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trigger a complex set of behaviors that may lead to thoughts of suicide.” The legislation’s intended purpose was to strengthen suicide awareness, prevention and education programs throughout the VA.
Despite this legislation, and a significant increase in VA’s mental health staff and budget in the years that followed, Veterans continued to die by suicide at an alarming rate. In 2015, Congress revisited the issue, leading to the passage of the Clay Hunt Suicide Prevention for American Veterans Act, named for a Marine who served in Afghanistan who died by suicide in March 2011 at the age of 28. The purpose of the Clay Hunt SAV Act was to further expand suicide prevention programs and mental health services at the VA. Congress is again exploring legislative options in the wake of four Veterans who committed suicide at VA medical centers in April 2019.
“It’s irresponsible for us to think that the government has it under control,” states Rieman, with regard to legislative and clinical efforts undertaken by Congress and VA, “that’s not a slap on them, it’s just unrealistic.” Rieman noted that one of the challenges with many government programs is their rigidity. “Lots of vets can’t process what’s happening internally, so we have to bend a little to help them get to where they need to be, rather than rule with a hammer,” he states.
Indeed, the circumstances surrounding John Toombs’ final moments is an example of how rigidity can work to hurt, rather than help some Veterans. Toombs was in the residential treatment program at the Murfreesboro VA that, although intended to be “an intensive therapeutic atmosphere,” also “demand[ed] strict discipline.” When, on the morning of November 22, 2016, Toombs failed to take his medication on time, he was abruptly kicked out of the program. His death by suicide took place only hours later.
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