Rep from VA’s Office of Suicide Prevention outlines department’s strategies while noting Legion’s critical role in stemming the tide of veteran suicides.
A leader in the U.S. Department of Veterans Affairs’ Office of Suicide Prevention had a captive audience when she spoke on Feb. 24 to The American Legion’s Veterans Affairs & Rehabilitation Commission.
But at the start of her remarks, Cicely Burrows-McElwain – the office’s Deputy Director of Operations for Special Projects and Social Science Officer – noted she also had an educated audience when it came to the focus of her address.
“It’s a topic that sometimes when we go out on behalf of the VA and speak on suicide prevention, we’re speaking to individuals that have kind of a very baseline level of understanding about how important the issue of suicide prevention is,” she said during the Legion’s Washington Conference in the nation’s capital. “But I know that when I’m coming to The American Legion, that is not the case. Because your organization has really committed on the front lines of addressing this issue and supporting one another (and) the military and veteran families that are out there, to ensure that we don’t continue to lose folks to suicide, which is such a preventable situation.”
That last part was reiterated by Burrows-McElwain. “We know that veteran suicide is a complex issue. There’s really not a singular solution out there,” she said. “We need all of us to play a part in the work that we’re doing here. The VA does take what we consider to be a public health approach to this one. It means that we have to start with the fundamental understanding that suicide is preventable.”
Burrows-McElwain said that approach includes clinical services, as well as connection. “You all joined (the Legion) because of the connection it brings to your brothers and sisters,” she said. “What it means that we’re acknowledging that in the approach to preventing suicide is that we’re an equal playing field when we talk about those folks that … have got the clinical training … alongside our community. Our faith-based groups. Everyone else we know, that we connect with and trust.”
Of the approximately 17.6 veterans who die by suicide each day, roughly seven are connected to VA health care. “This is why we talk about this public health approach,” Burrows-McElwain said. “For one reason or another, if those veterans aren’t coming to VA for care … it means that communities have the right ability to connect to those veterans and to see them at their lowest and to connect them to those services and support.”
Burrows-McElwain shared that most veterans who die by suicide use firearms to do so, and that there is a much shorter window to save someone who has attempted suicide than those using other means. “With our firearms, we recognize the risk is so much greater because of that lethality,” she said. “With over 70 percent of our veterans choosing that means, you have to do some conversations around the importance of securing our firearms. That’s a real big component of the work we’re doing right now.”
Burrows-McElwain laid out key areas that drive VA’s suicide prevention efforts:
· Promoting secure firearms storage.
· Building and sustaining community collaboration.
· Expanding crisis and intervention services.
· Advancing suicide prevention non-clinical support.
· Enhancing mental health care and access across the full continuum of care.
· Integrating suicide prevention within VA’s medical settings.
· Tailoring those services and interventions to the audience VA is talking to.
“Within your Legion work you have access to the training resources that the Legion put forward. You have access to us at the VA,” Burrows-McElwain said. “All of that is there, but if you don’t know how to access it … we really want to ensure that there’s a clear line of communication open.”
Suicide Prevention and Innovation. The commission also heard from staff from VA’s Office of Healthcare Innovation and Learning on a variety of initiatives, including some dealing with suicide prevention and mental health.
Matthew Rowley, the head of Community Engagement in VA’s Office of Healthcare Innovation and Learning, shared information on VA’s Mission Challenge. The program made available $20 million to veterans and veteran service organizations, community-based organizations, health tech companies, startups and universities submitting suicide prevention solutions to meet the unique needs of veterans.
More than 1,300 entries were submitted and 30 finalists chosen, with two first-place winners each receiving $3 million and three second-place finishers awarded $1 million. Hundreds of thousands of dollars were award to those finishing third and those who advanced past the opening phase.
“It was the largest federal grant challenge in history,” said Rowley, the office’s head of Community Engagement. “We have 10 finalists working through these pilots right now. One of the ones I’m particularly excited about – they’re all fantastic – is the idea of utilizing technology … to do professionally moderated peer support. This is on your phone, on your computer. This is focused on veterans who are not engaged with the VA.
“Ninety-eight percent of the folks who went through this report improved well-being. It’s touched 1.2 million veterans at five VA medical centers right now in the pilot phase.”
Evan Davis, VA’s Office of Healthcare Innovation and Learning’s Immersion Project Manager, talked about his office’s efforts in the area of mental health: anxiety and stress reduction and mental health approaches. One of the methods he brought up was the use of virtual reality headsets in treatment plans.
“Imagine that you’re working with your mental health provider, and we’ve got to talk about some really tough things,” Davis said. “Maybe we’re working on some desensitization. Anybody working with a mental health provider and they said, ‘Hey, I want you to go out to the community market and practice some things we’ve worked on today. And then report back to me next week or two weeks or three weeks.’
“What if we could just put you in here in a headset in the office and work together? What if I could help you hone those skills incrementally? And what if you had control? At any point you could take that headset off and say, ‘I’m done?’ We’ve never had that ability. Never had the power to give the power to the individual experiencing the therapy mode. That is a huge component of this mental health engagement with these devices.”
Also addressing the commission was Anne Lord Bailey, Executive Director of VA’s Strategic Initiative Lab (Strat Lab). The lab’s mission is to foster research projects that have a high risk for failure but a correspondingly high potential for return.
Bailey stressed that what VA’s innovation efforts are doing is “not replacing clinical staff with this technology. We are supporting clinical staff. We want to get this more in the hands of our patients to equip them to do what they want and need to do to get better and get healthier.”
Why ROAR? American Legion Veterans Benefits Policy Analyst Brandon McClain gave the commission a brief report on the Legion’s Regional Office Action Review (ROAR) program. Through ROAR, Legion experts and local veterans meet with VA Regional Office administrators and employees to see what they are doing to reduce the backlog, how they are staffed, and how new technology is being used to improve the process.
In addition to garnering information to share with Legionnaires at the local level, McClain said one of the purposes of ROAR visits is “to underscore the importance of the service officer corps and encourage personnel to become service officers. And last, we list to highlight the VA staffing challenges.”
McClain noted American Legion service officers provided more $21 billion in claims assistance for veterans in 2024. “This impact underscores the importance of our work and the oversight responsibilities we’ve been given,” he said.
McClain said ROAR aims to get an understanding of the claims process and the current backlog. Four VA Regional Offices were visited in 2024: Albuquerque, Phoenix, St. Petersburg, Fla., and Fort Harrison, Mont. He said Phoenix processed the highest number of claims between 2023 and 2024.
Three operational challenges were identified during the visits:
· Poor quality of case development, which included errors during Compensation & Pension exams.
· Training deficiencies and high turnover.
· Unnecessary delays during the decision review process.
McClain said addressing the challenges included enhanced training with real-life scenarios, improving case development and optimizing the decision review process.
Connecticut Legionnaire Honored. Roger Anderson, a member of American Legion Post 133 in South Windsor, was honored during the meeting as the VA Volunteer Services Volunteer of the Year. Unable to attend, his plaque was accepted on his behalf by Department of Connecticut Service Officer K. Robert Lewis.
Anderson was cited for serving as a VAVS rep for 15 years and for volunteering at the American Legion Auxiliary Christmas Tree Shop at the West Haven VAMC and the Connecticut Veterans Home and Hospital in Rocky Hill since the early 1990s, organizing bingo games for blind patients at the latter. He also plans coffee and donuts several times a year at the Newington VA Clinic and arranges for an annual bowling outing for the patients there.
Anderson was inducted into the Connecticut American Legion Hall of Fame in 2016.
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