From the U.S. Government Accountability Office, www.gao.gov Transcript for: Veterans Crisis Line Problems Description: Audio interview by GAO staff with Seto Bagdoyan, Director, Forensic Audits and Investigative Service Related GAO Work: GAO-16-373: Veterans Crisis Line: Additional Testing, Monitoring, and Information Needed to Ensure Better Quality Service Released: June 2016 [ Background Music ] [ Narrator: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. It's June 2016. Many service members returning from Afghanistan, Iraq, and other deployments have struggled with mental health issues, including post-traumatic stress disorder, depression, and substance abuse. The Department of Veterans' Affairs established the 24-hour Veterans' Crisis Line in July 2007 to help veterans in emotional crisis. A team led by Seto Bagdoyan, a director in the Forensic Audits and Investigative Service team, and Randy Williamson, a director in the Health Care team, recently looked into the service provided by the Veterans' Crisis Line and what the VA is doing to ensure the line meets callers' needs. GAO's, Jacques Arsenault, sat down with Seto to talk about what they found. [ Jacques Arsenault: ] It's so important to ensure that are veterans get the mental health support that they need, so, for starters, can you take a moment and explain what the Veterans' Crisis Line, or the VCL, offers, what it's role is? [ Seto Bagdoyan: ] Sure, VCL, as you mentioned, is the mental health support center for veterans. It's located in Canandaigua, New York, several hundred trained counselors whose job is to respond to calls coming in from veterans and their families in crisis. [ Jacques Arsenault: ] And so they provide emergency support, as well as maybe referrals to other services? [ Seto Bagdoyan: ] That's right, yes. They have a lot of resources at their fingertips, either by phone or online, and they also have the capability to refer emergency services, which they've done over 50,000 times since inception. [ Jacques Arsenault: ] Now, there's an 800 number if a veteran is in crisis or their family, they would call 1-800-273-TALK, or 1-800-273-8255, but they have to press a button? [ Seto Bagdoyan: ] That's right. They have to press 1 to get to the primary center, otherwise they will be thrown off into a backup loop of up to 164 different centers that are part of the National Lifeline, a suicide hotline. [ Jacques Arsenault: ] There have been some complaints about that the service on the crisis line, can you talk about what your team looked at and what you found? [ Seto Bagdoyan: ] Sure, our work being done for the House Veterans' Affairs Committee, they had received a number of allegations from veterans claiming that they were put on hold for prolonged periods of time. One veteran recorded a 45-minute hold period.So the committee asked us to go in and essentially do a top-to-bottom review, and we looked at response times, infrastructure, guidance, training, all those kinds of issues. [ Jacques Arsenault: ] And what did you find? [ Seto Bagdoyan: ] We found that VCL struggles with its timely response to incoming calls. For example, for FY-2015, they met their goal of responding to most calls, 90 percent of the calls, within 30 seconds only about 65 percent of the time,so that's quite a gap.And then what we did was perform a series of undercover calls in the July/August timeframe of 2015 where we called the hotline and, essentially, recorded the duration of the response time and found that they responded within 30 seconds 73 percent of the time, which, essentially, corroborated what VCL itself was tracking. [ Jacques Arsenault: ] So it sounds like in most of the cases they're timely, and while that might be good for some types of phone service, these are services for individuals or families that are in crisis or emergency situations. [ Seto Bagdoyan: ] Right, the people generally call, are -- pretty much in full crisis. I mean, they do get calls where they say, hey, you know, my medication ran out, can you help me out here or I need an appointment, or I just need someone to talk to, but those in full crisis, which we experienced during our field visit to VCL in Canandaigua, New York, they need help and they need it right away. [ Jacques Arsenault: ] Now you found, along those lines, that VA doesn't actually have performance targets or goals in terms of the wait times. [ Seto Bagdoyan: ] Right. For this instance, their aspirational goal is to answer 90 percent of the incoming calls to the primary center, which is very important for people to understand, the one in Canandaigua, within 30 seconds. But other things, including actions that they're taking to improve the infrastructure, operations, training, what have you, they're a little bit more open-ended in terms of timelines and they don't have much specificity. However, in their response to our recommendations, they laid out a little bit more specificity in terms of when they expect to accomplish certain things. [ Jacques Arsenault: ] So they're aspirational goals, as you mentioned, so they're not really holding themselves to these. [ Seto Bagdoyan: ] They were not at the beginning, but I think our presence, we would like to think, constructively, that has, essentially, compelled them to take this a lot more seriously than they may have in the beginning. [ Jacques Arsenault: ] Well then, finally, for service members, veterans, or their families who may be in crisis, what would you say is the bottom line of this report? [ Seto Bagdoyan: ] Bottom line, I would say that for all its shortcomings, VCL is an indispensable service for veterans and their families and loved ones. I think VCL and VA has been overwhelmed by volume. They had over half a million calls last fiscal year, and with their structural and operational challenges, they just couldn't get it done. I think they now get it, their response to our recommendations is pretty solid, and now they just have to go plan and execute, achieve results, and sustain those results. [ Background Music ] [ Narrator: ] To learn more, visit GAO.gov and be sure to tune in to the next episode of GAO's Watchdog Report for more from the congressional watchdog, the U.S. Government Accountability Office.