Rajeev Ramchand, Codirector, RAND Epstein Family Veterans Policy Research Institute; Senior Behavioral Scientist
My name is Rajeev Ramchand, and I’m a senior behavioral scientist at RAND, where I also co-direct the RAND Epstein Family Veterans Policy Research Institute. I study the prevalence, prevention, and treatment of substance use and mental health disorders, and my work specifically focuses on suicide prevention.
I testified before the House Veterans Affairs Committee in a hearing about the role of research and public health efforts in preventing veteran suicide. In my testimony I discuss how more timely, better quality, and more comprehensive data are foundational to preventing veteran suicide.
There are four strategies critical for preventing veteran suicides.
First, the national mortality data infrastructure needs to be improved. The Department of Veterans’ Affairs just released data on veteran suicide from 2019, meaning our data is over 20 months delayed. As a result, we don’t know if COVID-19 and the withdrawal of troops from Afghanistan have led to increased suicide rates among veterans.
To solve this problem, we need improvements in the timeliness and quality of death investigations across the U.S. This includes resources to update antiquated systems, ensure that investigators have the means to conduct comprehensive investigations, and resources to transmit these data more quickly and accurately to the CDC.
We also need better quality data, such as data on sexual orientation and gender identity, and improved recording of race and ethnicity data.
The second strategy to prevent veteran suicide is to use data to better understand veterans’ health care experiences outside the VA, starting with a focus on veterans receiving health care through other federal programs, such as Medicare and the Indian Health Service. Merging health care utilization data from these systems with data on veteran suicides would help identify where suicide risk may cluster within health systems, so that tailored interventions can be created and implemented to address suicide where it is concentrated.
The third strategy is the need to collect better and more comprehensive data on veteran firearm ownership and storage. Over two-thirds of veterans who died by suicide used a firearm to end their lives, and many experts argue that placing time and space between a person in crisis and his firearm by storing it unloaded and locked can be life-saving. But without timely data on how veterans are storing their guns, it will be impossible to know how suicide prevention strategies focused on safe storage practices are effective.
The last strategy I’ll mention is the need for data on suicide outcomes for novel treatments. As new treatments are developed and tested for patients with mental health conditions, such as PTSD, and substance use disorders, data is needed on whether these therapies specifically affect suicide risk. Proactive strategies are needed to actively recruit and monitor people with suicidal thoughts so we can understand the benefits these treatments may have for reducing suicide.
Too many Americans, and too many veterans, die from suicide each year. I am convinced that we can prevent many of these deaths, but we need to invest in data and science to do so. The investments I outlined today could help save veterans’ lives.