Pricey Editor:
As an LCSW working with veterans in psychological well being crises, I discovered Dr. Jenna Mehnert Baker’s January 2023 article, “Constructing a Psychological Well being Disaster System Past 988: Social Staff’ Moral Obligation,” well timed and poignant. In 2020, 6,146 veterans died by suicide (U.S. Division of Veterans Affairs, 2022). The brand new 988 disaster line is a optimistic step towards addressing crises locally, however the neighborhood wants extra help.
Social employees should advocate for a broader vary of companies and revolutionary options for psychological well being wants. Exactly, we should observe the recommendation routinely given to our purchasers: ask for assist. Licensed Peer Specialists stand prepared to offer that assist. Earlier than that may happen, as Dr. Baker posited, social employees are ethically obligated to advance psychological well being observe change. Veterans’ lives depend upon it.
One strategy to fulfill this obligation is to enhance suicide prevention. Suicide, a posh and “depraved downside,” has no singular trigger or answer (Bryan, 2021, p. 17). Mysteries round suicide embrace contributing components and the way to reliably establish those that might try suicide. Via the Veterans Well being Administration (VHA), social employees and peer specialists (PS) serve veterans at elevated threat for suicide. We work with veterans from all service eras, starting from 21 to 94 years previous. Some have a psychological well being prognosis; some don’t. All of them are in ache and determined for an answer to their plights which have led them to think about suicide.
When a veteran is at acute threat for suicide, usually after they report suicidal ideations with a plan or a suicide try, a “high-risk flag” is positioned within the veteran’s medical file to alert all suppliers to the veteran’s heightened threat, and veterans obtain enhanced care. Our VA management requires that clinicians carry out a threat evaluation and evaluation the veteran’s security plan at every go to.
Security plans are an efficient intervention in stopping future suicide makes an attempt (Stanley et al., 2018). Sadly, security plans are lacking from many VHA medical information, and people current range in high quality (Gamarra et al., 2015; Stanley et al., 2018). Veterans receiving therapy in neighborhood hospitals are sometimes discharged with no security plan, rising their threat for future suicidal habits. As high quality security plans have been proven to cut back the chance of suicide, we should present this service to all veterans in disaster. Solely licensed unbiased suppliers are at present accredited to carry out security plans inside the VHA.
Peer specialists may also help improve security plan completion. Friends are veterans who’re in restoration from psychological well being or substance use problems and have accomplished a certification program. In 2008, Congress included peer specialists in a mandate to enhance psychological well being therapy for veterans (Veterans’ Psychological Well being and Different Care Enhancements Act of 2008, 2008). Fifteen years later, friends continued to offer psychological well being and restoration companies within the VHA. To advance psychological well being therapy and improve security plan completion, peer specialists must be skilled and accredited to carry out extra duties, together with finishing security plans with veterans in danger for suicide. Simply as friends collaborate with veterans on “restoration plans,” friends can collaborate on security plans. It’s social employees’ moral obligation to advocate for friends to meet their potential and assist veterans in disaster.
Social employees can advance psychological well being observe past the 988 disaster line, however we don’t should do it alone.
Jessica Cahill Hughes, LCSW
References
Bryan, C. (2021). Rethinking suicide: Why prevention fails, and the way we are able to do higher. Oxford College Press.
Gamarra, J. M., Luciano, M. T., Gradus, J. L., & Wiltsey Stirman, S. (2015). Assessing variability and implementation constancy of suicide prevention security planning in a regional VA healthcare system. Disaster: The Journal of Disaster Intervention and Suicide Prevention, 36(6), 433–439. https://doi.org/10.1027/0227-5910/a000345
Stanley, B., Brown, G. Okay., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, Okay. L., Chaudhury, S. R., Bush, A. L., & Inexperienced, Okay. L. (2018). Comparability of the security planning intervention with follow-up vs. typical care of suicidal sufferers handled within the emergency division. JAMA Psychiatry, 75(9), 894–900. https://doi.org/10.1001/jamapsychiatry.2018.1776
U.S. Division of Veterans Affairs, Workplace of Psychological Well being and Suicide Prevention. (2022). 2022 Nationwide Veteran Suicide Prevention Annual Report. Retrieved {February 11, 2023} from https://www.mentalhealth.va.gov/suicide_prevention/data.asp
Veterans’ Psychological Well being and Different Care Enhancements Act of 2008. (2008). https://www.govinfo.gov/content/pkg/PLAW-110publ387/html/PLAW-110publ387.htm
Jessica Cahill Hughes, LCSW, has expertise working in psychological well being and disaster intervention, with a give attention to navy and veteran populations. She is incomes a DSW diploma from College of Kentucky and works in suicide prevention with the James H. Quillen VAMC in Tennessee.
The views expressed on this letter are these of the writer and don’t essentially characterize the views of the VHA.
