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The government has issued the NATIONAL STRATEGY FOR SUICIDE PREVENTION, 2024 [download here]. They state: “Suicide is an urgent and growing public health crisis. More than 49,000 people in the United States died by suicide in 2022. That’s one death every 11 minutes.” They continue: The 2024 National Strategy for Suicide Prevention is a bold new 10-year, comprehensive, whole-of-society approach to suicide prevention that provides concrete recommendations for addressing gaps in the suicide prevention field. This coordinated and comprehensive approach to suicide prevention at the national, state, tribal, local, and territorial levels relies upon critical partnerships across the public and private sectors. People with lived experience are critical to the success of this work. The National Strategy seeks to prevent suicide risk in the first place; identify and support people with increased risk through treatment and crisis intervention; prevent reattempts; promote long-term recovery; and support survivors of suicide loss.
Sadly, combat Veterans figure little in their bold new plan. The Strategy reads more like a cookbook for organizing and communicating and cooperating, a bureaucratic, political document rather than an ops plan for ending suicidal ideation. Rather than a truly revolutionary, root cause analysis of what combat and BLAST and repetitive head hits can lead to, and what Hyperbaric Oxygen Therapy (HBOT) is doing to eliminate suicidal ideation and heal brain wounds, the strategy glances off “treatment” to focus on intercepting and dealing with the suicidal.
Clearly we need a plan for dealing with “in extremis” cases, just as we need an “All hands on deck” approach to the epidemic. (One wonders, of course, why it’s twenty years in and we’re still congratulating ourselves for how hard we’re working to bring everyone together). How woeful and tired can it get?
But there is no sense of URGENCY about Veterans or the daily suicide rate, whatever it is. This chart is enough to show how the plan doesn’t seem to be working.
It’s unsurprising that the plan lacks attention to Veterans, and the need for immediacy for treatment of brain wounds. The Public Sector Chair of the strategy is Dr. Carolyn M. Clancy, MD, Assistant Undersecretary for Health, Discovery, Education and Affiliate Networks (DEAN) U.S. Department of Veterans Affairs. Dr Clancy wrote a scaremongering note to a member of Congress in 2015 that warned of the risks of HBOT, the lack of evidence, etc. The same arguments were regurgitated to Congress last month in almost verbatim form: HBOT is too risky, unproven, too costly, logistically hard, and proven to not work. This is a dereliction of duty on the part of the VA and DOD. They either haven’t kept up with science or they choose to ignore it. (Read the evidence).
Just read this for a sense of the wandering in the wilderness quality in the Strategy. It’s a failing grade with respect to treating and healing brain wounds as the #1 priority for the #1 clinical priority that the VA and DOD and the nation claim to care about.
STRATEGIC DIRECTION 2: Treatment and Crisis Services. Preventing suicide requires making sure those at risk of suicide get connected to the proper treatment and services they need. Therefore, this strategic direction focuses on the critical importance of implementing a systematic approach to suicide care within health systems, including emphasizing the structural role of the health system in preventing suicide rather than the responsibility resting solely in the hands of individual clinical providers. Additionally, Strategic Direction 2 sets the vision for a complete and coordinated crisis response infrastructure that includes not only a 24/7 nationally available crisis line but also a mobile crisis response, crisis stabilization facilities, and community based alternatives to 911 emergency response.
Sift through that and ask: What are you doing differently and what are you going to DO that will make an immediate difference, save lives, save money, and restore health to the warrior and the family? Hundreds of thousands of us? Are we going to be met with the same bushwa using drugs, talk therapy and “mental health” nostrums? Or is the system serious about healing? Healing that reduces need for black-box-labeled drugs and eliminates symptoms rather than masking them under the drug haze?
You’ll find no mention of the VA’s own statistics about suicides, and no apology for putting out so much chaff about their “centers of excellence” for TBI and PTSD. Look anywhere in the system they tout as doing so well: Intrepid Center/NICoE, DVBIC, Intrepid Spirit Centers, WRIICs, PREP, Care Coalitions, Wounded Warrior Battalions, and Independent Wellness Centers. Concussion Treatment Centers. The Mayo Clinic, U Penn, UCLA, Langone Center, the Shepherd Center, the Marcus Institute for Brain Health, UPMC Concussion Center. None of them even talk about brain wounds, much less medically approved HBOT for wound healing. What they are good at is all the rest: cognitive, and vestibular, and vision rehabilitation, along with physical therapy and psychotherapy. All of this is good. All may be necessary, but they are insufficient when there is underlying physical damage done to the brain. Heal Brains. Stop Suicides. Restore Lives. TreatNOW.
