Congressional Inquiry

Date: March - 2010

Inquiry from: Congressman Mitchell (D-AZ)

Context of inquiry: Questions regarding suicide prevention program.

Question 1: What's the status of the PSA?

Response: The Sinise and Norville public service announcements (PSAs) aired during

FY 2009, from October 2008 to September 2009.

Question 2: Is it still airing?

Response: No, the PSAs are not airing.  However, they are available on a number of Web sites:  VA's Mental Health Service, House Committee on Veterans Affairs, Official Web Site for the US Air Force, Military Officer Association of America, Military Lawyer Blog, American Legion, National Association of State Directors of Veterans Affairs, YouTube, CBS News, etc.  A Google search of "Suicide Prevention PSA Gary Sinise" displays 20 pages of citations.

Question 3: Where and how often?

Response:  The Company contracted for PSA distribution, Plow Share Group, Inc., reported that the PSA aired over 17,000 times across the country in 118 markets on 222 stations, one national cable outlet, and one local cable outlet.

Question 4:  Are they producing another one?

Response:  Gary Sinise has agreed to do another PSA for the Suicide Prevention Hotline.  Funding is available to produce a new PSA in FY 2010.

•5. Question 5:  What is the PSA schedule for 2010?

Response:  Production of a new PSA is planned for the summer of 2010 with release  over the 2010 holiday season.

Question 6:  What TV markets?

Response:  VA will contract with a distribution company to promote the PSA to every TV station in the country (over 1200 stations).

Question 7:  Whatever happened to the idea floated about buying time to air in movie theaters as part of coming attractions?

Response:  The idea was considered, but dropped in favor of televised PSAs, which were found to reach a larger numbers of viewers (by order of magnitude) and were much more cost effective.  Movie theater projections would have cost millions of dollars, while reaching very limited audiences.

Question 8:  Did VA do a cost/benefit analysis of that and determine it wasn't worth the expenditure?

Response:  Yes. The cost was considered too high compared to the number of potential viewers.  The comparison to movie theater airings is described in #3 above.  Transit Authority advertising (ads on buses, bus stops, trains, train stations, underground rail systems, and underground rail stations, etc.) produced a larger number of potential viewers at a lower cost.

Question 9:  Also, what is the status of the print ads?

Response:  North American Precis Syndicate (NAPS) was contracted by VA to assist in placing print ads.  NAPS released our printed material nationally to approximately 1,600 daily and 8,400 weekly papers.  The Suicide Prevention print ads got over 800 placements, with the average for most ads being between 200 and 400 placements.

In addition, large posters providing the Hotline number and Website are displayed at all medical facilities. They feature the slogan: "IT TAKES THE COURAGE AND STRENGTH OF A WARRIOR TO ASK FOR HELP."

The Office of Veterans Health Communications (OVHC) produced a large exhibit that is displayed at many Veteran Service Organization (VSO) and other meetings.  The display highlights the Suicide Prevention initiative and staff distributes tens of thousands of suicide prevention materials produced by VA.  These have been universally received with great enthusiasm by Veterans.

One of the products distributed to Veterans at VSO meetings, Community Suicide Prevention Organizations, VA employees, and Veterans who come to VA medical centers (VAMCs) are small stickers with the Suicide Prevention Hotline phone number printed on them.  These stickers have proven handy and useful in making referrals to the Help Line for Veterans or their family members.

A pilot project involving an advertising campaign was run in the Metropolitan Washington, DC, area.  Display ads on transit buses and in Metro stations ran from July through October 2008. This was labeled the Transient Authority Suicide Prevention (TASP) Campaign. The number of calls received by the Suicide Prevention Hotline from the DC metropolitan area more than doubled during the campaign. Calls to the Suicide Prevention Hotline were consistently around 57 per week in the months before the ad campaign. Calls during the campaign increased to 118 per week. The three-month campaign cost $110,000.

Subsequently, VHA expanded the TASP campaign to seven cities (Phase II TASP):    Dallas, TX; Las Vegas, NV; Los Angeles, CA; Miami, FL; Phoenix, AZ; San Francisco/Oakland, CA; and Spokane, WA.  The locations were carefully selected by the Office of Mental Health Services based on the numbers of attempted and completed suicides, and the available resources in a particular location.  Phase II TASP cost $1.3 million. There were numerous rescue stories associated with this Phase.  A story that received particular coverage is that of Las Vegas area Veteran, David Crosby, which was reported on local news, station KVBC Channel 3.

To further the suicide prevention outreach efforts and reach a broader audience, VA entered into a contract with media giant BluLine Media, Inc. to produce and display suicide prevention interior ads on 21,000 public transit buses in over 40 states and 127 markets across the United States.  The total daily ridership of these buses is 4.3 million.  This campaign was labeled "Phase III TASP (BluLine)."  BluLine discounted its rate from $2.1 million to $500 thousand.

Question 10:  Are they still on buses and/or trains?  If so, where?

Response: No, an extensive review of the completed campaigns is underway. Based on its results, another group of cities may be selected to promote the Hotline phone number.

Question 11:  When?

Response:  Possibly starting July 2010.

Question 12:  Are they going to return to Phoenix?

Response:  Yes, the VA Suicide Initiative Leadership has indicated that data from Phoenix would indicate a need to run ads again this year.

Question 13:  How successful were they?

Response:  In collaboration with the Offices of Veterans Health Communications and Mental Health, the Center of Excellence at Canandaigua has been conducting assessments of the communications campaign.  The Center is reviewing the association between exposure to public health media messaging, knowledge of hotline use among those known to the participant, and self-reported likelihood of hotline use if in need. The current evaluation strategy aims to collect data from three random samples of approximately 500 community members from each of the 2009 media campaign implementation sites. To identify any long term association between exposure to media messaging and likelihood of hotline use, data are collected at baseline (i.e. at the time of campaign implementation) and six and 12 months following the start of the campaign in each area.

The study is not yet complete, but preliminary data indicate an increase in the number of calls originating from the areas where the ads ran.  Using Phoenix as an example: in September 2008 (prior to the campaign), the Veterans' suicide prevention hotline received 38 calls (area code 602). In 2009, approximately 30 days after the start of the suicide prevention media campaign, the number of calls originating from that same area code increased by 234% (n=89).  This change is in contrast to the modest change or decrease among calls originating from other Arizona area codes during those same time periods (area code 480 = 17% decrease, area code 520 = 26% increase,  area code 623 = 18% increase, area code 928 = 6% increase).

Question 14:  Were they worth the cost?

Response: Yes, calls to the Suicide Prevention Hotline increased.  Many lives were saved through rescues, nearly 7,000, which were attributed to seeing the ads, PSAs, or promotional products we produced.  Additionally, referrals to VA mental health services increased.