Telehealth clinical technician Tina Torres (right) and Kathryn Samaniego, a doctor of audiology, work on the teleaudiology system at the Moab VA Clinic on Jan. 23. The clinic offers both telehealth services and in-person doctor visits to veterans. [Photo by Kevin D. Brydie / Moab Sun News]

After wrapping up three overseas tours with the U.S. Marine Corps, Moab resident Jacob Suter sees a fix for local veterans struggling with their health.

“I really can’t say enough good about the folks at our VA clinic,” Suter said. “We’re fortunate to have an outpatient clinic with the dedicated staff that’s there.”

Fifteen of Suter’s comrades in arms have committed suicide. Today, he works for the National Park Service and organizes his health care assistance and treatment locally through the Moab Veteran’s Affairs (VA) Clinic. He recently switched over from its telehealth services — appointments done through two-way, real-time audio and visual communication — to seeing an in-person doctor now available at the clinic on Mondays and Thursdays.

While he sees the in-person appointments with a doctor as a fix to improving health care access for veterans in the Moab area, he thinks the overall issue of suicide is still complex.

“I don’t think there’s a straightforward answer on how to fix that,” Suter said. “I just know it’s going to take a lot of work, a lot of people, and probably a lot of money to try to get that veteran suicide rate down.”

It’s something the clinic is keeping an eye on — efforts by the VA to address suicide include preventative measures like the Veterans Crisis Line and community outreach. Protocols are being adapted for VA employees to be able to better identify veterans who may be at risk and quickly connect them to mental health resources.

When the Moab VA Clinic opened in 2010, it offered nursing services and long-distance medical care through telehealth technology only. Veterans in Moab have been driving to Grand Junction, Colorado, to meet with doctors in-person and seek out assistance that they may need.

Renee Dunn is the doctor now providing in-person appointments at the Moab clinic.

Dunn worked for the Department of Veteran’s Affairs (VA) in San Antonio, Texas, for more than 15 years until this past summer, when she and her husband moved to Monticello. Throughout her career, Dunn has worked with emergency room care, home-based primary care and in geriatric health.

As they settled in, Dunn did some research and reached out to the local clinic.

“I knew this clinic was here,” she said of the Moab VA Clinic, “and I asked them if I could play a part in it. And it slowly evolved, and they got me down here in September.”

On days when she’s not in Moab, Dunn sees patients in Craig, Colorado, through telehealth technology from her home in Monticello. She said that providing long-distance care is a great option when there’s no clinic close by, but also said it’s not a perfect substitute for in-person examinations and consultations.

“I don’t want to play down the camera,” she said. “It actually gives a way to reach out to rural patients. But in my opinion, a face-to-face visit is also really great.”

When you meet with a patient on camera, Dunn said, “you miss the other senses. It’s good, but it’s not the best.”

Suter agrees that an in-person doctor is preferable to health care administered through a screen.

“Me personally, I do appreciate being able to speak face-to-face with somebody,” he said. Though he added, “If all I had was telehealth, I believe I could have made that work.”

Though many federal agencies have been disrupted by the current partial government shutdown, the U.S. Department of Veteran’s affairs has not been disrupted. In a Dec. 21 press release, Veterans Affairs Secretary Robert Wilkie made a statement in anticipation of the shutdown.

“Thanks to the leadership of President Trump and Congress, the VA is fully funded for fiscal year 2019, and in the event of a partial government shutdown, all VA operations will continue unimpeded,” he said.

When asked about the primary health concerns for veterans, Dunn said that the complexity of the health care system can leave some patients confused, and they might miss out on benefits for which they may be eligible.

“[Veteran patients] think that they have to drive all the way to Grand Junction for many things, which they don’t,” Dunn said.

Older patients who are using Medicare may not know that they can combine Medicare assistance with VA benefits to get more services, she said. This can include hearing aids and eye screenings. Because the closest full-service VA medical center in Grand Junction is more than 40 miles away, patients can arrange to have tests and procedures done at local facilities using their VA benefits. The clinic can also arrange to provide rides to veterans to and from Grand Junction when procedures and appointments are outside the scope of local care.

The Veterans’ Affairs Western Colorado Health Care System is based in Grand Junction and covers the Moab area. It has joined the VA in an effort to address the high rates of veteran suicide.

“Suicide prevention is the top clinical priority for the U.S. Department of Veterans Affairs and the VA has adopted a public health approach to suicide prevention,” said Shawn Montgomery, the acting director of communications and community development for the VA Western Colorado Health Care System. 

“Each community across the country plays a role in supporting Veterans, and communications and messaging about the resources available to Veterans and their families and caretakers is where we need help,” he said.

For example, the VA has produced a suicide prevention training video called S.A.V.E. The video is aimed at friends, family members and co-workers of veterans who may be experiencing mental health issues.

S.A.V.E. stands for “Signs,” “Ask,” “Validate,” “Encourage,” and “Expedite,” which are steps a person can take if they think a veteran is at risk of suicide or needs mental health care.

A report from the Veterans Health Administration estimated that the number of veteran deaths by suicide averaged 22 per day in 2012.

“Whenever a veteran comes in, we ask them specific questions about suicide,” Dunn said. “If they have any positive answers, then we refer them right away and they’re seen by mental health professionals from Grand Junction on the camera the same day before they leave the clinic.”

Suter said he has noticed the changes the VA is making in an effort to address veteran suicide rates.

“I think overall there’s been a lot of awareness brought to the suicide rate of veterans,” he said. “Any time you call in to the VA, like to schedule an appointment, it always gives you a prompt that says, ‘If this is an emergency call 911; if you’re having thoughts of suicide call this number,’ and they give you that suicide hotline number.”

He thinks the local clinic is doing a good job of providing services to local veterans.

“I’m very happy with the fact that in a town of less than 10,000 people, we have an outstanding clinic,” he said.

Access to health care increases for Moab veterans

“I just know it’s going to take a lot of work, a lot of people, and probably a lot of money to try to get that veteran suicide rate down.”

Dial 1-800-273-8255 and press 1 to talk to someone.

Send a text message to 838255 to connect with a VA responder.

Go to to start a confidential online chat session.

Do an online assessment at with a self-check quiz.

Visit for more information and resources on veteran suicide prevention.