Thread by @derekblumke

1. Screening + Drug Treatment = Increase in #Veteran #Suicides. Report co-published @Mad_In_America w/Robert Whitaker. Model of care causing suicide epidemic #vha madinamerica.com/2019/11/screen… @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems 2. Suicide rates for 18-34 year-old #veterans using #VHA for care have INCREASED BY 144% over 12 year period. #veteransuicides #veteransday @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra 3. Age adjusted #suicide rates for #VHA using vets nearly 20% higher than for non-VHA using vets. Crude suicide rates 32% higher @Hassan7Anthony @PaulRieckhoff

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff 4. Veterans with a mental health or substance abuse diagnosis who got mental health treatment were roughly TWICE AS LIKELY TO DIE BY SUICIDE than those who had a diagnosis but did get mental health treatment.

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff 5. Vets without a diagnosis who got MH treatment were more likely to die by suicide than vets without diagnosis and who did not access treatment. In 2014, VETS WHO GOT TREATMENT DIED AT TWICE THE RATE OF “UNTREATED” GROUP @Hubbard_WJ @JaredSLyon @JakeWoodTR

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR 6. 2010 to 2014, veterans at #VHA without a diagnosis who got MH treatment (ie prescribed #antidepressant wellbutrin for smoking cessation) were more likely to die by suicide than those with a diagnosis who were “untreated.”

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR 7. Screenings for depression, PTSD, anxiety, substance abuse has led to increased diagnosis of mental illness for vets using VA. #depression most common diagnosis. 2014 GAO report: 94% of vets diagnosed with #major depressive disorder were prescribed at least one #antidepressant

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR 8. As antidepressant usage increased in the US, suicide rates followed. 2003 analysis of UK patients treated for depression (or for other “affective disorder”) @DrDavidHealy & Chris Whitaker found suicide rate for those taking an #SSRI was 3.4x greater than “non-treatment group”

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR @DrDavidHealy 9. 2003, @DrDavidHealy & Canadian researchers conducted meta-analysis of all RCTs of SSRIs, which incorporated findings from trials that weren’t funded by pharmaceutical companies. They found suicide attempts were 2.28x higher for those treated with an #SSRI compared to placebo.

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR @DrDavidHealy 10. Diagnosis of vets with mental health/substance abuse disorders increased from 33% of vets at #VHA in 2005, to 44% in 2017. Increased screening = increased diagnosis = increased VHA vets prescribed antidepressants

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR @DrDavidHealy 11. Between 2005 and 2017, the 18-34 year-old vet population at VA less than doubled, but SUICIDES for this group INCREASED BY 5X. 144% INCREASE IN SUICIDES over 12 years. #VeteransDayWeekend #veteransday

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR @DrDavidHealy 12. 18-34 year-old vets using #vha for care can be seen as subgroup to be investigated. VA increased outreach and Screening + Antidepressants/Drug Treatment = Increase in Veteran Suicides @leahida @mtihic @DrMikeHaynie

@Mad_In_America @TaskandPurpose @MilitaryTimes @NBCNews @HouseVetAffairs @VetAffairsDems @VAChair @SVACDems @VFWHQ @AmericanLegion @AmericanMD @NBCNightlyNews @VickyNguyenTV @studentvets @iava @MinorityVets @AMVETSHQ @zachiscol @PaulSzoldra @Hassan7Anthony @PaulRieckhoff @Hubbard_WJ @JaredSLyon @JakeWoodTR @DrDavidHealy @leahida @mtihic @DrMikeHaynie 4. (edit) 4. Veterans with a mental health or substance abuse diagnosis who got mental health treatment were roughly TWICE AS LIKELY TO DIE BY SUICIDE than those who had a diagnosis but did NOT get mental health treatment.