By Christine Sexton, Florida Phoenix
Florida is stepping up its efforts to help abate veteran suicide by agreeing to spend $300,000 this year to expand statewide a suicide prevention program that now operates in only a handful of counties.
SB 116, which passed the Legislature unanimously and was signed into law by Gov. Ron DeSantis last month, goes beyond mental health services. It directs the Florida Department of Veterans Affairs (FDVA) to develop a statewide plan to establish adult day health care facilities across the state to serve veterans and their families.
Florida Department of Veterans Affairs Deputy Executive Director Bob Asztalos. (Photo via Bob Asztalos)
“This was our big bill, and we are very excited about the stuff in it. I mean, it’s, really good stuff,” the agency’s deputy executive director, Bob Asztalos, told the Florida Phoenix.
The National Library of Medicine notes that “suicide is a major public health challenge that disproportionately affects service members and veterans.” And for the past 12 years, suicide rates have been consistently higher among veterans than nonveterans.
Six hundred and twenty-two Florida military veterans killed themselves in 2023, the latest available data. That’s a dip from 655 veteran suicides in 2022 but an increase from the 612 who killed themselves in 2021.
This was our big bill, and we are very excited about the stuff in it. I mean, it's, really good stuff.
– FDVA Deputy Executive Director Bob Asztalos
Asztalos expects the expanded suicide training to become available for veteran service officers in the fall. These staff are co-located at U.S. Department of Veteran Affairs outpatient clinics, VA medical centers, and VA regional offices across the state. They understand federal and state laws regarding veteran benefits and help veterans navigate the system.
“They’re like our frontline troops, right? They’re out there in the field meeting with veterans every day, and so this is great training for them, because they’re the ones who run across the veterans who are, you know, having suicidal thoughts,” Asztalos said.
He added that the program won’t be limited to state employees but will include county-level staff who work with the American Legion and the Veterans of Foreign Wars.
“We’re going to open it up to any [service officer] who works day-to-day with veterans in crisis,” Asztalos said.
Asztalos said the agency will turn to The Fire Watch to help with education efforts. Through its “Watch Stander” program, the organization has helped drive down the veteran suicide rates in Duval, Clay, Baker, St. Johns, and Nassau counties since launching in 2019. Although veteran suicide rates in Florida dropped by 5% between 2019 and 2023, it dropped by 25% during the same period in the five northeast Florida counties served by The Fire Watch, Florida Department of Health data show.
Asztalos said he expects the expanded suicide prevention offerings to become available in the fall.
No ketamine for vets
Jon Albert via Florida House
U.S. Marne Corps veteran and state Rep. Jon Albert submitted a funding request for a five-year study into the effects of ketamine for the treatment of major depressive disorder among veterans and first responders. The $300,000 would have covered the first year of study preparation, regulatory approvals, staff hiring, and software programming. The goal was to begin treatment cycles for up to 250 veterans and first responders.
The study would have involved a large-scale multidisciplinary team, with input from University of Florida VA faculty and a Johns Hopkins collaborator, among others.
The Legislature included it in the state fiscal year 2025-26 budget, but Gov. Ron DeSantis vetoed it.
The Journal of American Medicine in 2017 published a consensus statement highlighting the need for the study of ketamine use for depression and mood disorders. Esketamine, a form of ketamine, is FDA-approved for managing depression that hasn’t responded to standard treatments. Ketamine itself is used off-label to treat depression.
Asztalos said the FDVA never took a position on funding the five-year study.
The Sgt. Ernest I. “Boots” Thomas VA Clinic in Tallahassee. (Photo by Michael Moline/Florida Phoenix)
Joining the ranks of VA adult day care
The U.S. Department of Veterans Affairs allows the use of adult day care program for veterans who reside at home but need help with activities of daily living such as bathing, grooming, and eating. Only New York and Iowa now are taking advantage of the adult day care centers, which can be located at VA facilities, such as nursing homes and hospitals, Asztalos said.
Florida will join those ranks when it opens a new VA nursing home in Collier County, Asztalos said, with plans to build an adult day care facility at the new home. Construction is expected to begin next year and it is anticipated to open in July 2029.
The new law directs the FDVA to develop a plan to establish centers across the state. In considering locations, the state must consider sites that will do the most good for the veteran population and estimate the costs of running the facilities. The report is due to the governor and Legislature on Nov. 1.
Asztalos estimates the facilities will cost about $10 million to construct.
“I would love to start opening up some adult day health cares in conjunction with our existing nursing homes,” he said.
While that’s his goal, he thinks the first two locations for the VA adult day care centers would be Port St. Lucie and Lake City. FDVA also has been approached by a town in South Florida with a vacant building they’d like to turn into an adult day care center.
“We’re going to go down and talk to them and see, so I envision we’re going to give them two, maybe three locations to start,” Asztalos said of the report.
The costs to provide the services would mostly come from the federal government and, Asztalos said, the centers could generate revenue if the state keeps the costs below what the federal government provides to pay for the services. The VA nursing homes until recently have been revenue generators for the state, he said. Florida has nine VA facilities — eight nursing homes and one assisted living facility.
“Usually we make about $5 million a year [collectively]. I mean, COVID and a workforce shortage has thrown us all out of whack, but we’re getting back this year. This year, we’re down a little bit less than a million dollars in deficit, but next year we’ll be back in the black completely.”
The National Suicide Prevention Lifeline can be reached at any time by calling 1-800-273-8255.
