Community Mental Health Summit at the Manhattan VAMC

On Monday, September 21, the Manhattan VA Medical Center held its annual Community Mental Health Summit, where VA administrators sought to improve understanding and communication between the VA and service providers and veterans within the community. The event was held in Atrium A (the main conference center), and was well-attended by a large audience made up mostly of service providers from non-VA programs and nonprofits in the area. The program as a whole was informative and interactive, but left us with many questions about how much community input would go toward actual changes at the Manhattan VAMC, or whether there will be follow-up with community members about what was discussed.


John Tatarakis introducing the Mental Health Summit

The event was hosted by Manhattan VAMC and co-sponsored by the Veterans Mental Health Coalition of NYC and the National Alliance on Mental Illness of NYC, both of which publicized the event broadly within the community of mental health service providers for veterans in the NYC area. We are grateful to VMHC-NYC and NAMI-NYC for letting us know about this so we could publicize it to the community members we reach.

VA Medical Centers are required to hold an annual Community Mental Health Summit, and it provides VAMCs with an important forum to be able to communicate its programs and goals to community members, while hearing back from the community on how it can improve. This is definitely a good thing. But it's been uncertain how much community input from these Summits over the last few years has resulted in any changes at the Manhattan VAMC or elsewhere. And community members are also left wondering how service providers or even veteran patients can provide feedback that will be heard and acted upon during the course of a year--and not only related to mental health.

VA staff explained the Veterans Choice Program that was enacted in 2014 as part of VA reforms passed in Washington, and veterans are eligible to use this program to be seen by non-VA providers if they reside more than 40 miles of driving distance away from their nearest VAMC, or would be excessively burdened by the travel distance, or if the wait time for an appointment exceeds 30 days, or if they meet other eligibility criteria. This was helpful information since this is a new program that has had even more recent modifications made to it.

VA staff also explained the National Resource Directory, which is a national directory operated by the VA and Department of Defense that allows users to enter a locality (by zip code, town/city, or state) and keyword to search for a broad span of resources in a specific area. It's a fantastic tool that more people need to know about, and resources can be rated with either a thumbs-up or thumbs-down. But if one looks for local NYC resources--many organizations we're familiar with in the community aren't listed, and very few resources have any thumbs-up or thumbs-down ratings. We might assume this is because the directory simply isn't as widely used as it could be, and organizations aren't being suggested as resources to be included in the directory. It will take the community as much as the VA to change this and utilize this tremendous resource to its full potential.

Most of the audience was aware that September is Suicide Prevention Month, and that the VA in particular has made an important national effort to publicize the Veterans Crisis Line (1-800-273-8255, veterans press 1) with the very moving new "Power of 1" video campaign that launched this month. Suicide prevention is a top-priority issue especially for the veterans we've surveyed and interacted with, as well as the many family members, friends, and service providers who have lost veterans from our community to suicide. Amid what was otherwise a very informative Summit, and given the national visibility of the VA's suicide prevention campaign--it was surprising to us that the Manhattan VAMC's Suicide Prevention Coordinator introduced her talk at the Summit by saying she'd just come back from a week and a half of vacation (during Suicide Prevention Month) and was unprepared to speak to the community. She stated that of the estimated 22 (or likely more) veterans who commit suicide each day nationally--an estimated 5 of them are actually receiving care from the VA. And she described non-serious calls referred to her from the Veterans Crisis Line--all of which together was disconcerting to those of us hoping to hear about more robust efforts to combat veteran suicide.

This isn't to undermine the vital work of so many great staff members who work at the Manhattan VAMC and other facilities across the NY Metro area--but rather to inform the community of what actually took place at the Summit, and to reflect that we as a community are looking for more from our local VA facilities--especially when it comes to veteran suicide. Everyone in attendance was handed a cloth bag full of Veterans Crisis Line brochures, folders, coasters, wallet cards, and dog tags, and we heard about their outreach to veterans at local job fairs, colleges, and other community events--where they hand out these promotional products. What we didn't get were details on how the VA--or the Manhattan VAMC in particular--is working to reach the 4 out of 5 veterans committing suicide each day who either can't or won't seek out help from the VA. We did hear about the "high risk" list that the Manhattan VAMC has--about 30 to 40 individuals at any given time, the Coordinator said--who have attempted or threatened suicide in recent months and who are sent home with "safe discharge" plans, a regimen for treatment, and are called periodically. But we did not hear on how the VA or the Manhattan VAMC in particular are working to eliminate veteran suicide for the veterans who are seeking help from the VA (around one in five who are still committing suicide each day).


Promotion is good--but do coasters save lives?

In the break-out sessions, local service providers discussed the many veterans they see who are turned away from VA care because of discharge status or other failures to meet eligibility requirements--and the Manhattan VAMC's Suicide Prevention Coordinator did discuss that she fielded cases (referrals from the Veteran Crisis Line or other cases) that she had to turn away for treatment due to ineligibility. And some VA staff members in the break-outs showed a lack of awareness of local resources such as NYCServes and the new Veteran Benefits Counselors at the Mayor's Office of Veterans Affairs to point veterans to state, city, or nonprofit resources that can serve and provide effective treatment for these veterans.

There was great crosstalk between service providers, and between community members and VA staff at this event. John Tatarakis was the key host of the event, and showed how seriously he takes the mission of the Community Mental Health Summit by being very responsive to questions, and by ensuring that it was a highly interactive and productive event. Service providers from the community stepped up and co-led discussions with VA staff, and this was great to see also. We highly recommend that community members make every effort to attend and take a greater role in these Summits at VAMCs across the area each year. But we also hope to see more detail, more follow-up, and better local-level integration and referrals to local resources for veterans--especially for veterans who come to the VA for help but do not meet eligibility requirements.

A new startup that the NYC Veterans Alliance is working with that will provide veterans and community members an opportunity to provide feedback on care at VAMCs, as well as other service providers and veteran organizations, is called Pathfinder. This online evaluation and feedback tool will launch soon, and we will promote this to our members and those we reach in the NYC veterans community. In the meantime, Pathfinder asks for your feedback on your experiences with veteran services and organizations to help them develop and finalize the tool they are launching. More on this soon.

Please leave a comment below on the Summit if you attended, or if you have specific feedback for Manhattan VAMC mental health staff. We will ensure that your comments are seen by Manhattan VAMC staff. Please keep feedback professional and constructive, and respectful of the many dedicated people who work to serve veterans every day.