Veterans' Affairs Secretary Denis McDonough says his agency is making progress on reducing the rate of veterans’ suicides and improving care for veterans.
But speaking with reporters after a keynote address at the Oregon Convention Center in Portland, McDonough said the more than 2,400 mental health professionals and veterans’ service advocates acknowledge there’s more to be done.
“It is not a mistake that we are doing this conference in Oregon,” McDonough said on Tuesday, July 16. “It is a state with a higher rate of veteran suicide than other states. We want to make sure we are focused on addressing this crisis here and across the country.
“I want veterans in Oregon to hear that suicide is preventable. There is still more work to be done.”
VA runs the nation’s largest integrated system of health care.
A national conference on suicide prevention rotates every other year between the sponsorship of VA and the Department of Defense, which includes active members of the U.S. armed forces.
According to a 2023 report by VA, based on 2021 mortality data, the suicide rate among veterans in Oregon was higher than in the West or the nation. Expressed in rates per 100,000, Oregon was at 49.6; West, 39.2, and U.S. average, 33.9. The raw totals of deaths for 2021, the latest available: Oregon, 139; west, 1,654; national, 6,392.
As for the involvement of firearms, it was 72.2% for Oregon veterans, and 52.2% for all adult non-veterans in 2021.
In its 2022 report, the U.S. veteran population declined 24.6% between 2001 and 2020, from 25.7 million to 19.4 million, while the non-veteran population increased by 27.2%. During those two decades, suicides among non-veterans rose from 81 to 121 daily; veterans, from 16.4 to 16.8 daily.
Glimmers of hope
But the 2023 VA report also says there is a basis for optimism, even though the 2021 national total of veteran suicides went up after declines in 2019 and 2020. (The rate had increased steadily since 2001.)
For veterans 75 and older in the care of the Veterans Health Administration — one of three main branches of VA — the rate declined 8.6% between 2020 and 2021. For veterans outside the VA system, the decline was 7.8%. For veterans ages 55-74 in VA care, the decline was 2.2% decline. For those ages 18-34, the decline was 1.9%.
McDonough said three things have helped.
First is the national suicide prevention lifeline that went live about two years ago. It’s 988, option 1 for veterans and their families. He said 2 million veterans have called to connect with mental health professionals.
He also said the VA has new authority that enables any veteran who is in crisis and wants to see a professional to go to any hospital, regardless of whether the person is enrolled in VA care. He said 50,000 veterans have done so within the past year.
“You will get that care and we will pay for that care,” he said.
“To veterans in crisis: You can beat this crisis. We are here for you because veteran suicide is preventable.”
VA also has allowed payment of community providers if veterans are more than 30 minutes from VA primary care or 60 minutes from VA specialty care.
McDonough said, however, that he does not foresee shifting all care for military veterans to non-VA providers, though such privatization has its advocates. “I have to say I do not see a big groundswell for that,” he said. “What I see is a groundswell that VA care fits into veterans’ lives.”
The third factor is the VA itself.
“We have been aggressive in reaching out to veterans,” he said.
“We want to make sure that if you have a condition that is a result of your service to the country, we can help treat that condition and also compensate you for any loss of quality of life that results from the condition.”
Diminished stigma
VA officials did nor permit direct news coverage of McDonough’s remarks because he spoke in detail about the experiences of four people, two veterans who survived attempts, and family members and others who witnessed tragedies.
“To a person, they said it is a strength, not a weakness, to get care,” he said, although he acknowledged that a stigma continues about mental health care.
“Many veterans come here and they want to move on with their lives. We have to do a better job of telling veterans what is available.”
Among the services, he said, are telehealth and more satellite clinics so that veterans can feel comfortable in alternative settings.
VA has instituted a veterans’ survey of satisfaction based on their access to care, appropriate service and respectful treatment. McDonough said ratings are quarterly and they are posted for every VA site. The average is 91.9%, although McDonough said there’s room for improvement.
Congress passed and President Joe Biden signed the PACT Act in 2022, which resulted in 430,000 new claims filed with the VA because the law broadened the number of presumptive conditions (more than two dozen) that can lead to a finding of a service-connected disability. Among the most publicized: Exposure to the herbicide Agent Orange during the Vietnam War, and to the burn pits used to dispose of trash in the Persian Gulf and the wars in Afghanistan and Iraq. Such pits contained toxic materials that should not have been burned.
PACT stands for Promise to Address Comprehensive Toxics.
McDonough said filed claims set records in each of the last two years, and the increase so far this year is 30% greater than in 2023. The VA has decided 15% more claims than last year’s record — and the average claim is resolved within 150 days.
While it’s still not fast enough, “it’s much better than it used to be.”
He said 75% of claims are decided in favor of veterans.
VA added 7,000 workers to its Veterans Benefits Administration to handle the increased workload.
He said veterans should not be shy about applying for benefits even if they think they are helping others get them first.
“We know they have earned these benefits,” he said. “We know that veterans in our care have better health outcomes, better quality-of-life outcomes, better access to mental health care and outcomes.”
VA history
Although the federal government has provided veterans’ services since the Civil War, a unified Veterans Bureau was created in 1921, and it became the Veterans Administration after World War II. VA got Cabinet status in 1989, though it retained the VA identification.
With McDonough’s appearance, two-thirds of Biden’s Cabinet secretaries have visited Oregon since the president took office in January 2021.
Also on his visit was a stopover at Willamette National Cemetery, where Technical Sgt. Don Malarkey is buried among other veterans. Malarkey died in 2017 at age 96 after living in Salem for many years after World War II. He was the last survivor of the Army's 101st Airborne Division unit memorialized in Stephen Ambrose's book, "Band of Brothers," and a subsequent 10-part miniseries on HBO.
McDonough himself is not a military veteran. He had been on the staff of Barack Obama before the Illinois senator was elected president in 2008, and he rose to deputy national security adviser to Obama. He became White House chief of staff for Obama’s entire second term from 2013 through 2017.
He said Biden, Obama’s vice president, invited him to return to government upon election as president in 2020.
“When the president of the United States calls you and tells you to take a job, the answer to the question is yes,” he said. “Another reason is a sense of duty to this country. And this is the most awesome mission there is — to work on behalf of veterans.”
During his White House years, McDonough often took part in decisions that involved the lives of armed forces members, such as military deployments. “It is a blessing to know that I get to work on behalf of the same men and women and make good on our promises to them,” he said.
pwong@pamplinmedia.com
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