VA’s mental-health programs criticized
Steve Vogel
The Washington Post
| Sunday, August 25, 2013, 10:05 a.m.
Shortly before his death on June 10, Army veteran Daniel Somers wrote a note for his family, asking his wife, Angel, to share it as she saw fit.
“I am left with basically nothing,” he typed on his laptop at their Phoenix townhouse. “Too trapped in a war to be at peace, too damaged to be at war.”
His service in Iraq, including multiple combat missions as a turret gunner, left him with severe post-traumatic stress disorder and traumatic brain injury. But the government, he wrote, had “turned around and abandoned me.”
Somers felt frustrated in his efforts to get mental health and medical care from the Department of Veterans Affairs. An antiquated scheduling system at the Phoenix medical center left him waiting, often in vain, for a postcard with the date of his next mental health appointment.
And he was caught in VA’s notorious disability claims backlog, which at its peak in March included more than 900,000 compensation requests from veterans, two-thirds of them waiting for more than 125 days. When Somers died, his case seeking full disability for his PTSD had been awaiting resolution for 20 months.
“Is it any wonder then that the latest figures show 22 veterans killing themselves each day?” Somers asked in his note.
Around 9 p.m. on June 10, while his wife, a nurse, was working, Somers took a handgun from his home and walked to a street several blocks away. When Phoenix police arrived at the scene, he shot himself in the head, police and family members said. He was 30.
Now his parents, Jean and Howard Somers, are determined to use their son’s death to expose what they see as critical deficiencies in the VA system for treating mental illness. They met with congressional and VA officials in Washington this month and opened Somers’s records to The Washington Post. It is an effort, they say, to show how the agency failed their son and a way, maybe, to help someone else.
“He was one of those million vets who didn’t get the care they needed,” said Jean Somers, 62, a former health care administrator.
In a speech Aug. 10 to the Disabled American Veterans, President Barack Obama declared a need to “end this epidemic of suicide among our veterans and troops,” and he announced $107 million in new funding to better treat PTSD and traumatic brain injury.
The daily average of 22 suicides by veterans, found in a VA study in February, was 20 percent higher than a 2007 department estimate. Suicides among active-duty troops reached 349 last year, the most since the Pentagon began closely tracking the number in 2001.
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Howard and Jean Somers were in New Jersey visiting family when Angel called with the news.
“Our whole lives have been turned upside down,” said Howard Somers, 65, a retired urologist who lives with his wife in San Diego.
After arriving in Phoenix, their grief turned to anger as they read through Daniel’s papers documenting his interactions with VA. The family shared Daniel’s story with local media, and his note was posted June 22 on the website Gawker.
For veterans’ organizations, Daniel Somers’s death is a case study in how federal agencies continue to fail veterans.
“It shines a light on these issues,” said Kim Ruocco, director of suicide-prevention programs for the Tragedy Assistance Program for Survivors (TAPS), a group for military families that organized the Somerses’ Washington visit.
Ruocco’s husband, Marine Maj. John Ruocco, a Cobra gunship pilot, killed himself in 2005 after returning from Iraq.
In a statement expressing condolences for Somers’s death, VA said that it “has made strong progress in the treatment of mental health disorders” in recent years, including hiring more than 1,600 mental health professionals in the past year, developing a suicide-prevention program to identify those at risk and bolstering its 24-hour Veterans Crisis Line. Over the past year, the Phoenix VA medical center has hired 32 mental health workers.
“Still, more must be done,” the department said.
Assigned to military intelligence, Daniel Somers deployed to Iraq in 2004 with a military police company. He served as a machine gunner in the turret of a Humvee, frequently exposed to roadside bombs and rocket attacks.
He returned home in February 2005 traumatized, his wife said. “He couldn’t sleep, and when he did, he’d wake up screaming.”
“I was called upon to employ deadly force on a regular basis — often in situations where non-combatants ended up in the crossfire,” he later wrote. “To this day, I am unable to provide even a rough approximation as to the number of civilian deaths in which I may be complicit.”
But he wanted to go back to Iraq, hoping to make amends, his wife said. He studied Arabic and volunteered to return in 2006 as an intelligence contractor.
Going back, however, just “made things worse,” Angel Somers said.
After coming home again in 2007, he channeled his energy — and his trauma — into music. He was the lead singer and guitarist for a Phoenix rock band called Lisa Savidge, writing songs that drew on his struggle with PTSD.
But his efforts to get adequate mental health care were less successful, family members said.
When he was admitted to the VA health system in February 2008, they said, he found that he could not make appointments over the phone but would be assigned a date and time by postcard.
When Daniel Somers did see a VA psychiatrist, the doctor retired. And when he tried to get information about his next appointment, the office told him there was a shortage of mental health providers and he’d be notified when he was assigned a new one.
He was seen 40 times, mostly in 2008, shuffled between psychiatrists, psychologists, social workers and nurses.
Family members paid to send Somers to a doctor in private practice, but his mental health continued to decline, they said.
VA had assigned him a relatively low disability rating for his PTSD: 30 percent, a level that assumes the veteran can be employed. Somers applied for a VA vocational rehabilitation program in October 2010. As part of the process, he met with a VA psychologist, who, according to Somers, told him his PTSD was so severe that he was unemployable.
He appealed his rating decision in October 2011, sending a cover letter detailing his problems. He was suffering from “unrelenting depression” and frequent visions of people around him “dying in horrible ways,” he wrote. Over the past year, he added, he had begun hearing threatening voices and experiencing nightly panic attacks.
It all “drives me to consider suicide very seriously on a daily basis,” he wrote.
There were physical ailments, too, including fibromyalgia, chronic fatigue, irritable bowel syndrome and chronic headaches.
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Looking back on their son’s experience, the Somerses ask basic questions.
“If your system is so difficult to get into,” Howard Somers asked, “how the hell are you going to prevent suicides?”
When the Somerses told this story during their meeting at VA headquarters with Jan Kemp, the department’s director of suicide-prevention programs, the official showed the parents a memo recently sent to facilities around the country, reiterating that all patients who miss mental health appointments should be called.
Kemp spoke with the Somerses for 90 minutes, well over the allotted time.
“She seemed frustrated and sympathetic,” Howard Somers said. “It ended up with her apologizing profusely.”
On July 23 — having learned of Daniel Somers’ death six weeks earlier — the Phoenix VA notified Angel Somers that her husband’s PTSD claim had been approved and that he had been granted 100 percent disability retroactively to 2008, a benefit that will now be paid to his wife.
The response from VA has left the family hopeful that changes are being made but angry that problems recognized for years continue to plague veterans.
“If he had not met so many obstacles, would my son be alive today?” Jean Somers asked.