59–010 

Calendar No. 279 

110TH CONGRESS REPORT " ! SENATE 1st Session 110–132 

JOSHUA OMVIG VETERANS SUICIDE PREVENTION ACT 

JULY 23, 2007.—Ordered to be printed 

Mr. AKAKA, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany S. 479] 

The Committee on Veterans’ Affairs, to which was referred the 

bill (S. 479), to reduce the incidence of suicide among veterans, 

having considered the same, reports favorably thereon, and recommends that the bill do pass. 

INTRODUCTION

On February 1, 2007, Senator Tom Harkin introduced S. 479, the 

proposed ‘‘Joshua Omvig Veterans Suicide Prevention Act,’’ which 

is named for an Iowa veteran who committed suicide after returning from Iraq. 

On April 25, 2007, the Committee held a hearing on veterans’ 

mental health issues at which Joshua Omvig’s father, Randall, appearing with his wife Ellen, spoke in favor of S. 479. 

On May 23, 2007, the Committee held a hearing on pending veterans’ health legislation at which testimony on S. 479, among other 

bills, was offered by: Gerald M. Cross, MD, FAAFP, the Department of Veterans Affairs’ Acting Principal Deputy Under Secretary 

for Health; Carl Blake, National Legislative Director, Paralyzed 

Veterans of America; Dennis M. Cullinan, Director, National Legislative Service, Veterans of Foreign Wars; Joy J. Ilem, Assistant National Legislative Director, Disabled American Veterans; Shannon 

Middleton, Deputy Director for Health, Veterans Affairs and Rehabilitation Commission, The American Legion; Bernard Edelman, 

Deputy Director for Policy and Government Affairs, Vietnam Veterans of America; and Jerry Reed, Executive Director, Suicide Prevention Action Network USA (SPAN USA). All of the witnesses 

from the veterans’ organizations and SPAN USA supported S. 479. 

The Department of Veterans Affairs did not support the legislation, 


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expressing the view that the bill’s provisions are duplicative of existing programs and initiatives. 

COMMITTEE MEETING

After carefully reviewing the testimony from the foregoing hearings, the Committee met in open session on June 27, 2007, to consider, among other legislation, S. 479. The Committee voted by 

voice vote to report favorably S. 479 to the Senate. 

SUMMARY OF S. 479 AS REPORTED

S. 479, as reported (hereinafter, ‘‘the Committee bill’’), would convey the sense of Congress that suicide among veterans suffering 

from post-traumatic stress disorder (PTSD) is a serious problem, 

and direct the Secretary of Veterans Affairs (hereinafter, ‘‘the Secretary’’) to take the measures described below. 

Section 3(a) would require that the Secretary develop and implement a comprehensive program for reducing the incidence of suicide among veterans, consisting of the following elements: 

Section 3(b)(1) would require that the program include a nationwide campaign to increase awareness in the veteran community 

that mental health is essential to overall health and that there are 

treatments that can promote recovery from mental illness. 

Section 3(b)(2) would require that the program include mandatory suicide prevention training for all medical personnel who 

interact with veterans. 

Section 3(b)(3) would require that the program include a mental 

health education and outreach effort, with special emphasis on veterans of Operations Enduring Freedom and Iraqi Freedom and 

their families. 

Section 3(b)(4) would require that the program include a peer 

support program under which veterans would be permitted to serve 

as peer counselors on mental health matters. 

Section 3(b)(5) would require that the program encourage all applicants for veterans’ benefits to undergo a mental health assessment. 

Section 3(b)(6) would require that the program provide for referrals for all veterans who show signs of mental health problems to 

appropriate counseling and treatment programs. 

Section 3(b)(7) would require that the program include designation of a suicide prevention counselor at each Department of Veterans Affairs (hereinafter, ‘‘VA’’) medical facility. 

Section 3(b)(8) would require that the program include research 

on best practices for suicide prevention among veterans, and establish a committee to advise on such research. 

Section 3(b)(9) would require that the program provide for referrals for all veterans who show signs or symptoms of substance 

abuse to appropriate counseling and treatment programs. 

Section 3(b)(10) would require that the program include mechanisms to ensure 24-hour mental health care services availability to 

veterans. 

Section 3(b)(11) would provide that the program may include a 

24-hour, toll-free telephone number, staffed by personnel with appropriate mental health training, through which veterans might receive information on and referral to mental health services. 


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Section 3(b)(12) would provide that the program may include 

such other activities and programs to reduce the incidence of veteran suicide as the Secretary considers appropriate. 

Section 4 would require the Secretary to report within 90 days 

on VA programs to reduce the incidence of suicide among veterans, 

and to present a plan for additional programs to this effect. This 

plan would be required to be formulated in consultation with the 

National Institute of Mental Health, the Substance Abuse and 

Mental Health Services Administration, and the Centers for Disease Control and Prevention. 

BACKGROUND AND DISCUSSION

At the Committee’s April 25, 2007, hearing on veterans’ mental 

health issues, Randall Omvig stated on behalf of his family, 

We would like to voice our strong support of the Joshua 

Omvig Veterans Suicide Prevention Act, S. 479, reintroduced by Senator Harkin and Senator Grassley. 

Mr. Omvig addressed the need for expanded mental health outreach and education for returning servicemembers, new veterans, 

and their families, as well as for a more aggressive and preventative approach to mental health treatment by VA and the Department of Defense. A number of provisions of S. 479, contained in 

section 3 of the Committee bill, directly address these concerns and 

are discussed below. 

De-stigmatizing Mental Health [Section 3(b)(1)]: As documented 

by numerous media sources, mental health issues are viewed by 

some members of the armed forces as a sign of weakness and an 

obstacle to career advancement. This stigma carries over to reservists and new veterans, some of whom choose to avoid counseling or 

treatment. Such was the case with Joshua Omvig, as conveyed in 

his father’s testimony. This section would direct the Secretary to 

take steps to address the stigma and to convey a message of hope 

and recovery to the veteran community. While the section suggests 

a number of potential steps in this direction, it would allow the 

Secretary to determine the best approach. 

Training of Employees and Other Personnel [Section 3(b)(2)]: 

Under this section, the Secretary would arrange for suicide prevention training for all mental health and social work professionals 

who interact with veterans. The Secretary would be left to determine the format of this training. The Committee notes that longterm employees with extensive experience in counseling veterans 

with PTSD, depression, or suicidal thoughts could be considered as 

having completed the requirements of the training. 

Family Education and Outreach [Section 3(b)(3)]: Upon his return from Iraq and disposition to reserve status, Joshua Omvig did 

not seek help from the military or VA for his mental health problems. This section would direct the Secretary to reach out to individuals such as Joshua, and their families, in order to educate 

them on readjustment issues and on the symptoms of mental 

health problems, and to encourage them to seek assistance if needed. These programs would necessarily be geared towards individuals who have not applied for VA health care services, including 

those still on active duty. The Committee recognizes that certain 

initiatives of recent years, such as VA briefings for units returning 


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from Iraq or Afghanistan, as well as expanded family eligibility for 

counseling at Veterans’ Centers, fall within the spirit of this section. The Secretary would be directed to develop additional programs in this vein, and would be given broad latitude to do so. 

Peer Support Program [Section 3(b)(4)]: At the Committee’s May 

23, 2007, hearing on pending veterans’ health legislation, two witnesses spoke in support of the peer counseling provision of S. 479. 

Referring to peer support received during his recovery from a spinal injury, Carl Blake of the Paralyzed Veterans of America stated: 

I know firsthand that being able to talk to someone who 

has experienced what you have experienced and has dealt 

with the same problems you are dealing with can help you 

overcome bouts of depression, sadness, and anger as you 

first come to grips with your condition. The peer counselor 

serves as a motivator to get you moving in the right direction. 

Jerry Reed of SPAN USA testified: 

I support the provisions in S. 479 that encourage peer 

support programs. While there is no substitute for licensed 

mental health professionals with respect to diagnosis and 

treatment of PTSD, depression, and anxiety, it is often fellow veterans who provide the support needed to convince 

a veteran to visit a licensed professional. 

Peer support, as envisioned under S. 479, is not a formalized, 

top-down, nationwide program that requires additional resources, 

but rather a resource in itself, whereby local managers can recruit 

volunteers to provide advice based on personal experience to other 

veterans who are willing to accept it, or to their families. The peer 

counselor training called for under the section is not intended as 

a formal, classroom process. Rather, it could be provided on a oneon-one basis whenever a clinician makes arrangements to pair a 

peer counselor with his or her assigned veteran. 

Health Assessments of Veterans [Section 3(b)(5)]: In the interests 

of suicide prevention and general well-being, veterans should be 

fully informed of their opportunities to receive timely mental 

health screening. The Committee notes that under this section, veterans applying for VA health benefits in particular would be encouraged to undergo a mental health assessment. 

Counseling and Treatment of Veterans [Section 3(b)(6)]: The Committee recognizes that veterans enrolled in the VA health system 

who report symptoms of mental illness are generally referred for 

appropriate counseling and treatment. This section would broadly 

direct the Secretary to be more aggressive in identifying at-risk 

veterans who exhibit symptoms of mental illness, but do not ask 

for help. 

Suicide Prevention Counselors [Section 3(b)(7)]: Under this section, a suicide prevention counselor would be designated at each 

VA medical facility. The Committee notes that some VA Medical 

Centers have already met the requirements of this section by assigning suicide prevention counselor functions to existing staff, or 

else by hiring new staff for this purpose. Either of these two approaches would bring a VA medical facility into compliance with 

the requirements of this section. 


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Research on Best Practices [Section 3(b)(8)]: The research called 

for under this section would encompass relevant studies currently 

in progress in addition to any new initiatives that VA clinicians or 

researchers may propose. The Secretary would be encouraged to 

look favorably on new research proposals in the field of suicide and 

suicide prevention. 

Substance Abuse Treatment [Section 3(b)(9)]: The Committee recognizes that veterans enrolled in the VA health system who report 

a substance abuse problem are generally referred for appropriate 

counseling and treatment. This section would broadly direct the 

Secretary to be more aggressive in identifying veterans who exhibit 

symptoms of substance abuse, but do not ask for help. 

24-Hour Mental Health Care [Section 3(b)(10)]: Under this section, the program mandated under section 3(a) would be required 

to include mechanisms to ensure the availability of mental health 

care services for veterans on a 24-hour basis. The Secretary would 

be left to determine how best to comply with this requirement. The 

Committee notes that a continuously operational mental health 

telephone hotline for veterans, as described under section 3(b)(11), 

could, if established and maintained in an effective manner, fulfill 

a significant element of the requirements of this section. 

Telephone Hotline [Section 3(b)(11)]: The Committee recognizes 

that the language of this section, referring to a potential mental 

health telephone hotline for veterans, is not obligatory. However, 

as noted above, the Committee believes that implementation of 

such a hotline could be a significant element in meeting the requirements of section 3(b)(10). 

At the Committee’s May 23, 2007, hearing, Mr. Reed of SPAN 

USA spoke of the benefits of a crisis hotline for at-risk veterans. 

According to Reed, 

For most individuals in a suicidal crisis, what is most important 

when utilizing a hotline is simply knowing that someone is listening and that they are not alone. A caller needs a competent counselor at the other end of the line who can conduct a lethality assessment and provide direction on next steps. 

Should the Secretary choose to utilize a telephone hotline, the 

Committee notes the possibility of utilizing an existing capacity 

rather than building from scratch. In his testimony, Mr. Reed recommended the existing, federally funded National Suicide Prevention Lifeline (NSPL) and its 1–800–273–TALK (8255) number, for 

this purpose: 

I think we should build upon what Congress has already 

funded and let 1–800–273–TALK be the door all callers in 

crisis, including veterans, enter. Once a caller dials the 

number, an option can be provided to be transferred to a 

VA call center if the individual wants the services and 

support of the VHA. 

The Committee views this as a sensible and cost-effective approach. However, it would remain up to the Secretary to determine 

how best to fulfill the requirements of section 3(b)(10), and whether 

to implement the option described in section 3(b)(11). 


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COMMITTEE BILL COST ESTIMATE

In compliance with paragraph 11(a) of rule XXVI of the Standing 

Rules of the Senate, the Committee, based on information supplied 

by the CBO, estimates that enactment of the Committee bill would, 

relative to current law, incur little, if any, cost. Enactment of the 

Committee bill would not affect direct spending or receipts, and 

would not affect the budget of State, local or tribal governments. 

The cost estimate provided by CBO follows: 

S. 479—Joshua Omvig Veterans Suicide Prevention Act 

S. 479 would require the Secretary of Veterans Affairs (VA) to 

develop and implement a comprehensive program to reduce the incidence of suicide among veterans. This bill would require that the 

program have specific components, including training for all staff 

who interact with veterans, a suicide prevention counselor at each 

medical facility, outreach and education for veterans and their families, and a national campaign aimed at reducing the stigma of 

mental illness among veterans. 

According to VA, most of those requirements are already in place 

or will be implemented before the end of the year. For example, 

training seminars have recently begun for all employees and peersupport groups are a regular facet of veterans’ rehabilitation centers. Annual screenings for suicide risk factors such as depression 

and alcohol abuse are routinely performed by primary care physicians. Two medical centers are focused on research and education 

about suicide and its prevention. In addition, VA works with other 

medical providers in the community to reach veterans who may not 

use the VA health care system. VA also plans to hire suicide-prevention professionals at each of its hospitals. The bill would authorize VA to create a toll-free hotline staffed by mental health personnel, and the agency plans to have such a hotline in operation 

by the end of August 2007. 

CBO estimates, therefore, that implementing this bill would have 

little, if any, cost because VA already has or soon will implement 

all the specific requirements of the bill. Enacting the bill would not 

affect direct spending or receipts. 

S. 479 contains no intergovernmental or private-sector mandates 

as defined in the Unfunded Mandates Reform Act and would not 

affect the budgets of state, local, or tribal governments. 

On March 19, 2007, CBO transmitted a cost estimate for H.R. 

327, the Joshua Omvig Veterans Suicide Prevention Act, as ordered 

reported by the House Committee on Veterans’ Affairs on March 

15, 2007. The two versions of the legislation are similar, and their 

estimated costs are identical. 

The CBO staff contact for this estimate is Michelle S. Patterson. 

This estimate was approved by Peter H. Fontaine, Deputy Assistant Director for Budget Analysis. 

REGULATORY IMPACT STATEMENT

In compliance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the Committee on Veterans’ Affairs has made 

an evaluation of the regulatory impact that would be incurred in 

carrying out the Committee bill. The Committee finds that the 

Committee bill would not entail any regulation of individuals or 


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businesses or result in any impact on the personal privacy of any 

individuals and that the paperwork resulting from enactment 

would be minimal. 

TABULATION OF VOTES CAST IN COMMITTEE

In compliance with paragraph 7 of rule XXVI of the Standing 

Rules of the Senate, the following is a tabulation of votes cast in 

person or by proxy by members of the Committee on Veterans’ Affairs at its June 27, 2007 meeting. 

On that date, the Committee, by voice vote, ordered S. 479 reported favorably to the Senate. 

AGENCY REPORT

On May 23, 2007, Gerald M. Cross, MD, FAAFP, VA’s Acting 

Principal Deputy Under Secretary for Health, appeared before the 

Committee and submitted testimony on, among other things, a 

draft version of the Joshua Omvig Veterans Suicide Prevention Act. 

Excerpts from this statement are reprinted below: 

STATEMENT OF THE VIEWS OF THE ADMINISTRATION

Good Morning Mr. Chairman and Members of the Committee: 

Thank you for inviting me here today to present the Administration’s views on several bills that would affect Department of Veterans Affairs (VA) programs that provide 

veterans benefits and services. With me today is Walter A. 

Hall, Assistant General Counsel. I am pleased to provide 

the Department’s views on 15 of the 20 bills under consideration by the Committee. I will briefly describe each bill, 

provide VA’s comments on each measure and estimates of 

costs (to the extent cost information is available), and answer any questions you and the Committee members may 

have. 

S. 479 JOSHUA OMVIG VETERANS SUICIDE PREVENTION ACT

S. 479 would require the Secretary to develop and implement a comprehensive program (comprised of 10 specific 

elements) for reducing the incidence of suicide among veterans. First, the program would include a national mental 

health campaign to increase awareness in the veteran 

community that mental health is essential to overall 

health and that effective modern treatment can promote 

recovery from mental illness. Second, it would call for 

mandatory training on suicide prevention for appropriate 

employees and contract personnel (including all medical 

personnel) who interact with veterans. This training would 

require the provision of information on the recognition of 

risk factors for suicide, protocols for responding to crisis 

situations involving veterans who may be at high risk for 

suicide, and best practices for suicide prevention. Third, 

the comprehensive program would include outreach programs and educational programs for veterans and their 

families, in particular OEF/OIF veterans and their families. The educational programs would serve to help: elimiVerDate Aug 31 2005 06:23 Jul 25, 2007 Jkt 059010 PO 00000 Frm 00007 Fmt 6659 Sfmt 6969 E:\HR\OC\SR132.XXX SR132

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nate or overcome stigmas associated with mental illness; 

further understanding of veterans’ readjustment issues; 

identify signs and symptoms of mental health problems; 

and encourage veterans to seek assistance for these types 

of problems. 

Fourth, the program would include a peer counseling 

program in which veterans are trained as peer-counselors 

to assist other veterans suffering from mental health 

issues. (Training of these veterans would have to include 

specific education on suicide prevention). The peer-counselors would also be responsible for conducting outreach on 

mental health matters to veterans and their families. The 

legislation would require the Secretary to make this peerprogram available in addition to other mental health services already offered by VA (including those that would be 

established by this Act). 

Fifth, the Secretary would be directed, as part of the 

comprehensive program, to encourage all veterans applying for VA benefits to undergo a mental health assessment 

at a VA medical facility or Vet Center. 

Sixth, the program would include the provision of referrals, as appropriate, to veterans who show signs or symptoms of mental health problems. 

Seventh, the Secretary would need to designate a suicide 

prevention counselor at each VA medical facility (other 

than a Vet Center). These counselors would work with a 

variety of local non-VA entities to engage in outreach to 

veterans about available VA mental health services. They 

would also be responsible for improving the coordination of 

mental health care furnished to veterans at the local level. 

Eighth, VA’s program would have to include research on 

best practices for suicide prevention among veterans. 

Moreover, the Secretary would need to establish a steering 

committee to advise on such research. Such committee 

would be comprised of representatives from the National 

Institute of Mental Health (NIMH), Substance Abuse and 

Mental Health Services Administration (SAMHSA), and 

the Centers for Disease Control and Prevention (CDC). 

Ninth, the Secretary would have to ensure the availability of VA mental health services on a 24-hour basis. 

Finally, the Secretary would be authorized to establish 

a continuously operational, toll-free telephone number that 

veterans could call for information on, and referrals to, appropriate mental health services. 

This legislation would permit the Secretary to include 

any other activities in the comprehensive program that the 

Secretary deems appropriate. It would also require the 

Secretary to submit, not later than 90 days after the date 

of enactment, a detailed report to Congress on all of the 

Department’s suicide prevention programs and activities. 

(Any suicide prevention programs VA establishes afterwards would have to be developed in consultation with 

NIMH, SAMHSA, and CDC). 

We appreciate the purpose of this legislation; however, 

we do not support this bill. It is unnecessary because it duVerDate Aug 31 2005 06:23 Jul 25, 2007 Jkt 059010 PO 00000 Frm 00008 Fmt 6659 Sfmt 6969 E:\HR\OC\SR132.XXX SR132

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plicates many efforts already underway by the Department. Indeed, many of the bill’s requirements are already 

being addressed and implemented through VA’s current 

Mental Health Strategic Plan. (As you will recall, this 

Strategic Plan was designed to both ensure that our Department continues as a leader in the area of mental 

health and to implement the goals of the President’s New 

Freedom Commission on Mental Health). We therefore ask 

that the Committee forbear in its consideration of S. 479. 

In the meantime, we will be happy to brief the Committee 

on the myriad initiatives we have right now and explore 

with you additional measures that could supplement these 

efforts. 

Should the Committee proceed to act on this measure, 

we note our objection to the bill’s requirement to train and 

use veterans as peer counselors for other veterans with 

mental health issues. The use of adult veterans as peercounselors in caring for other veterans who suffer from 

mental health issues is simply not advisable. Data on the 

efficacy of these types of programs do not reflect favorable 

results. Although well-intended, we believe such an approach to clinical care lacks scientific support. We strongly 

believe that VA mental health care services, including 

counseling, should continue to be provided by our capable, 

experienced, and appropriately-trained cadre of mental 

health care professionals. 

In addition, we do not think the bill’s requirement that 

we encourage every veteran seeking any type of VA benefit 

to obtain a mental health assessment is justified, and it 

may cause veterans to believe they have been stigmatized. 

* * * * * * * 

Æ 


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