Operation Deep Dive: Houston Community Blog October 2019

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As Operation Deep Dive continues to build momentum among key community stakeholders in Houston, we are elated to use this opportunity to share about the success we’ve had in relation to data sharing. 

Typically when a veteran death occurs, the local VA Medical Center (VA) is notified by the community through word of mouth. While that is helpful to some extent, much work is required on the VA’s behalf to gain more information on that veteran, the circumstances of their death, and a relative’s contact information. In Houston, that process looks a bit different due to the complementary partnership between the local VA Suicide Prevention Team at the Michael E DeBakey VA Medical Center (MEDVAMC) and the Harris County Medical Examiner. In an effort to share best practices with other communities, the following is a glimpse of what that data sharing process looks like. 

On a weekly basis, the Harris County Medical Examiner shares all suicide and non-natural death data (inclusive of next of kin contact information) with the MEDVAMC Suicide Prevention Team via fax. The Suicide Prevention Team then cross-references that data with the Department of Defense’s database to confirm which decedents were veterans. If the decedent was a veteran, the Suicide Prevention Team then reports that information back to the Harris County Medical Examiner for their records. The Suicide Prevention Team then reaches out to the veteran’s next of kin via phone to offer supportive services, and to gather more information about the veteran and the circumstances surrounding their death. This phone call, in combination with the Medical Examiner data, then completes the VA’s “Behavioral Health Autopsy.” A quick note on reaching out to next of kin: the Suicide Prevention Team does not actively reach out to additional family members, but are flexible to do so if the immediate next of kin requests or suggests it. Once the Behavioral Health Autopsy is complete, the National VA Office conducts a FIT Interview with the next of kin to gain a more detailed understanding of the veterans death and their circumstances around the time of their death. Meanwhile, the Suicide Prevention Team reports a summary of the veteran’s VA care, in addition to other pertinent information, as a part of the MEDVAMC’s health care providers peer-review process. This process also acts as an opportunity for the Suicide Prevention Team to provide feedback to MEDVAMC’s leadership to then influence larger change to improve care for veterans. Examples of change as a result of this process include instituting safety plans for all veterans exiting in-patient care, and instituting depression screenings at all primary care physician visits among others. 

While this was a lengthy post, our aim is to share an imperative best practice with the broader community so that others have the knowledge and a template to support replication and thus contribute to moving the needle on addressing veteran suicides in our communities. We welcome and encourage any questions or comments via email (houstonopdd@americaswarriorpartnership.org).