Investigation Proves Whistleblower Claims – VA Neglected some
Suicidal Veterans
note: This Blogmaster is aware of one veteran who previously attempted suicide and sought help from VA mental health facilities and was instead invited to an afternoon veterans' picnic, with no professional follow-up. Claims of depression brought prescriptions for Prozac from a primary care provider.
The
Department of Veterans Affairs has substantiated some of the allegations made
last year by a former epidemiologist who claimed that the agency neglected
assisting suicidal veterans and was slow to release important research data.
The
former employee, Dr. Steven S. Coughlin, was a principal investigator at
the VA’s Office of Public Health until
resigning in December 2012. Coughlin testified in March 2013 before an
investigative and oversight panel of the House Committee on Veterans’ Affairs.
(See “Whistleblower Accuses
Government Of Neglecting Suicidal Veterans And Suppressing Science”.)
The
VA’s Office of Research and Oversight investigated Coughlin’s claims and
completed a report on its findings last
summer. It did not brief Congressional staff of the House Committee on
Veterans’ Affairs on its report until January, according to Chairman Rep. Jeff
Miller (R-Fla.).
After
interviewing several VA staff and reviewing 3,000 pages of relevant
documentation, the investigators substantiated three of 10 allegations made by
Coughlin:
·
VA lost medical data obtained from the
children and spouses of Gulf War veterans that might have demonstrated an association
between illnesses, including those related to wartime exposure, in service
members and their offspring;
·
Coughlin’s superiors responded to his concerns
in a way that could have been perceived as threatening or retaliatory;
·
VA neglected to contact participants in a
study of Gulf War veterans who shared suicidal thoughts or feelings.
Regarding
Coughlin’s other claims, the investigators often said the disagreements between
Coughlin and his superiors resulted from conflicting priorities.
While
Coughlin, for example, said his supervisors were deliberately withholding
important data regarding exposure of Iraq and Afghanistan veterans to
toxins and inhalation hazards, those interviewed about the claim said the data
needed to be cleaned and that analysis should focus on the main subjects of the
study, which are traumatic brain injury and post-traumatic stress disorder. The
report urges VA to complete the analyses “as expeditiously as possible.”
Related
Story: Burn Pits Still Used In Afghanistan, Endanger Troop
Health
Coughlin,
who is now a professor of preventive medicine at the University of Tennessee in
Memphis, claimed that the decision to report his concerns took a toll on him
professionally and personally. “I quit my job and left because it wasn’t just
one ethical problem, it was a whole constellation,” he said. “I finally had
enough.”
He
remains concerned that veterans participating in different VA studies who
expressed suicidal feelings have not or may still not get a follow-up call from
a mental health provider. Before he left VA, he was eventually permitted to
involve clinicians in a 20-year study of 30,000 Gulf War veterans. A team
of social workers and psychologists placed follow-up phone calls to nearly 100
veterans who had reported suicidal behavior. The report found that a smaller
group of veterans participating in a separate study required follow-up; six
veterans were subsequently contacted.
Coughlin’s
supervisors told investigators that they had not rushed to develop a plan for
contacting suicidal veterans because they felt doing so “represented
a desirable innovation, rather than an immediate need.” They also worried that
calling veterans would violate privacy and confidentiality guarantees and
“thereby undermine Veterans’ trust in future [Office of Public Health]
surveys.”
Since
the investigation concluded, VA has taken several steps to address Coughlin’s
substantiated claims.
Dr. Tom
Puglisi, executive director of the Office of Research Oversight at the Veterans
Health Administration (VHA), said in a statement that the “evolving
standard is that participants demonstrating suicidal ideation in research
studies should be contacted promptly for clinical follow-up, and VHA expects
that future [Office of Public Health] surveys will adhere to this standard.”
The
report recommends increased Institutional Review Board oversight for research
conducted by the agency. Office of Public Health supervisors have participated
in human resources training in conflict resolution. That office has also
established timelines for analyzing and publishing data from major studies on
Gulf War, Iraq and Afghanistan veterans, including results that might indicate
a neurological explanation for Gulf War Illness.
In a
statement, the agency acknowledged the results of the investigation and said
the its “highest priority” is the mental health of veterans.
“The
Department of Veterans Affairs recognizes and respects the service, dedication
and many challenges of Veterans of the 1990-1991 Gulf War, and is committed to
improving the health and well-being of these Veterans,” Puglisi said.
“Research is a vital component in improving that treatment.”
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