Veterans Crisis Line: Actions Needed to Better Ensure Effectiveness of Communications with Veterans
Fast Facts
Suicides occur among veterans at twice the rate of nonveterans. The Department of Veterans Affairs has named suicide prevention one of its top priorities. To help, VA runs the Veterans Crisis Line, a 24/7 phone, chat, and text service.
We testified on crisis line challenges.
For example:
Staff handle multiple chat and text interactions at once, which can mean less attention for those contacting the crisis line in need and burnout for staff
Calls from "complex needs" callers—those who are abusive or call frequently—may be routed to responders without specific training for such calls, causing stress for staff and putting callers at risk
Highlights
What GAO Found
Crisis line data show it had about 3.8 million customer interactions from fiscal year 2021 through 2024, with the number increasing each year. GAO found the crisis line faces challenges in several areas:
- Customers with complex needs. The crisis line provides specialized training to responders in a unit that addresses complex callers. However, these callers are increasingly being routed to responders who may not have received the training, raising service quality and staffing concerns that could put customers at risk.
- Chat and text. Procedures for staff in this unit—such as responding to more than one customer at once—as well as how the unit is staffed may have adverse effects. These include increased responder burnout, which could also put customers at risk.
- Chat routing process. The chat platform did not automatically change the status of responders who were not available to respond timely to a chat (e.g., responders who were on a break or experiencing internet outages). As a result, chat customers could be redirected between two unavailable responders, or the chats could be abandoned.
Further, in July 2024, the Department of Veterans Affairs (VA) determined that, as a non-clinical service, the procedure the crisis line used to disclose incidents to customers or their representatives in cases when actions or inactions created a significant risk of harm to the customer was not applicable. The crisis line withdrew the procedure and a new one has not been established. This runs counter to VA's goal of building trust with stakeholders through transparency and accountability.
Why GAO Did This Study
An average of 17.6 U.S. veterans died by suicide per day in 2022—the most recent data available. Preventing suicide is a top stated priority of the VA. VA runs the Veterans Crisis Line: a 24/7 phone, chat, and text service, staffed by crisis responders who support veterans and their family and friends (i.e., customers).
This testimony is based on GAO's report publicly released today on the Veterans Crisis Line (GAO-25-107182). In preparing that report, GAO obtained, reviewed, and analyzed crisis line documents as well as data from fiscal years 2021 through 2024; interviewed crisis line and VA officials; surveyed all crisis line responders; and conducted interviews with a non-generalizable sample of eight responders.
Recommendations
In its report released today, GAO recommended that VA ensure that the crisis line more comprehensively assesses risks of adverse effects for (1) its customers with complex needs and (2) those using chat and text, making adjustments to procedures and staffing for both units, as needed. GAO also recommended that VA ensure that (3) its chat platform provider develops a solution to address chats going unanswered after customer redirection to an unavailable responder; and (4) it has a procedure for disclosing incidents.VA agreed with GAO’s recommendations; took action to address the third recommendation; and identified steps it plans to take to implement the remaining three.