US veterans face severe mental health needs; there have been more than 6000 suicides annually from 2008 to 2016, a 25.9% jump in suicides from 2005 to 2016, a suicide rate 1.5-fold higher than nonveterans, and higher suicide rates for veterans accessing Department of Veterans Affairs (VA) facilities vs those not using VA services, veterans overall, and nonveterans.1 On June 6, 2018, the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018 came into law as S 2372.2 The VA MISSION Act passed after former VA Secretary David Shulkin, MD, called suicide prevention his top clinical priority, stating that just 6 of 20 veterans who have committed suicide each day accessed VA care in the past year. In January 2018, President Donald Trump issued an executive order for the VA and the Departments of Defense and Homeland Security to coordinate seamless access to treatment for service members transitioning into veteran status to prevent suicides.
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Aggarwal NK. Ramifications of the VA MISSION Act of 2018 on Mental Health: Potential Implementation Challenges and Solutions. JAMA Psychiatry. 2020;77(4):337–338. doi:10.1001/jamapsychiatry.2019.3883
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