STATEMENT OF
JOY J. ILEM
ASSISTANT NATIONAL LEGISLATIVE DIRECTOR
OF THE
DISABLED AMERICAN VETERANS
BEFORE THE
COMMITTEE ON VETERANS’ AFFAIRS
UNITED STATES HOUSE OF REPRESENTATIVES
DECEMBER 12, 2007
Mr. Chairman and Members of the Committee:
Thank you for inviting the Disabled American Veterans (DAV) to provide testimony at this important hearing focused on preventing suicides and meeting other mental health challenges of veterans who receive their care from the Department of Veterans Affairs (VA). This hearing is especially timely given the series of disturbing reports that have appeared recently on these important issues.

The Department of Defense (DoD) and VA share a unique obligation to meet the healthcare and rehabilitative needs of veterans who have been wounded during military service or who suffer from readjustment difficulties and other consequences of combat deployments. VA recently announced it has made suicide prevention a priority and has developed a focused program based on increasing suicide awareness, prevention, and training to improve the recognition of suicide risk by healthcare staff. A national suicide prevention hotline has been established and suicide prevention coordinators have been hired in each VA medical center. DAV welcomes these efforts but we believe they will be fruitless if VA fails to improve the effectiveness of treatment for post traumatic stress disorder (PTSD), depression, substance abuse and other mental health disorders—which together appear to create the greatest threat to rising suicide rates in veterans.

Suicide is a significant public health problem and should be addressed by aggressive efforts in the veteran population. In the December issue of the American Journal of Public Health, 1 VA investigators reported the results of their longitudinal study carried out from 1999-2004 using nationally representative data to determine suicide rates among veterans treated by VA for depression. Of the over 800,000 veterans studied, 1,683 or 0.21 percent committed suicide. Overall, the rates of suicide among depressed veterans were 7-8 times higher than the rate for the general population. However, suicide rates in depressed veterans were similar to rates found in men receiving care for depression in managed care systems. Unlike other studies that report higher rates in older adults, this VA study found that depressed veterans who were younger were at the greatest risk. One of the findings of the study confirmed that veterans with co-morbid depression and substance abuse are at very high risk for suicide. Veterans from the northeast and
central U.S. had lower suicide rates than veterans from the south and west. This is consistent
with the geographic and regional suicide rate variations.

1 Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System:
Associations with Patient and Treatment Setting Characteristics. Zivin K, Kim M, McCarthy JF, Austin KL, Hoggat
KL, Walters H, Valenstein, M. AJPH (2007) 97(12):2193-2198.

Entire Statement here,
http://www.dav.org/voters/documents/statement_ilem_121207.pd f"> http://http://www.dav.org/voters/documents/statement_ilem_121207.pdf