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Veteran suicide tracking faulted

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Government report says VA data is being incorrectly reported

The Department of Veterans Affairs is incorrectly reporting suicide data and poorly tracks and cares for Vets at risk of suicide who are prescribed antidepressants, a new report by the U.S. Government Accountability Office suggests.

A yearlong audit discovered multiple instances where agency protocols for treatment of Veteran depression were broken, and patient and suicide data was flawed, the Dec. 12 report states.

Ten percent of those who received Veteran health care in the past five years were diagnosed with major depressive disorder, or more than 532,000 Veterans. Nearly all of them were prescribed antidepressants, but policies for follow-up care were rarely followed in the cases sampled, the audit states.

Independent government reviewers inspected 30 medical files for Veterans prescribed antidepressants following a major depression diagnosis at six VA medical centers in New York, Florida, Iowa, Pennsylvania, Arizona and Nevada spanning fiscal years 2009 through 2013.

Twenty-six of those Veterans weren’t assessed after four to six weeks as specified in the VA’s clinical practice guidelines, and 10 Veterans did not receive follow-up care within the time frame recommended, the audit found.

Eleven of the 30 cases had coding discrepancies, suggesting, “VA’s data may understate the prevalence” of major depression “among Veterans being treated through VA, to the extent that such discrepancies may permeate VA’s data.”

The report also said the VA lacked a system-wide process for tracking compliance with agency protocols for antidepressant treatment.

The accuracy of Veteran suicide data used for prevention work was also problematic.

“The demographic and clinical data that VA collects on Veteran suicides were not always complete, accurate or consistent,” the report states.

Forty out of 63 Behavioral Health Autopsy Program reports had incomplete data, six had incorrect dates of death and nine reported an incorrect number of outpatient mental health visits in the last 30 days, reviewers found.

The errors were attributed to different interpretations of the guidance given for filling out the forms, and the situation was “further exacerbated” because the forms “are generally not reviewed at any level within the Department.”

“Lack of complete, accurate, and consistent data and poor oversight can inhibit VA’s ability to identify, evaluate and improve ways to better inform its suicide prevention efforts,” the office wrote.

In 2013, Veterans Affairs officials estimated 1.5 million Veterans required mental health care, including treatment for major depression, the report states. The agency provides mental health services to Veterans at its 150 medical centers across the country.

A 24-hour confidential Veteran’s Crisis Line first established in 2007 for Veterans, their families and friends fielded about 287,000 calls, 54,800 online chats, and 11,300 text messages in fiscal year 2013, the report says.

In an Oct. 21 letter to the Government Accountability Office, Veterans Affairs concurred with all six recommended actions for improvement, including analysis of its coding methods, evaluation of the risk of antidepressant treatments that deviate from set policies, and new systems to review the accuracy of suicide data entries.

Source

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