By Dave Weiner, IPSA Mental Health Committee Member

In March of 2018, I had the fortunate experience to be part of the Mayors Challenge team. The Mayors Challenge is a great partnership between the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Veterans Affairs.  

The overarching goal of the Mayor’s Challenge is to reduce suicides among service members, Veterans and their families using a public health approach to suicide prevention. The multi-disciplinary team from Los Angeles consisted of members from the City of Los Angeles Mayors Office, Los Angeles County Department of Mental Health, Didi Hirsch, 211 LA, U.S. Army Suicide Prevention Office, Los Angeles County Sheriff’s Department Mental Evaluation Team (MET), Los Angeles Police Department Mental Evaluation Unit (MEU), Greater Los Angeles VA Suicide Prevention Office and I attended to represent VA Police from our region.

This entire program was funded by SAMHSA and the eight city teams met in Washington D.C. from March 2018 to develop a comprehensive framework for a strategic action plan that would be a benefit Veterans in the County and City of Los Angeles.

Veteran suicide rates

In July 2016, the VA conducted an analysis of veteran suicide rates. They reviewed 55 million Veteran records from 1979 to 2014, from every state in the United States. The data revealed that roughly 20 veterans died by suicide per day.

While the VA has made great strides in working to reduce the number of veteran suicides through the development of the Veterans Crisis Hotline, expanding capacity for same-day mental health appointments and hiring additional clinicians to address these critical issues, one element had been overlooked. This was the proactive outreach to Veterans in crisis like how both LAPD and LASD do proactive outreach to non-Veteran citizens in crisis in their respective communities.

Making a change locally

After working with the Mayors Challenge team in D.C., it was apparent there was an opportunity to do more for our Veterans locally. This led to the creation of the VA Police Veteran Mental Health Evaluation Team at the VA Long Beach healthcare system facility in August 2018. Like the MET and MEU teams at LASD and LAPD respectively, this new element is the proactive utilization of VA Police Department officers in conjunction with VA mental health clinicians to conduct outreach contacts and follow-up on cases of Veterans experiencing mental health issues/crises.

Building the program

Developing this program took a lot of internal and external coordination. Nothing like this had been attempted before. To the VA’s credit, they do have a program that pairs a VA Police Officer and clinician to teach first responders how to interact with Veterans in the field but that’s where it stops. The VMET team is a natural extension of that program and puts boots on the ground to interact directly with Veterans and provide the care and resources at the point of crisis.

It was critical to get buy-in from a plethora of people internal to the VA and support from law enforcement counterpart. It was equally important to connect with key stakeholders in the mental health field, social work services and the executive leadership of these groups.  

VMET pilot program

The VMET pilot program went live on August 20, 2018. In just six months, it went from concept to reality. The team performs a version of case management to ensure when they get a Veteran back to the medical center for care, that they are routing the Veteran to appropriate services. The team does periodic follow up to ensure the Veteran is staying on the right path and moving toward recovery.

This case management component is important. It shows that the team cares about the outcome and that they are partners in the Veteran’s success in recovery. The response to this service has been overwhelmingly positive and has garnered media attention of the team.

The team is a force multiplier in the fight against Veteran suicide. They can bring the resources the VA has to bear on an issue a Veteran has. This pro-active outreach, co-response model has changed the course in several Veterans’ lives.

It took a monument of effort to get this program operationalized. Below are some tips, ideas and strategies to replicate a program like this in another community:  

1. Develop a strong concept based on an existing problem.
2. Do your due diligence and research. Support theory with data.
3. Fully develop a concept and its benefit in an issues paper or other document/presentation format.
4. Use local, state and national level data to support the concept.
5. Define expected outcomes on both implementation and non-implementation.
6. Involve every stakeholder the program may impact or that you may need resources from to ensure your concept works and is successful. This may evolve over time as some stakeholders may not show up as obvious in the beginning.
7. Develop strong relationships with your key stakeholders. They will also likely end up being your strongest advocate and voice for you and what you are trying to achieve.
8. Get leadership buy-in as early as possible. This helps pave the way for folks who may want to derail what you are trying to achieve. The conversation changes with those folks when they know that leadership is supporting it, and they will be less likely put up roadblocks.
9. Keep leadership in the loop of progress and issues.
10. Select the right people to execute the mission you are trying to achieve. Selecting the wrong people will ultimately cause the demise of your program and damage your credibility and make it harder to do something similar in the future.
11. Ask for help any time you think you need it. Depending on the complexity of a project, collaborating with those trusted advisors will help your program succeed.
12. Be engaged and promote your program/project to those you will think benefit most from it. Be your own champion in this area.

To date of this article, the VMET team has responded to well over 400 calls for service involving Veterans in crisis to include necessary follow ups and case management.

Two media articles below highlight the team and their effectiveness.

https://www.washingtonpost.com/national/veterans-talking-veterans-back-from-the-brink-a-new-approach-to-policing-and-lives-in-crisis/2019/03/20/c1add29e-4508-11e9-8aab-95b8d80a1e4f_story.html

https://www.tpr.org/post/help-veterans-crisis-va-counselors-are-riding-along-police

About the Author

Dave Weiner is the founder and CEO of Secure Measures, LLC, a risk management consulting firm that provides protection solutions for the global ecosystem. Prior to founding his company, Weiner’s 26-year public safety career included roles in corporate security, training, K-9, SRT, community policing, investigations and culminated in retiring as Regional Chief of Police and Emergency Management.