Tamir Kalifa for The New York Times
WASHINGTON — Three veterans killed themselves last week on Department of Veterans Affairs health care properties, barely a month after President Trump announced an aggressive task force to address the unremitting problem of veteran suicide.
Mr. Trump’s executive order was a tacit acknowledgment of what the deaths rendered obvious: The department has not made a dent in stemming the approximately 20 suicide deaths every day among veterans, about one and a half times more often than those who have not served in the military, according to the most recent statistics available from the department.
A 2015 measure that required officials to provide annual reviews of mental health care and suicide prevention programs has found that veterans often receive good mental health care at many Department of Veterans Affairs centers — but that has not decreased suicide rates. A relatively new program, known as the Mayor’s Challenge, that helps city and state governments reach more veterans through more public health programs via Veterans Affairs partnerships has shown some promise, but no data exists yet demonstrating suicide reductions.
While the V.A. has been the public face of the issue, veterans are in many ways an amplification of the same factors that drive suicide in the broader American population: a fragmented health care system, a shortage of mental health resources, especially in rural areas, a lack of funding for suicide research and easy access to guns. All of these contribute to the drastically increased suicide rate among all Americans, which rose 33 percent from 1999 to 2017.
High rates of homelessness, traumatic brain injuries, post-traumatic stress and a military culture that can be resistant to seeking help are all aggravating factors for veterans, whose rates of suicide have been the subject of numerous hearings on Capitol Hill.
“We are not even at the Sputnik stage of understanding problems with mental health,” said Robert Wilkie, the secretary of veterans affairs. “I have said this is the No. 1 clinical priority that is made manifest by the president putting V.A. as the lead for this national task force.”
Some programs to address veteran suicide are showing promise.
A study of nine V.A. emergency rooms found 45 percent fewer suicidal behaviors among patients who received follow-up outreach after suicide attempts; as a result of this study, all V.A. medical centers have put into place the Safety Planning Intervention program.
Since the department in 2017 began tracking suicides at Veterans Affairs facilities — among the most high-profile of veteran suicides — there have been more than 260 suicide attempts, 240 of which have been interrupted, department officials say.
Yet about 70 percent of veterans do not regularly use the V.A., access to a federal department that may be viewed as central to suicide prevention.
“The vast majority of veterans that die by suicide are not seeking services,” said Julie Cerel, a professor at the University of Kentucky and president of the American Association of Suicidology. “So the V.A.s are kind of at a loss of how to serve this group of people. Yet when they do end their lives, it becomes the responsibility of the V.A.,” in the viewpoint of critics, she said.
Leadership turmoil — a consistent trait of the Trump administration — has complicated the V.A.’s attempt to address suicide. The agency’s director of its prevention office, Caitlin Thompson, resigned in 2017 after tangling with political appointees. According to a Government Accountability Office report last year, the office has essentially languished. Most notably, the office spent $57,000…
