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The Honolulu Advertiser
Posted on: Sunday, August 5, 2007

Tripler case underscores need for veterans' mental-health care

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The Senate Committee on Veterans Affairs will have hearings on VA care and benefits:

  • 10 a.m. Aug. 21, O'ahu Veterans Center, 1298 Kukila St., Honolulu.

  • 10:30 a.m. Aug. 23, Kalana O Maui Building, Maui County Council Chambers, eighth floor, Wailuku.

  • 1 p.m. Aug. 27, Keauhou Bay Sheraton, Keauhou II Room, 78-128 Ehukai St., Kailua, Kona.

    The committee also has spotlighted a new suicide prevention hot line for veterans, operated as part of the existing National Suicide Prevention Lifeline: 800-273-TALK.

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    Ensuring the well-being of America's veterans is held as a national ideal, but too often what is rendered to those who have served their country falls far short of that ideal.

    It's becoming tragically clearer that the failure to extend sufficient care and concern to veterans comes with a human cost. The sad story that unfolded about Robert Roth, an Air Force veteran who suffered from depression and bi-polar disorder, is simply one example.

    Roth's suicide at Tripler Army Medical Center came to light last week with the release the records of an ongoing investigation. His widow has been pursuing an administrative claim for medical negligence since his death Jan. 2, when he jumped from a 10th-floor balcony near where he worked as a Tripler ward clerk.

    Although Tripler has not commented on the case and full circumstances may not be known, the records available so far suggest a shortage of mental-health professionals to help people such as Roth, who was under treatment by a psychiatrist.

    Twice he had come to the emergency room expressing an intent to kill himself, and waited in frustration for several hours. He left without seeing a psychiatrist. Such treatment — or, the lack of it — is unconscionable.

    The workload of the mental-health staff at Tripler and other military hospitals is exacerbated by the immense strain of the war in Iraq and Afghanistan. Many military personnel are returning with post-traumatic stress disorder and other psychological problems. That creates a demand on veterans' care services that is only going to grow exponentially in coming years.

    The staff shortage throughout the system of 38 U.S. military hospitals also has been noted by a mental-health task force, which included Tripler on its tour late last September. Although it didn't mention Tripler in its findings, the group described the network of mental-health professionals as "woefully inadequate."

    The Roth investigation record also suggests other gaps that need to be closed. Investigators in the case were told that Tripler's ER did not have any written standard operating procedures for handling patients with suicidal intentions. Roth's car keys had not been confiscated on his Dec. 26 visit and he was able to drive away, despite the objections of the ER staff.

    In addition, it's puzzling that in records of Roth's psychiatric appointment the next day, his doctor indicated there had not been any indication of suicidal intent.

    This entire episode sharply underscores the need for medical-care improvements for veterans, with mental-health services one of the most critical needs.

    Congressional leaders, including Hawai'i's Sen. Daniel Akaka, are rightly seeking to fill those needs.

    Akaka, who chairs the Committee on Veterans Affairs, has been pursuing increased funding for mental health and other services, a drive that accelerated after the scandalous shortcomings at the Walter Reed Medical Center came to light.

    Other proposed improvements include a new requirement that the Veterans Administration provide service members with a mental health evaluation within 30 days of a request.

    Hawai'i residents will have their chance to add their own voices to the call for change at a series of field hearings convened by Akaka's Senate committee (see box).

    It's important that Hawai'i citizens and all Americans keep the pressure on government leaders to reverse this shameful trend. When our soldiers come home from the war, they need to know that their country honors their service by giving them a full hero's welcome — including the care they need to resume a productive life at home.