From the U.S. Government Accountability Office, www.gao.gov Transcript for: VA's Suicide Prevention Teams Face Increasing Workloads As Demand for Services Grow Description: While veterans comprise only 8 percent of the adult population in the U.S., they accounted for almost 14 percent of adult suicides in 2018. In response to these risks, the Department of Veterans Affairs has created a Suicide Prevention Program. But is this program offering veterans the support they need? We talk to GAO's Debra Draper to find out more. Related GAO Work: GAO-21-326, VA Health Care: Efforts Needed to Ensure Effective Use and Appropriate Staffing of Suicide Prevention Teams Released: April 2021 [Intro music:] [Debra Draper:] Suicide prevention teams are a critical component of VA's suicide prevention efforts. But increased workloads have created challenges. [Holly Hobbs:] Hi and welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office--celebrating 100 years of fact-based, non-partisan government oversight. I'm Holly Hobbs. Veterans are at higher risk for suicide than the general population, according to the Department of Veterans Affairs. While veterans comprise only 8 percent of the adult population in the U.S., they accounted for almost 14 percent of adult suicides in 2018. In response to these risks, the VA has created a Suicide Prevention Program. But is the program offering veterans the support they need? Today, we talk to Debra Draper--an expert on veterans' health issues, and a director in our Health Care Team--who has a new report out on VA's efforts. Thank you for joining us Debra! [Debra Draper:] Happy to discuss our work! [Holly Hobbs:] So Debra, our report looks at the Suicide Prevention Program, but specifically at the program's suicide prevention teams. What can you tell us about these teams? How do they work? [Debra Draper:] Well, first, it's important to note that veterans have a higher rate of suicide as compared to the general population. And in its strategic plan, VA identified suicide prevention as its top clinical priority. VA uses suicide prevention teams at local facilities to carry out its suicide prevention activities. These suicide prevention teams are responsible for monitoring and managing veterans, who have been identified as being high risk for suicide. That's one of the activities. They're also responsible for conducting outreach activities to make veterans aware of the other programs and efforts that are available to them. And these teams include a number of different types of staff, including suicide prevention coordinators and case managers. [Holly Hobbs:] So do these activities also include counseling services? [Debra Draper:] It could be counseling as well. It's really a range of activities to help veterans who are at risk of suicide to help them mitigate those risks. [Holly Hobbs:] Given that the number of veterans at risk of suicide, what do the prevention teams' caseloads look like? [Debra Draper:] We spoke with a number of suicide prevention teams and they consistently told us that their workload has increased over time, especially as more veterans are identified as being at risk of suicide. Adding to their workload are the increasing number of activities associated with VA's Suicide Prevention Program, which teams say has created challenges including burnout and turnover. And caseloads may vary, but a team from one facility--for example--told us they typically manage a caseload of about 150 to 200 veterans. [Holly Hobbs:] How is VA responding to concerns about caseloads for these teams? [Debra Draper:] VA told us they have taken a number of steps ah in response to concerns about caseloads. They recently made changes to their guidance and technical assistance, which may help address some of the challenges experienced by suicide prevention teams. For example, VA has initiated monthly calls for teams to obtain answers to questions that teams may have including providing technical assistance beyond what is typically covered during other calls. [Holly Hobbs:] And does the VA conduct evaluations of staffing needs or these activities? [Debra Draper:] Well, VA has not conducted an evaluation of suicide prevention teams, including an assessment of any challenges they face in implementing VA policies and the effects of program growth or workload. And as a result, VA does not have a good understanding of how its various activities and initiatives are affecting teams. And an evaluation would help to better target the guidance and other support VA provides to reduce the challenges teams face. [Holly Hobbs:] So it sounds like the Department of Veterans Affairs has taken steps to support veterans by providing suicide prevention teams. But that staff on these teams are challenged by heavy workloads, and that VA has not assessed the effects of these workloads on their staff or the veterans they serve. Debra, did we make any recommendations to the VA to help it better understand the challenges suicide prevention teams face? [Debra Draper:] We made a number of recommendations including that VA conduct an evaluation of suicide prevention teams to assess--among other things--they effects of program growth on the workload. We also recommended that VA use key practices for staffing model design in determining the staffing needs of teams. [Holly Hobbs:] And last question--what's the bottom line of this report? [Debra Draper:] The bottom line is that suicide prevention teams are a critical component of VA's suicide prevention efforts. But increased workloads and responsibilities have created challenges. Evaluating the workloads and responsibilities of these teams and ensuring appropriate staffing will go a long way to help address the identified challenges. [Holly Hobbs:] That was as Debra Draper talking about GAO's recent review of efforts to prevent veteran suicides. Thank you for your time, Debra! [Debra Draper:] Thank you! [Holly Hobbs:] And thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts. And make sure you leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at GAO.gov.