Suicide prevention: Effective advocacy and collaboration. A case in point (Charles Curie)

Advocacy is hard work. Collaboration is perhaps even harder work. Advocacy for and collaboration on efforts to promote effective approaches to suicide prevention can be particularly challenging in light of the stigma that surrounds the issue and the difficulty in finding resources (money) to meet the demands of competing public health priorities. It may seem as if, more often than not, we make little to no progress in advancing the priorities of the mental health and substance use treatment fields. The good news is there are many examples of the well-informed and prepared individual making a difference, when the opportunity presents itself, to advocate for the right thing. The profound impact of one such advocacy success for suicide prevention made the national news in recent weeks. TheUSA TODAY newspaper (otherwise known as the road warrior journal), in its July 29th issue on page 4A, reported on a federal government program that is jointly administered by the VA and SAMHSA. The article stated, “More than 22,000 veterans have sought help from a special hotline in its first year, and 1,221 suicides had been averted”. It went on to point out that a RAND Corp. study has “found that about 20% of soldiers returning from Iraq and Afghanistan display symptoms of PSTD, which raises the suicide risk”. There are several reasons this short article is significant. One obvious reason is it reports on quantifiable outcomes and demonstrates that access to the right supports, in this case a qualified hotline, helps people and saves lives. Also, it serves to educate the public about risk factors for suicide and brings the conversation to an open forum.
There is another, less obvious, reason this article is significant and, as Paul Harvey would say, “Now for the rest of the story”. It seemed like any other congressional hearing, representatives of federal agencies giving testimony to committee members on the challenges they face in trying to effectively meet the needs of constituents, what the Administration plans to do about it and how Congress can help. Advocates and private citizens then presented testimony depicting real life problems and shared potential solutions to solving those problems. On this particular day, representatives from the VA highlighted the mental health needs of a percentage of returning veterans. One of the proposals to address this need was funding a VA administered hotline so veterans and their families would have access to mental health supports and crisis intervention. Enter, the effective advocate, and at the time, the Executive Director of the Suicide Prevention Action Network USA (SPAN), Jerry Reed. In his time before the committee, Jerry took the opportunity to support the VA’s assessment that a hotline was needed and also educated the committee that a federally funded hotline already existed, 1-800-273-TALK. Jerry pointed out that it would be more cost-effective to augment this existing resource. It also was clear that to have one hotline available to all citizens would be less confusing and, as a large percentage of veterans would be returning to their previous lives in communities across the country, this would be an integrated way to provide a service rather than have a separate veterans’ hotline. The congressional committee embraced Jerry’s recommendation and the federal government followed suit. Turf issues do exist between federal agencies (I know this must be a shocking revelation!) but the VA and SAMHSA deserve credit for transcending turf and doing the hard work of collaboration this past year. Their efforts have effectively touched the lives of thousands of vets and their families and serves as an example of how government should work. It also points to how the VA can potentially accomplish its mission and expand its efforts by collaborating with community based providers at the regional and local levels as well. While there are other examples of wonderful collaborations, unfortunately, too many opportunities for effective collaboration that would facilitate greater access to care are never close to being realized. Also, Jerry’s intervention serves as an example to each of us that the hard work of advocacy, of being continually informed and prepared to take action at critical moments pay off. In this case, advocacy that resulted in saving lives. And now you know, “The rest of the story”. So what stories of advocacy and collaboration can you share?