The Department of Veterans Affairs (VA) partners with nongovernmental groups, like non-profits or universities, through formal agreements aimed at making veterans aware of available suicide prevention programs and mental health services.
Many veterans struggle with mental health conditions, several of which are risk factors for suicide. VA reported that almost two-thirds of veterans that died by suicide in 2019 did not receive Veterans Health Administration (VHA) services in 2018 or 2019.
A report by the Government Accountability Office (GAO) notes that within VA, seven different offices make these agreements, but information about them isn’t tracked centrally. For example, it took officials from VA and VHA more than four months to identify for GAO 43 relevant agreements entered into across seven offices over a five-year period. As a result, GAO says VA can’t readily search or identify all of its suicide prevention and mental health agreements.
GAO found that VA cannot readily track its agreements because VA policy does not require use of any single database to store agreement information. VA’s Strategic Relationships Application, which VA designed to document agreement information, could be used for tracking, but only four of the seven offices with such agreements used it. Requiring its use would facilitate VA’s ability to track all of its agreements and identify areas for improvement to better reach veterans not using its services.
Individual VA and VHA offices conduct ongoing oversight of their own suicide prevention and mental health agreements, as required by VA policy. For example, officials monitor performance metrics such as the number of veterans served. VA policy also requires annual reviews that are used to determine if a partnership is still needed. However, GAO found that officials did not always document the completion of these annual reviews. VA’s policy requires that “significant activity” be documented, but it does not specify that annual reviews fall under that category, though officials managing the policy confirmed they do. Providing specificity on what VA wants documented as significant activity—e.g., by adding examples to the policy or providing specific guidance—would help ensure that annual reviews are being documented and maintained for future use.
GAO is making three recommendations, including that VA require use of the Strategic Relationships Application and that VA ensure staff know to document annual reviews as significant activity. VA concurred with these recommendations.