Was this veteran denied VA care prior to suicide? Congress wants answers

Last October, former Marine sergeant and Army National Guard veteran Brandon Ketchum led a team in an awareness walk to honor military friends who had died by suicide.

But this year, Ketchum won’t be present at the Out of the Darkness event in Rock Island, Illinois. Instead, he will be among those remembered, having died July 8 of a self-inflicted gunshot wound just hours after expressing his frustration with Veterans Affairs medical care on a closed Facebook page.

Ketchum wrote that he had sought emergency inpatient care for his substance abuse issues but was turned away.

"I requested that I get admitted to 9W (psych ward) … I truly felt my safety and health were in jeopardy as I discussed with the doc. Not only did I get a NO, but three reasons of 'no,' based on me not being ‘[expletive] up enough,” Ketchum wrote in a now-removed post, according to the Madison, Wisconsin, television station WKOW and Kristine Nichols, Ketchum’s partner of three years.

The death immediately drew the interest of Ketchum’s congressional member, Rep. David Loebsack, D-Iowa, who asked the Iowa City VA Medical Center director July 12 for more information on the case.

This week, Iowa Republican Sens. Joni Ernst and Chuck Grassley, along with Sen. Ron Johnson, R-Wis., joined the chorus of lawmakers seeking answers about Ketchum's care.

They wrote a letter to VA Inspector General Michael Missal on Tuesday requesting that he investigate the matter.

"It’s important for policy makers within the VA and Congress to know if this was an isolated incident, how often veterans seeking inpatient mental health care are turned away and how often this leads to adverse consequences,” the senators wrote.

In a separate letter to VA Under Secretary for Health Dr. David Shulkin and Missal, Ernst reminded them of a request she made last year to investigate the death of Army veteran Richard Miles, who froze to death in a park in Des Moines, Iowa.
Ernst had asked the VA look into Miles’ access to mental health care, saying she believed it to be inadequate.

"I write today with increased concern for the mental health care treatment and subsequent recovery coordination provided to our veterans," Ernst said. "Immediately following Mr. Miles' death, I requested your office investigate the VA Central Iowa Health Care System’s mental health program."

Ketchum served in the Marine Corps from 2004 to 2008 as a combat engineer, deploying twice to Iraq, where he worked on counter-IED teams. He joined the Army National Guard in 2010 and deployed to Afghanistan, where he again worked to clear roadside bombs.

He was medically retired in 2013 for severe injuries to his spine, leg and brain and soon thereafter became addicted to opioid painkillers.

Later, he turned to heroin, Nichols said.

She said she worried about him all the time, "mostly about substance abuse," and once had to resuscitate him following an overdose.

But she never thought he’d consider suicide.

“We shared everything. We talked regularly about it,” Nichols said. "The name of his team for the Out of the Darkness Walk was Team 22, you know, for the number of veterans who commit suicide per day."

On the evening of July 7, the couple had been estranged over Ketchum’s drug use. Nichols had asked he stay at a house he was renovating and decide whether he wanted to "get clean." She reminded him he had much to live for, including her and his 4-year-old daughter.

The next day, Nichols called the VA's caregiver support line for advice on continuing to support Ketchum. She went to the house to talk to him about their future. Instead, she found his body.

“I didn’t know he had a gun in the house. I thought it had been stolen a few weeks earlier and I was glad, because the gun was always a sore subject between us,” she said.
A month later, she continues to ask herself what she could have done to prevent Ketchum's death.

But she also believes the VA could have done more.

While going through Ketchum’s belongings after his death, she found a message on his cellphone from his VA doctor, telling him he didn’t think inpatient care was appropriate at the time.

“I feel like the VA pushed him over the edge,” Nichols said. “I feel like he was asking for help and they couldn’t take the time.”

Ketchum’s death coincides with the release of the largest review of veteran suicides ever conducted by the VA. According to the comprehensive study released Wednesday, an average 20 veterans committed suicide daily from 2001 to 2014, with Iraq and Afghanistan veterans having some of the highest rates of suicide.

The rate of suicide for veterans near Ketchum’s age, 33, was 51 per 100,000 veterans. In contrast, the suicide rate for all veterans in the 30-39 age group was 46 per 100,000.

The report stressed that the suicide rate among veterans enrolled in VA care was significantly lower in 2014 than veterans not seen at VA. According to the study, of the average 20 former service members who died each day in 2014, 14 were not enrolled in VA health care.

Ketchum is among the average six a day being regularly seen by a VA doctor.

A VA official said Wednesday that the department could not speak about the specifics of Ketchum’s care “in accordance with his privacy rights.”

But spokeswoman Victoria Dillon added that the department is working to improve mental health services, screening and outreach to veterans in crisis.

“The Department of Veterans Affairs was saddened to learn that a veteran who was receiving care from us has died by suicide. This is a tragedy for everyone involved because even one veteran suicide is one too many,” Dillon said.

In recent years, VA has hired 5,300 mental health providers and support personnel and upgraded its Veterans Crisis Line to address veterans suicide. It has also elevated the profile of its suicide prevention office within the department and launched new partnerships with community health providers to offer counseling to veterans.

According to Nichols, the VA inspector general will be in Iowa on Friday as part of a fact-finding investigation on the matter.

Nichols said she appreciates the investigation but adds that it "isn't going to bring Brandon back."

What she'd like to see happen is for VA to listen to patients' needs and provide more outreach to veterans, to include home visits and programs exclusively for younger veterans.

"Brandon had a lot of support. He had a really great family. But he didn’t have a lot of peer support where we lived, and it’s something he struggled with," she said. "Many of the programs are intermingled with Vietnam vets. I think Brandon found them even more isolating.”

Veterans, service members and loved ones in crisis can call the Veterans Crisis Line at [login to see] , press 1. They also can send a text message to 838255 or chat online at VeteransCrisisLine.net to receive free, confidential support 24 hours a day, seven days a week, 365 days a year.