WASHINGTON – President Donald Trump signed an executive order Tuesday aimed at expanding mental-health care for transitioning veterans as they leave the military, in an effort to reduce suicides in a group that is considered particularly at risk.
The order will take effect March 9 and is expected to provide all new veterans with mental-health care for at least a year after they leave the military. Trump gave the Defense Department, the Department of Homeland Security and the Department of Veterans Affairs 60 days to iron out details and develop a joint plan, Veterans Affairs Secretary David Shulkin said in phone call with reporters.
Trump signed the order in the Oval Office during a short ceremony with Shulkin, Homeland Security Secretary Kirstjen Nielsen, Deputy Defense Secretary Patrick Shanahan, Chief of Staff John Kelly and other senior officials. The president called the order a "historic step to make sure that our incredible veterans are taken care of in a proper manner."
Trump said his administration wants veterans to get "the highest care and the care they so richly deserve," citing the passage of legislation last year that gave VA more flexibility to remove employees identified as problems.
"Now, when somebody doesn't do the job at the VA, we fire that person," Trump said. "When somebody's bad to our great veterans, even sadistically bad, we fire those people. Get them out."
The order is especially focused on the 60 percent of new veterans who do not qualify for care until the government establishes that a medical issue has ties to their military service. It calls for "seamless access to mental health treatment and suicide prevention resources for transitioning service members" in the year following military service, according to a fact sheet provided by the White House. Within 180 days, the departments are expected to report back to Trump on implementation of the plan.
Shulkin said suicide among veterans is his top clinical priority, and that he determined that people who have left the military within a year are between 1 1/2 to two times as likely to commit suicide as any other age group. The federal government estimates that about 20 veterans per day commit suicide.
"That is just an unacceptable number, and we are focused on doing everything we can to prevent these veterans' suicides," Shulkin said.
Defense Secretary Jim Mattis said in VA news release that his department looks forward to continuing to work with VA and making sure that veterans receive the care they need.
Homeland Security Secretary Kirstjen Nielsen said that the executive order is "critically important," and will provide service members "with the support they need as they transition to civilian life." She noted that her department includes the Coast Guard, and has a workforce in which 28 percent of the people have military experience.
Some details about the extended coverage, first reported Tuesday morning by Military Times, are not yet clear. But it is expected to include the expansion of peer group sessions from 18 of VA's largest "Whole Health" facilities to the rest of them, according to VA. Whole Health centers focus on encouraging veterans to set goals, share their stories and connect with other people.
The Defense Department also will expand the services of its Military OneSource program to apply to veterans for a full year after leaving the military, rather than 180 days, said one U.S. official, speaking on the condition of anonymity in order to discuss the plan's specifics. The program offers face-to-face counseling to discuss relationships, deployments and reintegration, and a 24-hour call that assists with everything from moving to managing a budget.
The Pentagon also will look for ways to start the transition process for service members earlier during their time in uniform, the official said.
"The issue here is looking at transition as a process, and not an event," the official said.
Shulkin said about 265,000 service members transition out of the military each year, and the cost of providing them with extended mental health coverage "will be in the magnitude of a couple hundred million dollars per year" coming out out of the Defense Department and VA budgets. But he said it will be paid for with existing money.
The government has long grappled with how to reduce the suicide rate among veterans. VA reported in 2013 that about 21 veterans per day took their lives, and updated the figure in 2016 with improved statistics.
According to a VA study released in 2016, the risk of suicide was 19 percent higher among male veterans than male civilians, and 2 1/2 times higher among female veterans than civilian women. The suicide rate for male veterans was highest among those between the ages of 18 and 29, and highest among women between 40 and 59, the study found.