Letter to the Hon. Paul Lawrence, Under Secretary for Benefits for the U.S. Dept. of Veterans Affairs - Underwood Urges the Department of Veterans Affairs To Improve Trainings for Veteran Suicide Prevention

Letter

Under Secretary Lawrence,

I am writing to request additional information on the suicide prevention training required for Veterans Benefit Administration (VBA) contractors. While I greatly appreciate the Department of Veterans Affairs' (VA) timely responses to my previous requests for information on this topic, additional questions remain to be answered.

A November 22, 2019, response from VA detailed that contracted examiners are required to complete a "general competency" training package within 180 days of joining VA's network. This "general" training includes a single module dedicated to suicide prevention. Per VA, these contracted examiners are sometimes afforded additional training opportunities through their professional licensing and continuing education programs, although these additional trainings are not required.

In the same response, VA outlined that the Disability Benefits Questionnaires (DBQs) assess for suicidality and that examiners have a protocol to follow if a veteran presents with significant risk. "This protocol involves calling the Veterans Crisis Line (VCL) and/or the appropriate law enforcement authorities based on the laws and regulations of each state in order to ensure a warm handoff for appropriate care. The VCL will then provide follow-up to the individual often offering local VA treatment resources. The contractors are currently required to give the claimant the VCL info when suicide risk (not just imminent risk) is found during the exams and to note such action was taken in the exam report. The VCL is then the centralized referral mechanism to VHA, as the VCL's role is to then assist the individual with local VA resources."[1]

I am concerned that the current guidelines place sole reliance on a telephone as the focal point for suicide prevention. Despite the effectiveness of the VCL, this may leave the veteran vulnerable to potential wait times, technical difficulties, and other issues that may arise while waiting for assistance. I encourage you to work with medical and mental health providers--including VA contracted providers and examiners--to ensure that appropriate training is designed and implemented. I also ask that you provide answers in writing to the questions below:

1. How are contract examiners trained to call emergency services or to help provide support to the veteran if they are in crisis? Please provide a copy of the training materials used.
2. What, if any, plans do you have to expand or update suicide prevention training and protocols for both VA and contracted clinicians and examiners?

Thank you for your prompt attention to this matter.

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