On a warm summer afternoon in Champion, Ohio, Michael Ecker, a 25-year-old Iraq war veteran, called out to his father from a leafy spot in their backyard. Then, as the two stood steps apart, Michael saluted, raised a gun to his head and pulled the trigger.
"His eyes rolled back," his father, Matt, said softly as he recounted the 2009 suicide. "There was just nothing I could do."
Weeks before he killed himself, Michael received a letter from the Department of Veterans Affairs accusing him of "over-reporting" the extent of his psychiatric problems. It was the culmination of a long struggle that Ecker, diagnosed with post-traumatic stress disorder and traumatic brain injury related to his service, had waged since returning home from the war to try to hold down a steady job, obtain VA disability benefits and resume a life as close to normal as possible.
"I've often thought about finding that doctor and saying, ‘Over-reporting?!' and giving him the death certificate," Matt Ecker said.
About once every half hour in America, a veteran within the VA healthcare system tries to commit suicide, according to VA figures for fiscal year 2011.
President Barack Obama singled out suicide prevention as a priority when he talked about veterans issues on the campaign trail in 2008. He once cited the case of an 89-year-old World War II veteran who took his life the day after complaining about his treatment by the VA.
"It is an outrage. It is a betrayal of the ideals that we ask our troops to risk their lives for," Obama told an audience in Charleston, West Virginia, on May 12, 2008. He reiterated those sentiments at a Veterans of Foreign Wars convention in Reno, Nevada, on Monday, saying he had told Pentagon chiefs and VA Secretary Eric Shinseki, "We've got to do better. … This has to be all hands on deck."
In the nearly three years since Ecker's death, the Obama administration has expanded efforts to tackle suicide among veterans, some of which were initiated at the end of the Bush administration. It has hired more suicide prevention staff and enhanced tracking of high-risk patients. Other benefits meant to help veterans returning from war have been expanded, particularly educational benefits under the 2008 GI Bill.
Perhaps the most lauded part of the VA's ramped-up effort to combat suicide has been a hotline that has received more than half a million calls since it was created in 2007, including more than 20,000 rescues of suicidal veterans. More recently it launched an online chat service and text messaging.
The VA has sought to improve data collection, too, and the numbers appear troubling: In 2011 there were 17,754 suicide attempts — about 48 a day — up from 10,888 in 2009.
That increase, the VA said, may largely reflect an improved tracking system put into place in 2010 and a growing number of patients treated at VA facilities. The VA couldn't provide data on the number of suicides within the VA system after 2009, but the figures through that date show a broadly stable rate since 2003 that is higher than the national average.
Outside the VA healthcare system, which has almost 9 million enrollees, the data becomes murky. The VA has estimated that roughly 18 veterans nationwide kill themselves every day, but that number is based on limited data.
Reuters conducted its own survey, contacting all 50 states but obtaining data for the 2005-to-2010 period from only 32 of them, accounting for about two-thirds of the U.S. veteran population. In those states, veteran suicides increased from 4,801 to 5,017 over a five-year period in which, the VA believes, the U.S. veteran population declined slightly.
While the data is imperfect — the VA estimates the reliability of such figures at 78 percent to 90 percent — the department said the numbers appeared broadly consistent with trends it has observed.
Shinseki told Reuters in an interview that the problem of veteran suicide appeared to be linked to a broader question about mental health in the United States. He pointed to data showing suicide is the second-biggest cause of death for people ages 25 to 34 and the fourth-biggest cause for people 35 to 54.
"We got a problem. Is mental health an issue in this country? Nobody talks about it," Shinseki said.
A copy of the July 29, 2009, VA letter to Ecker reviewed by Reuters denied him an increase in his disability benefits from the $974 he was already receiving, citing "over-reporting (of) both mood disturbance and impaired memory difficulty."
"Mr. Ecker's death is a tragic outcome. Our deepest sympathy goes out to his family and loved ones," the VA said in response to Reuters inquiries. "Experience has shown that access to quality mental health services from VA can make a positive difference in the lives of veterans and their families."
Matt Ecker wonders daily whether his son's suicide could have been prevented had he received better treatment or found a job he could keep in his condition. Frustrated with the system, his son had declined treatment from the VA and had turned to a local doctor. He also wonders whether Michael might have done better if he had re-enlist. Going to war was risky. But, in Michael's case, so was coming home.
"It's just as dangerous, as it turns out, out here — because of the lack of jobs, lack of everything," he said.