Download:
pdf |
pdf9/2/25
Pre-Decisional
Department of Veterans Affairs
Veterans Health Administration
Agency Information Collection Activity:
Suicide Prevention 2.0 Program - Community Opinion Survey
OMB Control No. 2900-0911
The Suicide Prevention 2.0 Program - Community Opinion Survey received one comment
in response to the 60-Day Federal Register Notice (VA-2025-VACO-0001-0046, FR Doc
No: 2025-12222) on August 21, 2025.
Document: VA-2025-VACO-0001-0084 – We appreciate the commentor’s concernssuggestions, and VA responds as follows:
•
The first comment states that Veterans experience suicidal thoughts and
behaviors at higher rates than non-Veterans and that data can help us be more
‘proactive’ and targeted in reaching Veterans at risk.
o VA is actively implementing a ‘precision medicine’ approach which utilizes
data to identify Veterans at risk to offer the most appropriate intervention at
the right time. VA’s research and evaluation activities are focused on
identifying risk profiles and testing evidence-based approaches by risk,
treatment needs and preferences of Veterans.
o VA’s Recovery Engagement and Coordination for Health–Veterans
Enhanced Treatment (REACH VET) predictive model algorithm has been
updated to include additional variables to improve performance.
o VA continues to partner with VA’s National AI Institute, Digital Health Office
to leverage technology and Artificial Intelligence to best develop and
enhance clinical surveillance and decision support tools.
•
The writer’s comment addresses the need for improved coordination and data
sharing across VHA and VBA and concerns about disability claims related to
suicidal behaviors.
o The Veterans Health Administration (VHA), Office of Suicide Prevention
(OSP) and Veterans Benefits Administration (VBA), Office of Performance
Analysis & Integrity (PA&I) have an established relationship through the
data request process related to Veterans who have died by suicide.
o A suicide attempt, in and of itself, is not a disability or a standalone
diagnosis for which service connection can be granted on a direct or
secondary basis. Therefore, VA would neither grant nor deny a suicide
attempt as secondary to PTSD, depression, somatic symptoms, or any
other mental or physical disability. However, VA can consider a suicide
attempt (and/or suicidal ideation) as a symptom of a mental health
disability. If the underlying mental health disability is related to the
Veteran’s service, then VA can use the suicide attempt in determining the
disability severity and to assign a corresponding evaluation under 38 CFR
§ 4.130. For instance, a suicide attempt could support a 70% evaluation
(shown as suicidal ideation) or a 100% evaluation (shown as persistent
danger to self/others). Additionally, in the court case Bankhead v. Shulkin,
29 Vet.App. 10 (2017), the United States Court of Appeals for Veterans
Pre-Decisional
9/2/25
Claims examined the term “suicidal ideation” under the 70% evaluation
level for § 4.130 and determined that the presence of suicidal ideation
alone may cause occupational and social impairment. When evaluating
mental health conditions, the Court also indicated that VA must: 1.) engage
in a holistic analysis in which it assesses the severity, frequency, and
duration of signs and symptoms of the mental disorder; 2.) quantify the
level of occupational and social impairment caused by those signs and
symptoms; and 3.) assign an evaluation that most nearly approximates that
level of occupational and social impairment. Moreover, if the suicide
attempt that is due to a service-connected mental health condition results
in a separate disability, then VA can grant service connection for any
resulting chronic residual disabilities on a secondary basis in accordance
with 38 CFR § 3.310(a).
•
The writer comments on the value of monitoring Veterans at risk for suicide as
they discharge from inpatient psychiatry to outpatient levels of care, a vulnerable
time for suicide death. Intervention should be Veteran-centric and involve family
and caregivers for a wholistic approach.
o VHA inpatient mental health services provide comprehensive Veterancentered, team-based care, to address the specific needs of each Veteran,
and when agreed upon by the Veteran, family and caregivers are involved
in treatment planning.
o All Veterans who receive inpatient mental health services in VA are offered
the opportunity to develop or update a customized safety plan prior to
discharge.
o Post-discharge engagement in mental health services is a priority for VA
and as such, VA ensures the scheduling of follow up mental health care
and monitors follow up appointments post inpatient mental health
discharge.
o Veterans flagged high risk for suicide are offered enhanced mental health
services and also receive caring letters 12 months post discharge, as
described above.
•
Lastly, the writer comments about the workplace and socioeconomic stressors
and risks that can lead to suicidality for VA employees, many of whom are
Veterans.
o VA acknowledges its responsibility to support employees and help reduce
risks through assistance programs and training initiatives that provide skill
development and tools to prevent burn-out. Establishing a supportive
environment is essential for staff well-being and resilience. Within a safetyfocused culture, leaders at all levels are encouraged to promote a nonpunitive approach and a commitment to creating a learning environment
that uses adversity to improve quality and processes for both clients and
staff.
•
The purpose of the Community Opinion Survey is to assess the impacts of VA’s
community-based interventions by obtaining information from community
members (Veterans and civilians) about the level of support for Veterans and for
mental health and suicide prevention they perceive within their community.
Pre-Decisional
9/2/25
VA’s Office of Suicide Prevention (OSP) appreciates the opportunity to review and
respond to the comments. The commenter did not request any changes to the
Community Opinion Survey and we make no changes to the information collection at this
time.
Submitted by:
Digitally signed by
SUSAN
SUSAN STRICKLAND
2025.09.12
STRICKLAND Date:
10:40:40 -04'00'
Susan Strickland, PhD
Associate Director, Research and Evaluation
Office of Suicide Prevention
Veterans Health Administration
Department of Veterans Affairs
| File Type | application/pdf |
| Author | CSP |
| File Modified | 2025-09-12 |
| File Created | 2025-09-12 |