VA Secretary Collins Is Wrong About Veteran Suicide Prevention Funding

Since taking office as the secretary of the Department of Veterans Affairs (VA), Doug Collins has harped on one point repeatedly: The VA spends too much money on its suicide prevention operations and gets too little in return. Seventeen veterans die by suicide each day—a number that hasn’t meaningfully changed for 15 years—despite an annual budget of $588 million for its prevention programs that Collins says are rife with “serious vulnerabilities for waste.” He advocates for “tak[ing] the programs, let’s take the outreach we’re using and maybe redirect that $588 million to suicide prevention programs that are working.”

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On its face, this seems like a compelling account. For instance, the recent National Veteran Suicide Prevention Annual Report shows that the overall veteran suicide rate is entrenched at roughly double that of the general population, and is edging upward, not down.

But Collins is dangerously wrong.

A close examination of where that $588 million is allocated, along with the report’s data, reveals the opposite story: The VA’s programs need more funding, not less. These initiatives are keeping the veteran suicide rate much lower than it otherwise would be.

How the VA Reaches Veterans in Crisis

More than half of the VA’s suicide prevention budget—$307 million—funds the Veterans Crisis Line (VCL). Veterans who contact the VCL are, by far, the highest-risk subgroup in the veteran population. Calls, texts, and chats combined surged to 1.3 million in 2025, and the average call is answered in under ten seconds. About 18 percent involve someone in active suicidal crisis, and 4 percent are acute enough to require emergency dispatch.

These interventions save many lives. Since the 24-hour line launched in 2007, VCL responders have initiated more than 429,000 emergency dispatches—between 50 and 100 every day. Veterans are 11 times more likely to have reduced suicidal urgency at the end of the call than at its start, and 83 percent say the contact was instrumental in keeping them from acting on thoughts of killing themselves.

The crisis line also serves as a gateway to subsequent care. More than 1.6 million callers—urgent and routine—have been referred to the VA’s suicide prevention coordinators (SPCs) for quick follow-up. SPCs are embedded at the VA’s 170 medical centers and represent the second-largest share of the annual budget at $92 million. Beyond managing VCL callers, they oversee suicide risk screening, expedited mental health appointments, missed-appointment checkups, safety planning, and health record flagging for at-risk patients.

Every additional contact with an SPC is associated with 4 to 5 percent lower odds of a suicide attempt in the following year. And among VA-using veterans who survive a nonfatal attempt, less than 2 percent die by suicide over the next dozen years.

The annual report makes the positive trajectory crystal clear: Among individuals who contacted the VCL, the suicide rate in the month following the call dropped 24.2 percent over the past three years. The total numbers—718 deaths per 100,000 callers in the 30 days after contact—remain alarmingly high. But the progress is unmistakable.

These are precisely the efforts that deserve more resources, not fewer. Slashing VCL and SPC funding that actively supports veterans during their most vulnerable moments wouldn’t just be shortsighted. It would be lethal.

The Gun Access Risk Factor

Firearms are used in 73.3 percent of all veteran suicide deaths. Creating time and distance between a person in crisis and firearms saves lives. Most suicide attempts aren’t the culmination of months of meticulous planning—they’re driven by a sudden surge of overwhelming despair. If veterans can survive the high-danger window without easy access to a firearm, their risk of death drops dramatically, not just in the moment, but over the long term.

Since 2013, the VA has built a comprehensive firearm suicide prevention strategy encompassing mandatory clinician training on counseling secure storage of firearms that respects Second Amendment rights, risk management consultation services, guides for peer-to-peer secure storage conversations, and a pilot program providing free lockboxes to moderate- and high-risk veterans.

The VA has also forged a multipronged partnership with the National Shooting Sports Foundation (NSSF), the firearm industry’s trade association, to promote more space between at-risk veterans and access to their firearms. NSSF’s own interest grew out of awareness that firearm suicides affect so many.

NSSF, along with The American Legion, also works to dispel the myth that the VA confiscates firearms—a widespread misperception that has long deterred many veterans from seeking care for their mental health conditions. (Full disclosure: I authored the fact sheet that NSSF and the Legion distribute on this topic.) The VA’s recent announcement—coming on top of legislation last year—that it ended the practice of reporting veterans with fiduciaries to the national firearm background check system should put the falsehood of confiscation to rest once and for all. But Collins has allotted no resources to inform veterans who avoided the VA out of this unfounded fear that they can obtain lifesaving help they need without hesitation.

A similar void surrounds the VA’s external contract for firearm suicide prevention messaging. Thirty-nine million dollars in special funding is earmarked for “paid media,” yet there is no indication that any of that sum has been spent by Collins in his 13 months in office.

Cutting-Edge VA Treatments and Innovation

Elsewhere in the agency, the VA continues to innovate. It employs 107 trained experts whose sole job is delivering tailored, evidence-based therapy by video telehealth visits to veterans with a recent history of a suicidal attempt or preparatory behavior who prefer to receive care from home—free of the barriers of travel, cost, missed time at work, and child care barriers that hinder in-person visits. No-show rates for telehealth run much lower than for in-person care, meaning more of this critical intervention takes place. Since the program launched in 2021, more than 12,000 veterans have entered treatment, and the VA reports significant reductions in suicidal ideation and depressive symptoms among participants. Would Collins diminish this one-of-a-kind approach?

VA Health Systems Research, which funds critical studies on the emotional, medical, and social drivers of veteran suicide, along with groundbreaking therapies, addresses these problems. The Suicide Prevention Research Impact Network coordinates roughly 440 VA researchers and partners nationwide, while the Suicide Prevention Actively Managed Portfolio oversees research deepening understanding of what works.

The payoff is tangible. For example, a recent VA study published in JAMA Network Open showed that veterans newly diagnosed with PTSD who completed up to eight sessions of evidence-based psychotherapy had a 23 percent lower risk of suicide death than those who didn’t start these therapies. That’s actionable intelligence that many providers outside the VA can learn from. Should this kind of research be defunded?

The VA further leads innovation through its $20 million Mission Daybreak grand challenge—which engages thousands of veterans, researchers, technologists, advocates, clinicians, and health experts to develop forward-thinking solutions for preventing veteran suicide. Since its launch in 2022, it has generated over 260 concepts, with seven pilots now funded. Should the VA stop innovating?

Dr. Harold Kudler, a retired psychiatrist with three decades of clinical experience in the VA who was later the agency’s national lead for mental health policy during the first Trump administration, notes that “no other health system has anything approaching VA’s upstream approach to suicide prevention or invests in the research and training needed to continuously improve prevention.”

The VA Outperforms the Private Sector

Sixty-one percent of veterans who die by suicide don’t use VA health care—and they fare worse than those who do.

The long-term trends are striking. From 2001 to 2023, suicide rates rose 29.6 percent for female veterans using the VA—but 64.6 percent for those who didn’t. For male veterans, rates climbed 23.0 percent among VA users and 71.1 percent among non-users.

In each of the last four years, veterans receiving all their care through the Veterans Community Care Program (VCCP)—the network of 1.7 million community providers delivering care authorized and paid for by the VA—were more likely to die by suicide than veterans treated solely within the VA. Connection to the VA system carries a distinct survival advantage.

One possible influence is the difference in clinician training. Every VA mental health provider completes training yearly in suicide prevention, including counseling patients to limit firearm access during high-risk periods. By contrast, fewer than 2 percent of VCCP providers have done so, even once. That discrepancy is unconscionable.

The VA spends tens of millions annually to reach at-risk veterans who never walk through its doors—through grants with nonprofits and partnerships with veteran service organizations and state governments.

It stands to reason that if we intend to reduce veteran suicides, we would spend more money on VA care. Instead, Secretary Collins says he wants to strip VA resources and redirect them to private “programs that are working.” His obvious candidates? Recipients of the Staff Sergeant Parker Gordon Fox Suicide Prevention Program—a congressionally mandated pilot providing funds to community organizations for upstream intervention with risk factors for suicide.

The pitch almost sounds reasonable. Unfortunately, for $55 million annually, the program is getting little return on investment. Collins would cut programs that get tangible results and divert the money to ones that don’t.

What made the original Fox Grant legislation groundbreaking wasn’t just its local community focus but its insistence on accountability. The bill’s architects required comprehensive outcome data to determine which programs succeed. Grant recipients are required to administer mental health and social stability assessments when veterans enter and exit their programs.

A VA report published this week reveals a bleak picture of the first three years. The Fox program succeeded in referring thousands of veterans to care and social assistance but had very limited impact on reducing suicide risk factors. Few individuals completed grantee services, and of those, 80 percent—a staggering number—produced no outcome data that their conditions improved, worsened, or stayed the same. Eighty percent. No data.

And it’s not just Fox. A national RAND survey last year of non-VA veteran suicide prevention programs concluded that “programs have yet to demonstrate concrete results on what they are trying to accomplish, let alone an impact on reducing suicide.”

What Can Be Done?

Every veteran suicide is a tragedy and, undisputedly, far more needs to be done to mitigate them. Here are practical steps Congress and the VA could implement tomorrow. Many of these were suggested in President Trump’s first-term President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) report.

Staffing:

• Increase SPC staffing for 30-day follow-up with veterans who contact the VCL— those at the very highest risk, who markedly benefit from that engagement.

• Increase VCL peer-support staffing. Callers to the VCL who are contacted by trained, veteran peer specialists are more likely to follow through with subsequent appointments.

• Enforce VA mental health staffing ratios. A 2020 VA directive specified the number of outpatient mental health clinicians required to adequately care for veterans. Fewer than half of VA facilities meet this minimum.

Community accountability:

• Mandate annual suicide prevention and lethal means safety training for VCCP mental health providers. Every VA mental health provider completes this training yearly. Almost no VCCP providers do.

• Require post-suicide analyses following suicides in the VCCP, mirroring what’s mandated after suicides occur in direct VA care.

• Strengthen Fox Grant accountability. Mandate grant recipients conduct pre- and post-intervention assessments. Renew funding only to programs that demonstrate improved outcomes.

Access to firearms:

• Pass the Saving Our Veterans Lives Act (S.926 King; H.R.1987 Deluzio), which offers free firearm lockboxes and safes to veterans. A third of veterans who store firearms loaded and unlocked report not owning a lockbox or safe—and for many, cost is the barrier.

• Increase funding for The Armory Project, a joint initiative of the VA and Face the Fight that partners with federal firearm licensees (FFLs) across five states to offer veterans and service members out-of-home and in-home secure storage options.

• Widely disseminate information dispelling the myth that the VA confiscates firearms. This misperception drives veterans in mental health crises away from needed care. Correcting it is one of the most beneficial suicide prevention efforts the agency could pursue.

Secretary Collins is right about one thing: The number and rate of veteran suicides are unacceptable. But he’s wrong about the solution.

He faces a clear choice: slash the VA programs that are discernably working with the highest-risk populations or build on them. Diverting those funds toward community alternatives with little or no proven effectiveness is not reform—it will cost lives.

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