Congressional Record, Volume 153 Issue 130 (Wednesday, September 5, 2007)

[Congressional Record Volume 153, Number 130 (Wednesday, September 5, 2007)]
[Senate]
[Pages S11097-S11101]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

JOSHUA OMVIG SUICIDE PREVENTION ACT

Mr. HARKIN. Mr. President, I come to the floor at this Time to
respond a little to the comments made prior to the recess for our
Republican and Democratic caucuses today, made on the floor by the
Senator from Oklahoma, Mr. Coburn, regarding the bill called the Joshua
Omvig Suicide Prevention Act. I want to lay out what the bill does,
where we are on it, and respond to some of the objections that the
Senator from Oklahoma raised.
Shortly before the Senate adjourned for the August recess, we sought
unanimous consent to pass this bill, the Joshua Omvig Suicide
Prevention Act, and send it to the President for his signature.
Unfortunately, an objection was lodged on the other side of the aisle
by--as we know from this morning--the Senator from Oklahoma. I am
saddened by the objection to this legislation.
My staff and I have spent a great deal of Time trying to understand
the reasons behind this objection and respond to the concerns that have
been raised. I thought it would be helpful for my fellow Senators, and
anyone who is watching, if I took some Time to review why I believe the
Senate needs to act now to pass this important bill, and why I find it
so puzzling that one Senator would object.
Let me give a little bit of history. I introduced this legislation,
along with my colleague from Iowa, Senator Grassley, after learning
about the case of a young Iowan--his name was Joshua Omvig--who
tragically took his own life shortly after returning home from an 11-
month deployment in Iraq. Joshua was a member of the U.S. Army Reserve,
339th MP Company, based in Davenport, IA. Before leaving for Iraq, he
was a member of the Grundy Center Volunteer Fire Department and the
Grundy Center Police Reserves. He was honored to serve his country in
the Reserves and hoped to return to his community to serve as a police
officer. Please remember what I just said. He was honored to serve his
country in the Reserves, and he hoped to return to his community to
serve as a police officer. Keep that in mind. I will return to it
later.
His family is convinced that if the Veterans' Administration had more
services for veterans in place, Joshua would have received the help he
needed and he would still be alive. But rather than withdrawing into
their grief, Joshua's parents have dedicated themselves to ensuring no
other family has to suffer this way. Ellen and Randy Omvig, Joshua's
parents, have assisted countless veterans and their families in
navigating the VA system. They have been outspoken advocates of
improved mental health services for servicemembers and veterans. In
April, the Omvigs testified before the Senate Veterans Affairs
Committee on the importance of appropriate suicide prevention, early
detection, and treatment programs for our veterans. The goal of the
Joshua Omvig Act is simple: to improve suicide prevention and early
detection and to improve assistance to veterans in crisis in order to
prevent suicides among those who have so bravely served our country.
We know there is an urgent, overwhelming need for this bill. A study
in last month's issue of the Journal of Epidemiology and Community
Health found that those who have been in combat are twice as likely to
commit suicide as those who have never served in a war.
The Veterans' Administration estimates that more than 5,000 veterans
take their lives each year. These numbers are certain to increase
dramatically, given the growing number of soldiers returning from
combat in Iraq and Afghanistan. Suicide rates are 35

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percent higher for Iraq veterans than for the general population. Let
me repeat that statement. Suicide rates are 35 percent higher for Iraq
war veterans than for the general population. The Department of Defense
recently reported that the Army is seeing the highest rate of suicide
in 28 years.
So what does the Joshua Omvig Veterans Suicide Prevention Act do? It
directs the Department of Veterans Affairs to create a comprehensive
program to address the troubling rate of suicide among veterans
returning from combat. The legislation takes a multifaceted approach
toward the prevention of suicide. It emphasizes the importance of
social support, family involvement, readjustment services, as well as
further research to decrease the number of suicides among our veterans.
It also boosts training for all Department of Veterans Affairs staff,
contractors, and medical personnel who interact with veterans, teaching
them to identify risk factors
Mr. REID. Mr. President, will the Senator yield?
Mr. HARKIN. Yes.
Mr. REID. Mr. President, it is my understanding the Senator from Iowa
is speaking on veteran suicide; is that right?
Mr. HARKIN. Yes.
Mr. REID. I spoke briefly yesterday morning. A 19-year-old--as the
Senator knows, my dad killed himself, so I understand something about
suicide--a 19-year-old soldier from Las Vegas came back to Las Vegas.
He told his parents and everybody else he didn't want to go back to
Iraq. I think they said they gave him medicine--Prozac, whatever it
was--and sent him back. In a matter of a few days, he killed himself.
Suicide is a devastating problem. It is a problem in the civilian
population. Mr. President, 31,000 people kill themselves every year. We
don't understand the issue at all. We haven't studied it enough. What
is going on in the civilian side is a mere shadow of what is going on
in the military.
Mr. HARKIN. That is true.
Mr. REID. We have had hundreds of soldiers who have killed themselves
in Iraq. A lot of them are not suicide reported.
I so admire and appreciate what the Senator from Iowa is doing with
regard to this legislation. It is so very important. Suicide is a
national problem, and with the emotional and mental problems our troops
are having coming back, we have to get to the bottom of this issue and
see what we can do to prevent further deaths.
Mr. HARKIN. Mr. President, I thank my leader for joining with me on
this issue. I respond to him, I just said--I don't know if the leader
was on the floor at the time--that suicide rates for Iraq veterans--
Iraq veterans--is 35 percent higher than the general population. The
Department of Defense has said their suicide rate in the Regular Army
is at the highest rate in 28 years.
I say to the distinguished Senator from Nevada, this bill I am
talking about was introduced in the House earlier this year. There were
154 cosponsors on both sides of the aisle. This bill, the Joshua Omvig
suicide prevention bill, passed the House in March 423 to 0--423 to 0.
We can't get much better than that.
It came to the Senate. The Senate Veterans' Affairs Committee had
three hearings on it and the House had two hearings, for a total of
five hearings. Every veterans group, every veterans support group,
disabled veterans, everyone came to testify on the need for this
legislation.
We went through the committee process, had the hearings, and had all
the testimony. Joshua's parents testified. We brought it out on the
floor for a unanimous consent agreement before we left on the August
break. It passed the House 423 to 0. Then I found there was an
objection raised.
I started to nose around to find out who raised the objection. It was
Senator Coburn from Oklahoma. I talked with the Senator from Oklahoma.
He said, first of all, he was upset that there were not any hearings.
He told me that right out in the back of the lobby. I said: Senator, we
had hearings. We had three in the Senate, two in the House. Well, he
had to go check on it.
Then he raised other objections and came on the floor this morning to
say why he has objections. Now I am going to respond to those
objections in kind to let the Senator know his objections are
unfathomable.

So here we are faced with a dire situation among our veterans, with
the highest suicide rates ever, and we are trying to pass legislation
to direct the Department of Veterans Affairs to do certain things to
set up processes and procedures so that our veterans will have the kind
of counseling and the kind of medical intervention so they do not
commit suicide, and yet we have one objection raised.
Mr. REID. Mr. President, if I could direct another question to my
friend. We have so much to do in the Senate. Certain measures expire at
the end of the fiscal year. But I say to my friend, I feel very
strongly about this issue, for obvious reasons. Everyone should
understand, if people want to stop us from moving forward on this
legislation, they are going to have to vote accordingly. We are not
going to let one or two Senators stop us from moving forward on this
bill.
I have the greatest respect for Dr. Coburn, the junior Senator from
Oklahoma. I hope the Senator's conversations with him will bear fruit
and we can move forward tonight. But if they don't, we are going to
figure our way past this before we leave here this year, OK?
Mr. HARKIN. I appreciate it.
Mr. REID. Every day we wait is another person calling--as I remember
it, and it has been a long time ago now, I say to my friend, a long
time ago. My dad was a lot younger than I am right now when he killed
himself. I can remember that phone call. I can remember that phone
call. I had a wonderful morning. I had been out to watch Muhammad Ali
work out. I spent many hours with Muhammad Ali. I got back to the
office and Joan Shea, the receptionist, said: Your mother is on the
line. I said: Hi. She said: Your pop killed himself. What is this
about?
So anyway, 31,000 people get phone calls such as that every year on
the civilian side, and we have probably thousands of other people who
commit suicide who are not listed as suicides. And then we have the
situation the Senator from Iowa just indicated. The people who are
coming home are 35 percent higher, in a ratio of killing themselves,
than the people in the civilian population. That is scary.
The other problem, I say to my friend, is Active-Duty soldiers,
troops also have problems. Every day we don't do this bill is another
day someone is going to kill themselves.
Mr. HARKIN. Mr. President, I thank the leader. I ask the leader, if
we can, if the objection is not withdrawn, I hope we can bring the bill
up and move the bill legislatively on the floor.
Mr. REID. I have indicated to the Senator, we are going to do that.
We, of course, have to see what is ahead of us, but it is something
about which I feel strongly. The floor staff is watching Senator Harkin
and me talk today. We will figure out a way to do it.
Mr. HARKIN. Mr. President, I appreciate the sensitivity of the
Senator from Nevada, our distinguished majority leader, on this issue.
Basically, what the bill does, again as I said, is to boost training
for all Department of Veterans Affairs staff, contractors, and medical
personnel, teaching them to identify risk factors for suicide and refer
veterans to the appropriate mental health counseling and mental health
centers.
As I said at the outset, this has been the most bipartisan piece of
legislation I can imagine. Senator Grassley and I introduced it in the
Senate, appropriately since Joshua Omvig was from Iowa. We have 30
different cosponsors from both sides of the aisle. It was introduced in
the other body by Congressman Leonard Boswell of Iowa, who is the
Congressman from the district in which Joshua Omvig lived. In fact, it
is that version of the bill we are trying to pass today.
I may have misspoke earlier. He secured 152 bipartisan cosponsors of
the bill. It passed the House in March by a vote of 423 to 0. No
Republican objected over there. No one; 423, not a single dissenting
vote. That is why I was so surprised and, quite frankly, dismayed when
an objection was raised on the other side of the aisle preventing
passage of the bill before the August recess.
How many more veterans have committed suicide since that time who
might have been, through counseling,

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through outreach, through some way given the appropriate support
services so they wouldn't have to commit suicide?
This morning, the Senator from Oklahoma, Mr. Coburn, offered several
reasons for his objection. That is what I would like to respond to now.
He mentioned that the bill is duplicative of the VA's plans to
prevent suicide and that veterans' receipt of benefits would be
contingent on the screening. He also raised concerns about the validity
of the peer counseling provisions of the bill. Finally, he expressed
concern that if the VA asked veterans about their mental health, this
information might be used to inhibit their ability to purchase
handguns. All of these concerns are unfounded, and I want to explain.
In 2004, the VA developed a series of suicide prevention initiatives
as part of a comprehensive mental health strategic plan. All well and
good. Unfortunately, very few of the initiatives have been implemented.
During the first 2 years following development of the plan, a
Government Accountability Office report found that the VA did not even
spend $100 million of the $300 million that was specifically allocated
for this initiative. One-third of the money specifically allocated was
not spent.
I think our veterans have paid a steep price, a tragic price for this
foot dragging. When the VA has announced plans to undertake suicide
prevention initiatives, usually it is in response to some highly
publicized incident. They usually announce the plans and then they do
not follow through.
For example, in February the VA finally announced it would put
suicide prevention crisis counselors in VA facilities. That was only
after the tragic, high-profile suicide of Jonathan Schulze, a marine
who received two Purple Hearts for his service in Iraq. When Schulze
informed his local VA facility that he was thinking about killing
himself, he was told he was 26th on the local VA's waiting list for VA
mental health services. He went home and killed himself that night. In
response to that, the VA said: We are going to put VA suicide
prevention crisis counselors in all VA facilities.
Although they announced it, 7 months later they have still not fully
implemented this initiative. Yes, if there is a tragic case like that,
the VA will come out and say they are going to do things. Seven months
later they still have not implemented the initiative.
What would our bill do, the Omvig Act? The Omvig Act would require
the Veterans' Administration to designate a suicide prevention
counselor at each medical facility. No more foot dragging; it would
require them to do that right now.
In late July, the VA announced the implementation of a 24-hour
suicide prevention hotline. That is also in the Joshua Omvig bill. That
VA plan has been around since 2004. Three years later they say they are
finally going to put it into effect. I suppose that is some kind of
progress. But by writing this very sensible provision into law, we will
ensure that the VA does not backslide on this either. As part of its
2004 strategic plan, the VA set a plan to train all front-line staff on
suicide prevention. In 2004, they said that. They still have failed to
provide this training. Maybe that is what the Senator from Oklahoma is
saying is duplicative. Yes, we say you have to have a 24-hour suicide
hotline. The VA said they were going to do that in 2004. They said they
were finally going to implement it in July. It still isn't manned, and
the counselors they said they were going to have do that in February, 7
months later they haven't done that. We say you have to do it. Is that
duplicative? No, it is putting into law and mandating that the VA has
to do this.
The Omvig Act directs the Secretary to ensure that staff members have
the training necessary to identify risk factors for suicide and to make
appropriate referrals for assistance. Is that too much to ask? Is that
too burdensome for veterans who put their lives on the line in
Afghanistan and Iraq and other places? It just says the staffs have to
have the training necessary to identify risk factors for suicide to
make appropriate referrals for assistance.
The VA said they were going to do that in 2004, but they never have.
Because they have not done this, many Armed Forces personnel who have
been discharged and have VA benefits are not receiving these services.
The Omvig family and numerous veterans support groups testified during
our hearings about the importance of outreach to reduce the stigma
associated with mental health issues and to assist veterans and their
families in transitioning to civilian life. This legislation, the Omvig
bill, would establish a program to provide education and outreach to
families to help them identify symptoms of mental health problems and
to encourage families to seek assistance.
The VA inspector general issued a report this May, confirming that
the VA is falling short of the necessary system-wide implementation of
suicide prevention programs--their own inspector general. They found
that many VA clinics lacked properly trained staff. Need I repeat
myself? They did not provide 24-hour services and provided inadequate
mental health screening. That is their own inspector general.
The inspector general also found that the VA had not established best
practices research to ensure a standard of suicide prevention.
The Omvig bill addresses all these issues. The aim of the bill is to
improve early detection and intervention, provide access to services
for veterans in crisis and thereby prevent suicide among those who have
put their lives on the line to defend our Nation.
The Senator from Oklahoma objected. He expressed concern that the
receipt of benefits would be contingent on the screening, and that
there is no opt-out provision. Let's look at this. The fact is, the
Department of Defense already requires soldiers returning from
deployment to complete a checklist of symptoms such as anxiety,
difficulty sleeping, suicidal thoughts. There are no opt-outs for this
mental health screening because these programs are critical to ensure
that those with mental health concerns receive the assistance they
need.
The DOD, the Department of Defense, says if you are going to be
redeployed, you have to have mental health screening--no opt-out. We
are saying the screening provision in the Omvig bill does not mandate a
formal checklist of mental health symptoms. It just ensures that
medical professionals incorporate questions about veterans' mental
health into primary care visits. In other words, what we are trying to
say is mental health care should be integrated into primary health
care. That is all we are saying.
Just as a medical professional would ask questions about risk factors
for heart disease, it is responsible medicine to ask about risk factors
for suicide, especially among this group since the data show how high
it is, how high the incidence is of suicide.
Doctors ask their patients all the time if they are getting enough
exercise and eating healthy. They should also ask if a veteran is
sleeping well and if they have been anxious. These questions are
critical in order for doctors to get a full picture of the veteran's
health and well-being.
I want to make it very clear, the bill does not make the receipt of
benefits contingent on veterans undergoing a separate mental health
screening. Rather, it merely seeks to incorporate into their screening
process, into their primary health care process, this process, that the
health professionals are incorporating appropriate questions about
suicide risk into their practice. Not to do this is totally
irresponsible.
The Senator from Oklahoma also mentioned his concern that the peer
counseling provisions in the bill are not effective. Again, I am
surprised by this as there is a large body of research that peer
support programs are effective in alleviating post-traumatic stress
symptoms, PTSD symptoms and depression, reducing the likelihood of
hospitalization and increasing social support. President Bush's New
Freedom Commission on Mental Health recognizes peer support approaches
as an emerging best practice in helping people to recover from
traumatic events.

Who better to counsel with a soldier who has served in Iraq and had a
lot of trauma, or from Afghanistan who had a lot of trauma, than a
peer, one of their own peers to talk to them about it, or their
families? Peer support approaches offer a low-cost and effective
supplement to traditional services in which

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transitioning veterans can talk to someone who had similar experiences
and understands what they are going through. This is well-recognized,
evidence-based service that allows veterans to talk to someone who had
similar experiences and, as I said, understands what they are going
through. How can there be an objection to that?
Finally, regarding the concern of the Senator about veterans' ability
to access firearms, I am very puzzled. This bill ensures that the VA
takes appropriate measures to follow up with veterans who are at risk
for suicide. OK. There are strict privacy laws that govern the doctor-
patient relationship. Privacy laws prevent the release of information
about any patient. There is an exception if the patient is a serious
threat to himself or others, but no medical professional can refer an
individual to the background check system that would limit access to
firearms.
Let me repeat that: No medical professional can refer an individual
to the background check system that would limit access to firearms.
This can only be done through the judicial process. In other words,
before an individual can be placed on the NICS list where they can't
purchase a handgun--and this prevents an individual who is mentally ill
from purchasing a firearm--a judge must make a determination that the
individual belongs on that list.
As many of my colleagues are aware, there is legislation that has
passed the House and was recently approved by the Judiciary Committee
that would encourage States to do a better job reporting to the NICS
system in the wake of the tragic shootings at Virginia Tech. If
Senators have concerns about how the NICS system operates, it seems to
me that legislation is the appropriate venue for those concerns. But to
hold up the Omvig suicide prevention bill that delivers critical
suicide prevention services to veterans based on concerns related to an
unrelated pending bill is very troubling.
There is an editorial that appeared in the New York Times on August
30. Let me read from that. Here is what the editorial in the New York
Times said on August 30:

Again, the editorial goes on.

The Senator's office points to another bill near passage--
prompted by the Virginia Tech gun massacre--that would
encourage states to do a better job of listing mentally
troubled individuals on the Federal roll of risky gun
purchasers. But tying these two measures together is itself
evidence of defective reasoning, or at least scurrilous
politicking. The Virginia Tech measure has nothing to do with
veterans and affects only those Americans formally judged by
a court to be mentally disturbed.
It is an eminently good thing that the anti-suicide
measures would require medical specialists to keep track of
veterans found to be high risks for suicide. But that's to
care for them as human beings, under that other
constitutional right to life--liberty and the pursuit of
happiness. Respect for the grave sacrifices by veterans
requires the Senate to strike down the Coburn ploy and hurry
this vital measure to President Bush.

Mr. President, I ask unanimous consent that the full editorial be
printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

[From the New York Times, Aug. 30, 2007]

Locked, Loaded and Looney

As the Army's suicide rate hits record levels in the Iraq
war, there's small wonder practically everyone in Congress
wants to deal with the parallel emerging crisis of depressed
veterans tempted to take their own lives. Everyone that is,
except Senator Tom Coburn, Republican of Oklahoma. He stands
alone in blocking final passage of a suicide prevention bill
in fear that the government's record-keeping on troubled vets
might somehow crimp their ability to purchase handguns. Even
the craven gun lobby should manage some shame over this
absurd example of Second Amendment idolatry.
The House has unanimously approved a measure mandating the
screening of all veterans for suicide risk, but Senator
Coburn worries that veterans' medical data might be
appropriated by other agencies to deny that all-encompassing
right to wield arms on the domestic front. The senator's
office points to another bill near passage--prompted by the
Virginia Tech gun massacre--that would encourage states to do
a better job of listing mentally troubled individuals on the
federal roll of risky gun purchasers. But tying these two
measures together is itself evidence of defective reasoning
or at least scurrilous politicking. The Virginia Tech measure
has nothing to do with veterans and affects only those
Americans formally judged by a court to be mentally
disturbed. It is an eminently good thing that the anti-
suicide measure would require medical specialists to keep
track of veterans found to be high risks for suicide. But
that's to care for them as human beings, under that other
constitutional right--to life liberty and the pursuit of
happiness. Respect for the grave sacrifices by veterans
requires the Senate to strike down the Coburn ploy and hurry
this vital measure to President Bush.

Mr. HARKIN. Lastly, Mr. Coburn spoke on the floor and mentioned his
staff had made suggestions about the language. Again, I am very
surprised to hear this. Staff from my office and Senator Grassley's
office met with Senator Coburn's staff before the recess in an attempt
to resolve any differences.
Their staff made no suggestion as to what it would take to lift
Senator Coburn's hold. Over recess, I instructed my staff to make
attempts to meet with his staff, but his staff was always unavailable.
Over the last few days, we once again attempted to reach out to his
staff in an effort to move the bill. But, again, we have not heard
anything back.
We suggested we would be willing to work with Senator Coburn on the
tracking language he was concerned about. But we have not heard
anything from his office until the Senator spoke on the floor this
morning.
This bill has received full consideration, as I said, in the House
and the Senate. It passed without a single dissenting voice in the
House. Is the Senator from Oklahoma saying there are 423 totally
irresponsible people in the House? I mean, there are people in the
House every bit as conservative as the Senator from Oklahoma. They did
not raise any objections to this. We had three hearings in the Senate
on the bill, two hearings in the House.
Josh Omvig's parents testified before the Senate VA Committee in
April. I wish to recount something they said. At the beginning of my
remarks, I mentioned that Joshua Omvig, before he went into the
military, had been a member of the Grundy Center Volunteer Fire
Department and Police Reserve.
He had hoped to return to serve his community as a police officer. I
said: Remember that, because I am going to return to it. I now return
to it.
It was his dream to one day become a police officer. As he pursued
that dream, he worked alongside many Grundy Center fire and policemen.
Here is what Mr. Omvig said to the committee:

The day after Josh's suicide, the Grundy Center police
department and fire department had a time where a
professional counselor was brought in to help them cope and
deal with what happened that day. Do we as a nation take the
same measures for our troops who have served for us for
months in a combat area? Are we providing our military men
and women the appropriate services to help them assimilate to
civilian life? Are we providing them with what they need to
survive the peace? Ellen and I have to say ``No'' not at this
time. We can and must do more!

Now, I saw Joshua's parents at the time when they were here in
Washington. And, you know, it is always awkward to talk to parents
about the death of any of their children, especially a young person
taking his own life. I said to both the parents: Was there any
indication? I mean, do you have any idea why Joshua would take his own
life?
Mr. Omvig said: Yeah, I know exactly why. I said: Why? He said: Well,
Joshua always wanted to be a police officer, all his life growing up.
That is why he volunteered on the police reserves, volunteer fire. He
went into the service thinking that would help him to become a police
officer. He was worried that if he sought mental health services, he
would never be able to become a police officer. What a shame. What a
shame that in this country we still treat mental health like that. That
is why we have to do a better job.

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That is why counseling, someone talking to Joshua, one of his peers
who has been through the same thing who may have then gone on to become
a police officer could say: You can get mental health help. You can get
the necessary treatment, and you can still become a police officer.
Well, while we delay and fail to act, we are losing more and more
veterans to suicide. As I said, the VA plan was written 3 years ago,
and they are still not implementing it.
The PTSD program treatment at Walter Reed accepts only 65 patients
each year. Yet more than 45,000 veterans sought medical help for post-
traumatic stress disorder in the first 3 months of 2007; Walter Reed
accepts 65 a year.
The VA must be better equipped to deal with veterans who are in
crisis. With this bill, we can ensure that the VA will provide
comprehensive and critical services, even when the issue is not in the
headlines because of some tragedy. We need to hold the VA accountable.
As I said, even their own inspector general said they were not living
up to it, our GAO said they were not. We need to make it clear that
preventing suicide among our veterans is a congressional and national
priority. For our veterans who have served their country, fought for
our country, many times they are being left to fight their own private
mental health life wars alone, private wars they too often lose.
I urge the objecting Senator to reexamine this important bill,
reconsider his objection. Lives are at stake. We need to move forward
with the Joshua Omvig Veterans Suicide Prevention Act as quickly as
possible.
I yield the floor.

____________________