Department of Veterans Affairs Secretary Denis McDonough sought to
defend the veterans crisis line Wednesday in a letter to the Kansas
senator who has raised concerns with how some veterans are treated after
calling it.

McDonough wrote in the three-page letter to Republican U.S. Sen.
Jerry Moran that the VA “takes any allegations of insufficient care or
service very seriously and will investigate thoroughly.”

“We also want to reaffirm our appreciation and support for
whistleblowers at VA, who raise important issues and help us better
serve our nation’s heroes,” McDonough wrote. “It takes courage to raise
concerns, and we at VA are dedicated to building a culture where every
employee feels empowered and unafraid to do so.”

The Government Accountability Office has opened an investigation
into the veterans crisis line after Moran, the top GOP senator on the
Veterans’ Affairs Committee, asked them to do so in response to multiple
whistleblower allegations of “gross mismanagement.”

McDonough wrote in the letter that he wanted to share additional
information with Moran about why staff members at the veterans crisis
line transfer people to the “callers with complex needs” program. That
process is at the center of Moran’s concerns.

“Callers with complex needs are known callers who display
inappropriately abusive behavior (e.g. cursing at responders or being
racist toward responders); sexual behavior; or high-frequency calling
for a purpose other than crisis support (e.g. calling VCL hundreds of
times per day),” McDonough wrote.

“Oftentimes, these callers are not veterans — or those calling on
behalf of veterans — and can take up resources that would normally be
used to serve veterans in immediate crisis,” McDonough added.

The complex needs program, he wrote, was established in the spring of
2018 and consists of more than 100 staff who receive 32 hours of
training on “behavior-shaping, boundary-setting and coaching.”

“In the rare situation that we come close to capacity for (callers
with complex needs) callers during any shift, we will add staff to that
shift, using overtime and other tools,” McDonough wrote.

Sometimes people transferred to the callers with complex needs unit
will receive a “selectively delayed response,” which McDonough wrote is a
“best practice” that can help those people “modify their behavior by
pausing their engagement with a responder.”

“While engaged in a delay, the caller hears a caring message about
why they are waiting for a response, how to shape their behavior to be
removed from a hold, and what to do if in crisis,” McDonough wrote.
“Crucially, there is always an option for these callers to connect to
support immediately if they are experiencing an urgent crisis, and these
callers are neither placed on indefinite holds nor involuntarily
disconnected.”

Those callers also have “extensive records” within the veterans
crisis line, meaning that even if they are disconnected from the call
for any reason, there is “no break in record retention.”