Veterans in Crisis

On an evening last March, 42-year-old Dedra Hughes’ thoughts turned to suicide. The Army veteran, who had been diagnosed with post-traumatic stress disorder five years earlier, had split with her boyfriend days before. She was unemployed and had stopped taking classes. And she was convinced her two daughters would be better off without her.

Sitting on the floor of her suburban Chicago living room, Hughes attempted to slash her wrist but didn’t draw blood, and says she passed out from anxiety. Her 12-year-old discovered her there on the floor with the knife beside her.

Hughes decided that night to turn to the national Veterans Crisis Line, a 24-hour, seven-day-a week service that promises an immediate, open line to professional help. But when Hughes phoned, she said, her call went straight to hold. After several minutes, she became frustrated and hung up.

“I would never call the hotline again,” said Hughes. She said she needed to quickly get to someone that night who could give her help and reassurance.

“That’s what I wanted,” she said. “Someone to make me feel that I mattered.” After reaching out to a local veterans group, someone arrived at her home that night.

Several complaints about the crisis line prompted the Coalition of Veterans Organizations to describe it as “seriously deficient” in a letter to the Department of Veterans Affairs last year.
Veterans calling for help got voicemail or no answer, according to the letter. It said others were told only to contact a local VA facility for help. The letter prompted the Inspector General for the VA to begin an inspection of the program, which is ongoing.

The Department of Veterans Affairs operates the Veterans Crisis Line call center in Canandaigua, NY. Scripps photo by Matt Anzur.

In response to the letter, the VA wrote back saying that it had discovered a voicemail service being used at one back-up center in violation of the rules. Aside from that, interim VA Under Secretary for Health Carolyn M. Clancy wrote that she was “not aware of any phone service malfunction that would result in a Veteran’s call not being connected.” Rep. Mike Coffman, a Colorado Republican and member of the House Committee on Veterans’ Affairs, calls the crisis line’s performance with these calls a “failure.” Veterans seeking help from it, he said, “are isolated and they’re alone and they’re fragile and they’re reaching out….because they’re at the end. And so there’s not anybody there.” The VA estimates 22 veterans commit suicide every day. “How many veterans will lose their lives due to suicide and the time it takes them to unwind this bureaucracy?” said Coffman, a veteran of the Army and Marine Corps.

When veterans in crisis pick up the phone for help, their calls are directed to the Veterans Crisis Line call center on the VA campus in Canandaigua, NY. Scripps photo by Matt Anzur.

The crisis line directs all calls first to its leafy Veterans Affairs campus in the Finger Lakes town of Canandaigua, New York. The center opened eight years ago to provide instant support for those in crisis.

If the lines are busy, calls should automatically go to one of five back-up centers that work under contract around the country. If lines at one back-up centers are jammed, calls get forwarded on to another, which can create a frustrating round-robin leaving veterans on hold without help, and increasing the likelihood they will hang up.

VA officials say the number of calls has grown enormously since the program began in 2007 -- from about 60 calls a day with two rolling daily to backup centers that first year, to answering about 1,000 calls a day plus 300 going to backup centers currently, according to Julianne Mullane, who became acting program manager for the crisis line in January.

Since the start of the program, the number of phone lines has grown from four to 52, and the number of phone staff from 14 to 255, according to the VA. The backup centers are coordinated by a contractor, Link2Health Solutions, Inc., which is a subsidiary of the Mental Health Association of New York City.

It is unclear how many calls go unanswered. Scripps requested detailed call records from the VA, but the agency has not provided them.

Mullane said that the 300 daily rollover calls are “getting to people who are trained in crisis intervention,” and she disputed that the backup system is broken.

Since January, Julianne Mullane has served as acting program manager of the Veterans Crisis Line. Scripps photo by Matt Anzur.

“The struggle is constantly to keep up our quality, because every single one is life or death,” Mullane said.

For an agency still reeling from the revelation last year that veterans faced long delays in getting medical care and that VA hospital workers had fabricated wait times, there is little margin for error.

Additionally, a December 2014 audit of the VA’s National Call Center for Homeless Veterans found that more than a quarter of calls were routed to voicemail, and that resources designated for homeless vets were being diverted to the Veterans Crisis Line.

The Crisis Line has requested technology updates and more staff, and Mullane said extra workers should be in place within six months.

Coffman says that’s not good enough. “It has to be fixed yesterday,” he said. “There can be no delay.”

The crisis line will receive scrutiny under the Clay Hunt Suicide Prevention for American Veterans Act, approved this month by Congress. It requires outside evaluation of suicide prevention practices at the VA each year.

Even when calls are answered, there’s no guarantee help will be at the other end of the line. A 35-year-old Denver veteran with a history of PTSD told Scripps she called the crisis line in June 2013 as her condition began to worsen. She’d become increasingly afraid to leave the house and answer the phone, and over several months had developed a plan to kill herself. She asked not to be identified because she doesn’t want friends and extended family to know of her suicide attempt.

At work one day, she says, she closed her office door and crawled under her desk with her phone. “It seemed like a safer place to be,” she said. She says she called the crisis line, explained that she was spiraling mentally and that she had a suicide plan.

“I was transferred from person to person; put on hold for long periods of time,” she told Scripps. Eventually, she said, someone promised that she’d get a call back, but it never came. The next day she climbed into her SUV preparing to drive off a bridge, but stopped herself at the last minute. She drove straight to a VA Hospital, where she spent two weeks in treatment, she said.

"If you’ve asked for help and they’re not able to help you expediently, quickly, efficiently, then there’s no point in having the hotline,” she said.

After hearing about this veteran’s experience from Scripps, Mullane, the crisis line official, said, “I’m horrified. When you’re taking a thousand calls a day, not every one is going to go perfectly and that’s unfortunate.”

John Draper, project director for the National Suicide Prevention Lifeline, which coordinates with the VA’s Canandaigua center to provide backup support for veterans in crisis, said there is no set standard for how long is too long to wait.

“Too long of a wait is when a person hangs up, naturally,” said Draper, who is also president of Link2Health Solutions.

Veterans in Crisis: 36 minutes on hold from Scripps Washington Bureau on Vimeo.

William Fuzi knows what it means to wait. The 44-year-old Marine veteran spent 36 minutes on hold waiting for help in the early morning hours last Sept. 7. Fuzi said he was alone at his Corpus Christi, Texas, home when he began experiencing intermittent chest pains and believed he was having an anxiety attack.

He dialed the veterans crisis line and was put on hold. For the first three minutes, he says, he waited and listened as jazz music played over the phone. Then his anger began to build. This can’t be true, he thought, as he continued to wait.

“If I was suicidal…three minutes and it would have been over,” he said. So he picked up his video camera and began recording the minutes and seconds as they ticked by on his phone screen. For more than half an hour, the tape shows, Fuzi provides side commentary as his wait continues. “Can’t figure out what’s going to make them answer,” he asks at one point.

“Maybe the music’s meant to make you kill yourself,” he says at another.

“I just needed somebody to talk to,” he says later. “One more time...how many veterans die per day?”

At 12:59 a.m., with his phone showing 35 minutes, 59 seconds, an operator finally picks up. “You guys busy tonight?” he asks. By this point, he tells the operator, he’s feeling better. Assuring her he’s going to be OK, the call ends.

Interviewed recently by Scripps, Fuzi said he still gets frustrated thinking about the experience. “They’re trying to save people’s lives, but you can only save people’s lives if you’re there,” he said.

Mullane attributed Fuzi’s long wait to an isolated backup center malfunction. “It was a one-time thing that got corrected quickly, but it still happened,” Mullane said. “And we don’t want that to happen.”

Veterans in Crisis: Advocate speaks out from Scripps Washington Bureau on Vimeo.

Rochelle Crump was the Chicago-area veterans’ activist who came to Dedra Hughes’ home to provide support on the night she failed to get through on the crisis line.

Crump said she had already had a bad experience with the crisis line two months earlier, when she got on the line with a vet who had recently moved from Chicago and needed help.

To Crump’s surprise, she said, the operator downplayed the crisis and suggested the veteran contact the local VA for help instead.

Crump said she then turned to the service’s online chat system for help, but an automated e-mail told her she would hear back within 48 hours.

Crump, herself a veteran of the Women’s Army Corps, says such delays can be deadly. When vets are in crisis, she said, “They need someone right then. Not later.”

Scripps national investigative producer Angela M. Hill contributed to this story.