Report: Linking 311 with VA Suicide Hotline

Report: Linking 311 with VA Suicide Hotline

Advocates have proposed that NYC’s 3-1-1 information system directly connect suicidal veterans who dial the system to the federally-funded VA Suicide Hotline. This initiative received the strongest support of the sixteen listed in the survey. A total of 95.39% of respondents indicated that they view this as either essential or very important.

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NYC 311 Phone Service. New Yorkers call 311 for information about garbage pickup, parking, MTA service, to report noisy neighbors or problems with their landlord, or to learn about employment opportunities or other city services. If individuals reporting more urgent situations reach 311, such as reporting a gas leak, they are transferred to the city’s 911 service to ensure a prompt and appropriate response. If a 311 caller reports suicidal thoughts, they are referred to LifeNet, a NYC-based mental health counseling service administered by the Mental Health Association of NYC.[1] LifeNet does not offer specialized counseling services related to military or combat service, nor does it have routine familiarity with the experiences of military veterans.

NYC 311 Website and Mobile App. To reach users via internet and mobile devices, the 311 website features a menu of common requests, access to paying city fees and fines, placing complaints, and an array of other information. The mobile app mirrors much of the website’s features and information. With both the website and app, 311 offers a search feature where users can type in terms such as “suicide” or “veteran suicide.” When “suicide” is searched, the user is offered three links:

  • Report a person threatening suicide—which directs the user to dial 911.
  • Report a medical emergency—which directs the user to dial 911.
    • Information about death investigations.

If a user enters the words “veteran suicide,” no results are found.[2]

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Veterans Crisis Line. The Veterans Crisis Line is a national, 24-hour hotline for veterans and family members, and currently administered by the Department of Veterans Affairs from the Canandaigua VA Medical Center facility in upstate New York. Five backup or overflow sites around the U.S. take additional calls to ensure calls are answered promptly and receive the full attention they require.[3] Backup sites are administered by the Mental Health Association of NYC,[4] via a contract that Link2Health Solutions[5] holds with the Department of Veterans Affairs.[6]

Veterans Crisis Line counselors, some of whom are themselves veterans, are trained in subjects specific to suicidal veterans, including:

  • Battlemind PTSD
  • Characteristics of adults with psychological distress
  • Combat injured soldiers
  • Human immunodeficiency virus (HIV) with alcohol and lifestyle associated problems
  • Major depressive episodes and work stress
  • Mental health problems with active/reserve troops returning from Iraq
  • Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) stress and traumatic brain injury (TBI)
  • Strategies for preventing suicide in TBI patients
  • Suicide mortality, treatment for depression
  • The Veterans Health Administration (VHA) and military sexual trauma
  • Treatment of clients with acute suicidal ideation 
  • War and military mental health[7]

Counselors specialize in providing immediate support to veterans in crisis, coordinating with local emergency services when needed, and connecting callers with local VA suicide prevention coordinators when callers consent. The Veterans Crisis Line manages approximately 22,000 calls per month,[8] some of which are referred by 911 and 311 lines from municipalities across the country.

Veterans Crisis Chat/Text. Trained VA counselors also provide the additional service of anonymous online chat via www.veteranscrisisline.net. Chat software includes the message:

Sometimes technical issues cause a chat to end unexpectedly.

If this happens, please come back to chat again or call us at

1-800-273-TALK (8255) and press 1.

Trained VA counselors are also available via texting 838255 (VETALK) free of charge. Texts are limited to 160 characters, and performance of texting software is dependent on the user’s cell phone service.[9] 

NYC’s Need for Counselors Trained in Crises Faced by Veterans. Currently the VA estimates that an average of 22 veterans per day across the nation take their own lives,[10] and veterans are 50% more likely than their civilian counterparts to commit suicide.[11] Advocates have suggested that any New Yorker calling 311 to report a veteran in crisis would be better served by the VA’s resources and specialists who work continuously with veterans, rather than LifeNet counselors who are not trained specifically on mental health issues connected to combat trauma or other military experiences.

Respondent Comment. One respondent offered a dissenting comment on this subject:

  • I have mixed feelings about referring suicidal veterans to the federal hotline--I don't know if the federal line is run all that well. I think it might be better to improve local veterans services, so if someone needs urgent assistance, they're not waiting on hold to talk to someone--they can get help from somewhere in the city.

Recommendations. While it is critical to work toward preventing veterans from reaching suicidal crisis, the Veterans Crisis Line is nevertheless the most effective resource to assist veterans in crisis across the United States, including NYC. Given that veterans are currently suffering higher rates of suicide and suicidal crisis than their civilian counterparts, NYC government must ensure that veterans, their family members, and the NYC public have immediate access to the Veterans Crisis Line phone, chat, and text resources. We therefore offer the following recommendations:

  1. NYC 311, the Mayor’s Office of Veterans Affairs (MOVA), and the Department of Health and Mental Hygiene (DOHMH) should coordinate with the Department of Veterans Affairs and/or MHA-NYC to implement the direct connection of calls made by suicidal veterans or their family members from NYC’s 311 phone service (as well as the MHA-NYC’s LifeNet service) to the Veterans Crisis Line. This would be similar to existing 311 referral agreements in other municipalities across the U.S.
  2. The NYC 311 website and app should include a “Veteran Contemplating Suicide” link to Veteran Crisis Line phone, chat, and text resources that appears when users search for “suicide” and/or “veteran suicide.”
  3. NYC 311, MOVA, DOHMH, and MHA-NYC should implement a “Veterans in Crisis 101” training requirement for 311 operators and LifeNet operators to understand the unique needs of veterans who may be in suicidal crisis.
  4. NYC 311, MOVA, and DOHMH should coordinate with the Department of Veterans Affairs and/or MHA-NYC to implement the direct connection of calls made by suicidal veterans or their family members that do not necessitate immediate dispatch of emergency services to the Veterans Crisis Line. This would be similar to existing 911 referral agreements in other municipalities across the U.S.

[2] Screenshot taken on June 19, 2015.

[8] Noted in the documentary film “Crisis Hotline: Veterans Press 1”

[10] Page 15, “Suicide Data Report, Department of Veterans Affairs Mental Health Services Suicide Prevention Program,” http://www.va.gov/opa/docs/suicide-data-report-2012-final.pdf

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