The number of veteran suicides has tragically risen over the past decades. Despite a tremendous effort from government and advocacy groups to reverse the trend, the number of suicides over the years do not show a sustained decrease over time: just the opposite.
The Department of Veteran’s Affairs’s (VA) recent suicide data shows an overall increase in veteran suicide from 2005 to 2020. Current approaches to tackle this focus heavily on mental health, awareness campaigns, population-based outreach, and reducing barriers for those who ask for help. This current approach puts the onus on struggling veterans themselves to self-assess their need for help and then proactively seek the care that they need. The current sub optimized prevention model requires the struggling veterans to take the first step. This must be flipped to enable VA, Veteran Service Organizations (VSO), and other organizations to proactively reach out to veterans in real-time before their struggles lead them on a dark path to destructive behavior and death by suicide. By transforming this sub-optimized model, veteran suicide can be reduced by at least 10%, saving hundreds of lives this year.
ClearForce, in collaboration with partners in both government and academia, has created an innovative solution called Resolve™ that monitors, correlates, and analyzes real-time evidence-based social determinants to support proactive outreach based on research-informed risk factors. ClearForce is changing the legacy model of care by not waiting for the veteran to call, text, or ask for help. Informed by research from the VA, Department of Defense (DoD), Centers for Disease Control and Prevention (CDC), the University of Virginia, and other leading academic and scientific research, ClearForce employs new thinking, new technology, analytics, behavioral science expertise, health sciences acumen, and enhanced privacy to advance the science of community-based care. The Resolve solution will enable organizations to provide targeted outreach to individual veterans, not as victims or broken people, but as warriors who need the resources and support to move forward in a positive direction.
ClearForce utilizes public data to set triggers tied to the science of prevention to alert when a veteran may be at elevated risk due to financial pressure, legal and law enforcement challenges, homelessness, substance abuse, or relationship issues. All of these factors have been demonstrated to be indicators of enhanced suicide risk.
To be clear, this is not an intrusive data solution; rather, it deploys technology grounded in privacy, legal compliance, non-biased decisioning, and data protection. Privacy and compliance are the keys to unlocking the value of social determinants to identify those who are struggling. Our solution employs advanced anonymization and serves as a technology conduit to allow supporting organizations to define risk triggers and become aware of behavioral risk in real-time. Social determinant alerts can also be integrated with other data within our secure workflow or shared with other systems to form a more comprehensive understanding of the veteran.
For the Resolve platform to make the biggest impact, social determinant information that is predictive and meaningful but also limited in scope must be curated. This solution aggregates social determinant attributes and applies machine learning and Artificial Intelligence (AI) to support an analytic decisioning capability and the creation of a composite risk score of a veteran that measures their suicide risk. By aggregating source data on individual veterans, one can view a more complete and holistic picture of the veteran. This integrated understanding is critical to early intervention.
Resolve focuses on harnessing multiple sources of real-time information to help identify at-risk veterans and support proactive intervention. The program will be able to identify precisely when a struggling veteran reaches out on public-facing social media.
Effective intervention cannot solely rely upon generalized population-based assessments, they must be able to focus on the one individual who is struggling. Consider the value of the “check engine” light in a vehicle. It comes on early when a component is pending failure and it brings the impending issue to the forefront. Resolve enables the individual veteran to have a check engine light that illuminates early concerns, signifying they would benefit from focused and enhanced attention. The platform's role-based architecture secures access to sensitive information, protects privacy through initial anonymization, automates consistent and compliant workflows, and builds a full audit trail of accountability.
Today, a struggling veteran must take the first step on their path to course correct and move forward on a positive trajectory. This starts with the veteran realizing they are struggling, and then they must navigate the barriers, real or perceived, to access the resources intended to support them. Currently, supporting organizations and the VA address this challenge with awareness campaigns and population-based outreach. For example, following the U.S. withdrawal from Afghanistan, the VA and many VSOs supported an awareness campaign to inform veterans of options to talk about their feelings, and to remind them their service and sacrifice mattered. ClearForce can enhance this reactive, population-based model by identifying and connecting the veteran who is struggling, thus reducing the burden placed on the veteran today.
While awareness population-based campaigns are important tools, ClearForce will enable organizations to become aware of the specific veteran who is struggling before they get into crisis and make bad decisions that exacerbate their challenges. Any individual veteran can be enrolled into ClearForce’s solution by an organization to unlock the use of publicly available behavioral data or offered the opportunity to join a private reporting ecosystem where ClearForce enables the organization to become their virtual wingman or combat buddy. Both options allow the organization access to proactive, push-based alerting tied to behavior or event-based risk, which is supported by decades of research.
As an example, a veteran who is struggling financially would be identified through a financial alert that was sourced from public record data. That alert would be transmitted via ClearForce to an organization in real-time, and that decision would move the veteran to the top of a calling queue. If the veteran is deemed to be at elevated risk and in need of more than a call, ClearForce would suggest the best option to support them.
For those veterans who opt into the full Resolve platform, additional functionality with our web-based reporting portal will be provided. The reporting portal supports both on-the-record and anonymous communication paths. It structures reporting input using a configurable set of drop-down menus that the veteran can follow to fully capture their experience. It can include assessment functions, such as the Columbia-Suicide Severity Rating Scale (C-SSRS).
The reporting portal can also be tailored to allow a veteran to identify friends, family, and fellow veterans to join their “Tribe.” This will allow the veteran to have a built-in connectedness function with those they trust or served with. This enhances the organization's understanding and establishes a line of communication that can add context to their overall understanding of the veteran. Another advantage of the “Tribe” is that veterans can also be part of helping others within their “Tribe.” A strong coping mechanism to prevent suicide and improve resilience is peer support, and the idea of the “Tribe” expands on this. Veterans lose some of this connectedness when they transition out of DoD or the National Guard. The “Tribe” can help restore connectedness with our enhanced reporting capability.
ClearForce deploys a secure cloud technology platform operating with the highest levels of information security controls that is independently audited and certified as SOC2 Type II compliant. The platform functions as a technology conduit for healthcare systems to securely receive alerts on their side of the firewall. Our system serves as an automated event aggregation engine and a centralized platform to consume specific social determinant attributes and make the results actionable.
Beyond potential substance abuse issues, the compounding impact of being arrested or possible incarceration can create a heightened risk to mental health. DoD reports state that approximately 15% of veterans who died by suicide were struggling with using drugs or alcohol, and approximately 26% were dealing with administrative or legal difficulties 90 days prior to death. In most cases, it will not be a single data point that indicates heightened risk, but rather patterns or multiple occurrences of adverse events.
ClearForce can be quickly deployed and integrated as part of an existing system or function as a stand-alone capability. For our commercial customers, an initial deployment can take less than two weeks, which includes training, deployment, and integration.
One of the primary barriers to accessing individual veteran data is privacy. ClearForce is a market leader in compliance and privacy. ClearForce partnered with a preeminent privacy and employment law firm, to build a best-in-class workflow and ensure the users of its platform maintain compliance with federal and state privacy laws. ClearForce supports compliance with the Fair Credit Reporting Act (FCRA) and U.S. Equal Employment Opportunity Commission (EEOC). These added features lockdown guard rails that support privacy and build trust within the community.
Broad-based outreach to curb veteran suicide is only partially effective because it depends exclusively on bottom-up engagement. There is an opportunity for local, and state governments, Veteran Service Organizations (VSO) and other participating organizations to be able to reach out directly to a specific veteran precisely at a time when they are at their most vulnerable.
Resolve is anchored on the critical pillars of trust, science, empowerment, and technology. Our multi-disciplined and leadership-centric approach combines proven technology, decades of research and science, subject matter experts from clinical and public health, and successful business acumen to both prevent and reduce veteran suicide.
