A group of 21 Senate Democrats has asked the Department of Veterans Affairs to explain why it spent just $57,000 of $6.2 million budgeted for paid media advertising campaigns directed at suicide prevention in fiscal 2018, a deficiency they called "appalling" for its lack of oversight.
The lawmakers, led by Senate Veterans Affairs Committee ranking member Sen. Jon Tester of Montana, demanded a full accounting of the $17.7 million budgeted by VA for suicide prevention outreach, which includes both paid advertising such as radio spots, billboards and digital ads, as well as unpaid outreach such as public service announcements, social media and the VA's own Crisis Line website.
According to the Government Accountability Office, the VA developed 47 pieces of social media content in 2018, down from 339 in 2016; failed to air any public service announcements on radio or TV for more than a year; and did not develop any new paid advertising for 2018 despite having a budget of $6.2 million.
A GAO report published in November blamed the decline in outreach on leadership turnover and reorganization within the VA.
During the time frame examined by the GAO, the VA's suicide prevention efforts shifted from suicide prevention to mental health outreach, primarily due to reorganization of the suicide prevention offices in 2017. For three months, the job of national director for suicide prevention was vacant. In October 2017, Keita Franklin, then the head of the Defense Suicide Prevention Office, was detailed to the VA as acting national director. She was named permanent director in April 2018.
VA staffers told the GAO that, for an extended period, leadership simply wasn't available for meetings to discuss outreach activities.
In response, the senators wrote a letter to VA Secretary Robert Wilkie on Dec. 20, calling the lapse in outreach due to staffing issues a "dereliction of VA's responsibility to veterans."
"Dysfunction at VA cannot be the excuse for the lack of a plan to execute suicide prevention outreach," the senators wrote. "Efforts to prevent suicide must remain at the forefront of the Department's care of veterans."
In congressional testimony and response to the GAO report, VA officials said they used $1.5 million -- not $57,000 -- of the $6.2 million and have conducted outreach events and created a PSA that wasn't included in the GAO report, a partnership with Johnson & Johnson featuring Tom Hanks, part of the "Be There" campaign.
According to the VA, its suicide prevention coordinators reached nearly 2 million people at 18,836 events; touched 18 million people by social media during one week in October alone; and help nearly 2,000 callers a day to the Veterans Crisis Line, the department's suicide prevention hotline.
"This year, I'm making sure that we are spending the funding 100 percent," Dr. Steven Lieberman, the executive in charge of the Veterans Health Administration, said at a joint Senate and House Veterans Affairs Committees hearing Dec. 19. "We certainly have obligated all the dollars, and we have plans to reach out, including social media, this year. We have to get it right."
According to VA data, veterans account for 14 percent of all suicides in the U.S., and the suicide rate among veterans is 1.5 times greater than for non-veterans, when adjusted for age and gender.
Between 2015 and 2016 -- the most recent years for which data are available, and before the substantial slide in outreach, according to the GAO -- the suicide rate among young veterans ages 18 to 34 climbed substantially, from 40.4 deaths per 100,000 population to 45 suicides per 100,000.
Many of the senators who signed the letter were present at the Dec. 19 hearing when Wilkie and Lieberman discussed the GAO report and its recommendations. Most were not satisfied with the VA officials' responses.
"Forgive me, but we've seen this movie before," said Sen. Richard Blumenthal, D-Conn. "We've seen a slew of secretaries who have made commitments and promises, and we are expressing the frustration and impatience that is well-founded in fact."
In addition to requesting a full accounting of the $17.7 million, the senators asked the VA to consult with experts to develop metrics to track public health campaigns and measure their success.
-- Patricia Kime can be reached at firstname.lastname@example.org. Follow her on Twitter @patriciakime.