Iowa legislators look for answers after veteran's suicide

Source: Cedar Rapids Gazette

By James Lynch

Members of Iowa’s U.S. congressional delegation want to know why an Iowa veteran who committed suicide reportedly was denied admittance to the Iowa City Department of Veterans Affairs Hospital hours earlier.

U.S. Rep. Dave Loebsack, D-Iowa City, and Sens. Chuck Grassley and Joni Ernst, both Republicans, have written VA officials demanding answers to what Ernst has called the hospital’s “apparent failure or refusal to properly treat” combat veteran Brandon Ketchum, 33, of Davenport.

Ketchum served in the Marine Corps in Iraq and in the Iowa Army National Guard in Afghanistan.

According to a post on his Facebook page, he went to the hospital July 7 seeking help with his post-traumatic stress disorder, only to be told to go home and take his medication.

In that post, Ketchum wrote that he was seeking assistance because he believed he was a threat to his own safety.

According to a statement from the VA in response to questions from Loebsack, an “immediate crisis response will be initiated when a veteran states they are in danger of hurting themselves or others, or is perceived to be in immediate danger.”

Despite that policy and the hospital’s familiarity with Ketchum’s “struggle with post-traumatic stress disorder as well as repeated flags for suicide over the last three years,” his request to be admitted to the psychiatric ward — due to what he termed “serious mental issues” — reportedly was denied, the three senators wrote in a letter Tuesday to Michael Missal, the VA’s inspector general in Washington, D.C.

“Mr. Ketchum took his own life just over 24 hours later,” they wrote.

In light of Ketchum’s death, Ernst, Grassley and Ketchum’s home-state Sen. Ron Johnson of Wisconsin “strongly urge” the VA review his July 7 visit to the Iowa City facility “to determine what, if any, steps can be taken in the future to better protect our veteran population, including potential changes to VA policy, if applicable.”

“It is also important for policymakers within the VA and in Congress to know if this is an isolated incident, how often veterans seeking inpatient mental health care are turned away, and how often this leads to adverse consequences,” they wrote.

In 2014, an average of 20 veterans a day committed suicide, according to the Va. Six of those 20 were users of VA services.

At this time, Ernst does not believe that this specific matter is systematic, “however, it does raise a red flag and needs to be investigated fully so that if there are any issues, the VA can work to prevent it from becoming systemic,” her spokeswoman Leigh Claffey said Tuesday.

However, based on comments he hears from veterans’ families, Loebsack is concerned that Ketchum’s is not an isolated incident.

“We’ve heard from some other families who have concerns about the psychiatric care at the VA facility in Iowa City,” Loebsack told The Gazette Tuesday.

He is trying to schedule a call with VA Secretary Robert McDonald — who has not responded to his July 21 letter seeking answers. As with Grassley and Ernst, he is asking the VA inspector general to open an investigation.

“When something like this happens this close to home, I have to get answers,” Loebsack said. “I have a lot of jobs as a congressman, and one of them is oversight of federal agencies. It’s not acceptable if they are not responding.”

Grassley spokeswoman Jill Gerber said Tuesday it’s not unusual for the senator to hear concerns about veterans’ access to mental health care — but more often from concerned citizens than veterans themselves. That’s why it’s important to determine whether Ketchum’s case reflects systemic failures or an isolated incident.

Grassley and Ernst both cited the case of Robert Miles, 41, an Iraq War veteran who froze to death in a Des Moines park in 2015. According to his friends, instead of being admitted for inpatient treatment at the Des Moines VA hospital, he was told he would receive an appointment with a psychiatrist.

Isolated or not, “too many veterans have died while waiting to receive assistance from the VA,” Ernst said. “Our veterans deserve better than a completely incompetent VA.”

Loebsack characterized the VA’s response to his July 21 letter to McDonald as “very minimal,” with no official response from the VA in Iowa City or Washington, D.C. The Iowa City VA sent a general statement that didn’t address any of the questions Loebsack posed, he said.

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

Citing privacy concerns, the VA declined to speak about the specifics of the case.

“I never thought he would do it,” his partner, Kristine Nichols, told the Quad-City Times. “I didn’t know he had a gun.”

Ketchum, whom she met in 2013, told her he already had been diagnosed with PTSD by the time he left Iowa for his third deployment. He was taking antidepressants while serving in Afghanistan.

By the end of that abbreviated tour, he was also prescribed narcotic pain pills.

Before his death, Ketchum had signed a waiver that granted Nichols access to his VA medical records. In the days after finding him dead of a self-inflicted gunshot wound, she wanted to know what had happened.

“He did tell them his life was falling apart,” she said of notes made by a doctor during his VA visit on July 7.

Nichols is in the process of requesting additional records. But she is troubled by what has emerged so far, including that no one from Iowa City appears to have done a follow-up with Brandon until 30 hours after his appointment. At 4 p.m. the day he died, his doctor left a voicemail message, asking how he was doing, Nichols said.

The VA cannot publicly answer questions about Ketchum’s visit. Officials in Iowa City are not permitted to even confirm he was there.

His case file is wholly protected by privacy laws. But a spokesman responded to general questions about medical center policy.

Spokesman Jamie Johnson confirmed the policy, writing in an email to the Quad-City Times, that, “Yes, patients (are) asked at every visit” if they are suicidal. If he or she answers yes, the VA “probe(s) further to figure out the level of risk, the safety plan, and whether the patient requires admission to be safe.”

That has Nichols wanting to know why Ketchum was turned away if he asked to be admitted.

“The VA is guilty in this situation,” she said. “All he needed was 48 hours — three days, maybe, to get clean.”