
These shortages are particularly acute in rural areas, where many veterans live. And they are occurring as demand increases — not just because of the recent influx of Iraq and Afghanistan veterans, but also because of older veterans’ and civilians’ growing needs. As a result, proposals that would allow veterans to receive care outside the VA system, such as those advanced by Concerned Veterans for America, may be part of the solution, but they will not fully address the problem.
Second, as the USA Today editorial pointed out, veterans’ access to guns remains problematic. Here, however, the VA’s efforts have been stymied by gun-rights supporters. The VA recognized this in 2009, and in partnership with the National Shooting Sports Association, began a project to provide gun locks to veterans at no cost. Within 18 months, it had distributed 242,100 locks. The intent of the program was to provide an additional barrier that a veteran would have to overcome in a moment of crisis, with the thinking that in the time it took to unlock, reassemble, and load the gun, he might reconsider his decision.
The program, however, was not without its critics. In 2013, Rep. Steve Stockman (R., Texas) introduced the “Veterans Second Amendment Protection Act,” which stipulates that a veteran can only be found mentally incompetent — and thus be stripped of his or her weapons — through the “finding of a judge, magistrate, or other judicial authority.”
In 2015, both FOX News and the Washington Times reported concerns that the VA’s efforts were “raising concerns about a government-run gun registry.” Addressing veteran suicide, in other words, has continually collided with the anxieties of gun-rights activists and those suspicious of the government.
All of this suggests the VA is an easy — and, in some cases, appropriate — target for condemnation in the debate over veteran suicide. Certainly, Congress must fully fund the VA so that it can conduct cutting-edge research, implement the best research-based treatments, and recruit the most qualified staff, and it should also facilitate implementation of the Clay Hunt Suicide Prevention Act.
The rest of us, however, can also do more. We must encourage more talented, dedicated people to enter mental-health fields and support federal and nonprofit programs that provide financial support as a person trains and competitive salaries when he graduates.
We must also bring reason to the debate over troubled veterans’ access to firearms. Allowing a veteran to choose to secure his own weapons is hardly an act of government overreach. Calling it such, and not supporting these programs, is dangerously irresponsible.
The suicide rate in the United States, and particularly among veterans, must remain a national priority. Addressing it requires recognizing and capitalizing on the successes of an organization that is often only criticized. More than this, it requires that we all take a clear-eyed view of the challenges that exist throughout U.S. culture that have contributed to the problem. Recognizing these problems, and acting on them, will likely save more lives than a bunch of push-ups.
David Kieran is assistant professor of history at Washington & Jefferson College in Washington, Pa.
First Published December 3, 2016, 5:00 a.m.