A suicide hotline for veterans is still plagued with issues than a year after an inspector general first identified problems, according to a report released Monday.
The latest report found that than a quarter of calls to the Veterans Crisis Line (VCL) rolled over to backup centers, much higher than the Veterans Affairs Department goal of 10 percent.
Further, the report said, none of the recommendations made in the original February 2016 report have been fully implemented.
“Veterans are at a disproportionately high risk for suicide compared to the rate of U.S. civilian adults,” Michael Missal, Veterans Affairs inspector general, said in a statement. “The VCL is a critical effort to reduce veteran suicide for those who call in crisis. Therefore, it is imperative that VA take further steps to increase the effectiveness of VCL operations.”
The Veterans Crisis Line was launched in 2007 and fields than 500,000 calls annually. Once the main center reaches capacity, calls are rerouted to one of four backup centers run by a VA contractor.
A February 2016 inspector general report that found some calls being routed to the backup centers were going to voicemail or did not receive immediate action. The report prompted harsh criticism from lawmakers.
The report made seven recommendations for the VA including collecting data on calls made to the hotline and making sure all training for crisis hotline staffers is documented. In a written response included in the report, the VA agreed with all of the recommendations and said it would implement them by Sept. 30.
In Monday’s report, the inspector general said none of the recommendations had been implemented as of Dec. 15, 2016, though the VA continues to work on them.
The new report also found that 28 percent of calls from August to September rerouted to the backup centers despite the VA’s goal of no than 10 percent of calls rolling over.
Monday’s report does not address how many of the backup center calls are still going to voicemail. But it said two of the centers placed callers into a queue, which left some veterans waiting 30 minutes or to talk to someone.
The report also found a number of issues with the governance structure, operations and quality assurance practices of the hotline. For example, the VA’s Office of Suicide Prevention and the crisis line’s clinical staff “felt marginalized concerning decision-making with clinical implications,” the report says.
Also, the hotline has no process in place to routinely obtain or review data on how many veterans attempt or commit suicide after calling, so there’s no way of knowing exactly how effective the hotline is, according to the report.
In a response included in the report, acting Under Secretary of Health Poonam Alaigh said the hotline “is the strongest it’s ever been since its inception in 2007.”
Alaigh highlighted the opening of the hotline’s Atlanta center in October and said the hotline “comprehensive workforce management system and optimized staffing patterns.”
“This will provide callers with immediate service and achieve zero percent routine rollover to contracted back-up centers,” she said.
Still, the VA agrees with all 16 recommendations made in Monday’s report, she wrote.
Sen. Johnny Isakson (R-Ga.), chairman of the Senate Veterans Affairs Committee, said he was disappointed with the lack of progress in improving the hotline.
“This crisis line is a lifeline for many veterans, and I am disappointed by the lack of action taken by the Department of Veterans Affairs to consider the recommendations for improving the shortcomings of the Veterans Crisis Line that were previously identified by the inspector general than a year ago in February 2016,” he said in a statement. “The Veterans Crisis Line should be collaborating with clinical services every step of the way. I urge [VA] Secretary [David] Shulkin to act without further delay to remedy this issue.”
Rep. Tim Walz (D-Minn.), ranking member of the House Veterans Affairs Committee, called the issues with the crisis line “unacceptable.”
“Let me be clear: the ongoing issues with the Veterans Crisis Line identified in today’s VA Office of Inspector General report are completely unacceptable,” Walz said in a statement. “Secretary Shulkin needs to take immediate action to address this situation. When veterans seek mental healthcare, they should have immediate access. They deserve nothing less and upholding our responsibility to them means fixing this problem now.”