Veterans Crisis Line looks to balance anonymity with location tools

The rollout of new location identification tools will help connect more retired servicemembers in crisis with nearby emergency services, even as responders work to maintain their privacy, a Department of Veterans Affairs official said on Wednesday. 

Testifying before the House Veterans’ Affairs Subcommittee on Health, Matthew Miller — executive director of VA’s office of suicide prevention — said the department’s Veterans Crisis Line has provided significant help to veterans contemplating suicide since its launch in 2007, particularly after VA adopted the 988 Suicide and Crisis Lifeline in July 2022.

As of the two-year anniversary of VA’s implementation of the “988 then press 1” streamlined call option, Miller said the Veterans Crisis Line “has successfully adapted to a 22% increase in calls per day, a 77% increase in texts per day and a 27.5% increase in chats per day.”

The crisis line provides veterans with 24/7 access to responders — psychologists, nurse practitioners and others — through calls, texts or chat. Veterans often receive referrals to suicide prevention coordinators in VA medical facilities across the country, with Miller saying that more than 80% of callers accept referrals for additional care after reaching out to the line. 

The agency is using or adopting additional tools to locate callers in extreme crises, although Miller noted that “the fine line that we walk is veterans and service members call us because they believe we're safe.” 

Earlier this week, he noted that the Substance Abuse and Mental Health Services Administration — which funds the 988 Lifeline — “announced the pilot implementation of geo-routing, geolocation services” to help responders identify and then direct calls to local services. 

“It's going to help 988 to link callers to more localized and the most localized crisis call centers and, in turn, resources to address their needs within the VA,” Miller said, noting that roughly 5% to 6% of current calls responders receive result in the need for an emergency dispatch.

In serious “last resort” situations, he also said VA already has “options that we can engage to try to locate that veteran based upon a number of variables.”

Miller said the use of these enhanced location services, however, comes with the acknowledgement that the crisis line “is allowing veterans to interact with us anonymously, if they so choose.”

“We want to be very careful how much we pursue information from the veteran, unless it's absolutely necessary to provide them with the highest quality care,” he said, adding that “in an emergency dispatch, we may need the veterans location.”

Miller also noted that the crisis line’s documentation system “is separate from the VA health record” to maintain confidentiality, although “it has interoperability and linkages through the suicide prevention coordinators.”

While VA has launched a number of programs to help veterans in crisis — including looking at ways of using artificial intelligence to identify retired servicemembers in need — suicide rates have continued to rise. 

The department’s 2023 National Veteran Suicide Prevention Annual Report, which was based on data from 2021, found that the rate of veteran suicide had increased by 11.6% from 2020. This has resulted in approximately 17 veterans taking their own lives each day.