By Adam Schwartz | Investigative Commentary
The Department of Veterans Affairs (VA) continues to position Lethal Means Safety (LMS) initiatives—including the distribution of firearm cable locks and lethal means counseling—as a key component of its suicide prevention strategy. However, growing concerns are being raised not only about the empirical foundation of these programs, but also about their implementation at the regional level and the shifting of responsibility away from local VA Medical Centers.
Deflecting Local Accountability
When our team first reached out to April Eilers and Dr. Velez at the Veterans Health Care System of the Ozarks (VHSO) in Fayetteville, Arkansas, we posed several specific questions about local implementation, efficacy tracking, and the outcomes of VA-funded initiatives such as the LMS program and the Veteran 988 Suicide & Crisis Line. The response was telling:
“Some of the questions you asked are national and not local... Please email vhafavfoia@va.gov.”
This included questions such as:
The answer we received is both dismissive and deeply troubling. The VA regional hospitals are not only the point of distribution for these services but also the front line in data collection, reporting, and veteran outcomes. National reports, budgets, and programmatic efficacy rely on data generated at the local level. If that data is inaccessible or unavailable locally, it calls into question the integrity of the national metrics the VA promotes.
The 988 Crisis Line: A Misattributed Success?
Among the most egregious deflections is the VA’s implication that the 988 Suicide & Crisis Lifeline is a VA-driven success. In reality, the 988 system predates VA involvement by nearly two decades. The line originated in 2005 through a federal grant awarded by the Substance Abuse and Mental Health Services Administration (SAMHSA) to Vibrant Emotional Health, a nonprofit organization affiliated with Mental Health America.
Following the passage of the National Suicide Hotline Designation Act of 2020, the 988 number became codified into law, with Vibrant receiving a five-year grant in FY22 to administer the Lifeline. Features such as georouting, which launched in 2024, now allow calls to be routed based on the user’s physical location—not area code—further enhancing the system’s local responsiveness.
Given this infrastructure, it should be entirely possible—and reasonable—to request and receive data on:
To dismiss such questions as “not local” is to willfully obscure performance accountability under the guise of bureaucratic jurisdiction.
LMS Program: Evidence Gaps and Cultural Disconnects
While VA Director Dr. George Velez points to a 2020 study published in the American Journal of Public Health as “empirical evidence” for LMS programs, this research was limited to 232 Mississippi National Guard members—87% male, 77% white. It does not represent the broader veteran population, which is more diverse in service background, race, and life experience. More critically, National Guard members experience vastly different service conditions than active-duty personnel. Unlike those who serve full-time, train daily, and deploy multiple times with little civilian support, Guard members typically serve one weekend a month, two weeks a year, and complete a limited number of deployments with significantly more downtime and a civilian support system at home. This distinction is crucial, as the trauma and stressors faced by active-duty service members are markedly different, especially when it comes to transitioning out of the military.
Additional pilot programs conducted by the VA show promising feedback, yet lack randomized control groups, long-term tracking, or confirmation of whether gun locks are actually used. Without these verifications, claims of impact remain speculative at best.
Meanwhile, internal reviews have highlighted concerning implementation gaps. A 2022 VA Office of Inspector General (OIG) report revealed that:
These lapses suggest a troubling pattern of bureaucratic box-checking over authentic, veteran-centered care. As one clinician told the OIG anonymously:
“We’re counting locks, not lives.”
Conflicts of Interest and the Need for Independent Review
Further complicating the integrity of these programs are financial entanglements. Some of the researchers who advocate for or train others in LMS strategies have disclosed receiving consulting fees or royalties—raising legitimate concerns about the independence of their recommendations.
A 2022 peer-reviewed analysis calls for more randomized controlled trials with larger, more representative populations. Until such studies are completed and subjected to independent review, the foundation of VA’s LMS approach remains tenuous.
Cultural Competency and Practical Limitations
Furthermore, the VA’s gun lock and cable lock initiatives are a misallocation of time and resources. According to surveys, 63% of gun owners cite home protection as their primary reason for ownership. A locked or disabled firearm undermines its intended purpose during a home invasion, where reaction time is critical. If the rationale behind these locks is that they would slow a veteran down in a moment of crisis, the same logic applies in a life-threatening home invasion scenario—creating an unsafe and impractical situation. Veterans who are suicidal will still have access to their firearms in under 10 seconds if using biometric or coded lockboxes, which are designed for quick access to ensure both safety and usability. Given that 75% of suicides occur within one hour of ideation, and 24% happen in less than five minutes, a mere 10-20 second delay is unlikely to be a meaningful deterrent.
Additionally, the referenced study lacks conclusive evidence that these measures actually mitigate veteran suicide. While firearm safety efforts may reduce accidental child deaths—a worthy cause—it is not the issue being addressed here. There is also insufficient data on whether veterans leave suicide notes, making it difficult to assess intervention opportunities. If, as some data suggests, 25-30% of suicides involve note-writing, that means these individuals took additional time before their actions, contradicting the idea that a brief delay from a gun lock would alter their decision.
Overlooked Solutions: The Power of Community-Based Healing
While billions are funneled into top-down VA initiatives like the LMS initiative, grassroots programs receive only a fraction of that support if any. Veteran-run organizations like the Two Black Ravens Foundation employ art, photography, and storytelling as pathways to healing. These community-driven, peer-supported efforts show anecdotal evidence of reducing suicide risk by as much as 20% in areas where they are active.
But funding remains elusive. As one veteran advocate bluntly put it:
“There’s no profit in painting. Just healing.”
Time for Accountability and Reform
If the VA is truly committed to ending veteran suicide, it must:
Until then, veterans and their families are left asking: Are these programs preventing suicides—or just checking boxes?
In the interest of fairness and transparency, I provided both April Eilers and Dr. Velez with the opportunity to offer a formal response or clarification to the issues raised in this article. The deadline for their response was 1500hrs on 14 April 2025. Unfortunately, they chose not respond by the deadline. I continue to welcome their comments and would be happy to include their perspectives in an updated version of this article, as we remain committed to ensuring their voices are represented fully and fairly.