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Health Services Research & Development

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2023 HSR&D/QUERI National Conference Abstract

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1201 — Recommendations from Women Veterans for Strengthening Veterans Crisis Line Services for Women Veterans

Lead/Presenter: Melissa Dichter,  COIN - Pittsburgh/Philadelphia
All Authors: Dichter ME (Center for Health Equity Research and Promotion, Philadelphia), Monteith L (Rocky Mountain MIRECC for Suicide Prevention) Krishnamurti L (Center for Health Equity Research and Promotion, Pittsburgh) Agha A (Center for Health Equity Research and Promotion, Philadelphia) Iverson K (National Center for PTSD, Boston)

Objectives:
The Veterans Crisis Line (VCL), the VA’s free 24-hour crisis hotline, is designed to provide crisis and suicide prevention support all Veterans, regardless of demographic characteristics. Earlier research has found gender differences in crisis experiences and suicide prevention needs of Veterans and suggests that women Veterans’ use of VCL may differ from that of men Veterans’. There has been little research to date, however, specifically focusing on women Veterans experiences with VCL and the functioning of VCL for the women Veteran population. The object of this study was to understand women Veterans’ experiences with VCL and identify women Veterans’ recommendations for strengthening VCL services for this population.

Methods:
We conducted in-depth qualitative interviews, via telephone, with 26 women Veterans who had contacted VCL within the 12 months prior to recruitment. Veterans were recruited to participate via letters and follow-up telephone calls to those who had received Veterans Health Administration (VHA) healthcare in the prior year. Thus, participants were limited to women Veterans who also use VHA care, but, as VCL use was self-identified by the Veterans, the study was not limited to those who provide their identifying information on VCL calls (i.e., includes Veterans who contact VCL anonymously). Interviews were audio-recorded, with participant consent, and transcribed verbatim. Team-based inductive content analysis approaches were used to code the transcript data and identify themes.

Results:
Participants strongly recommended that VCL callers be provided an option of VCL responder gender, noting that for some women Veterans, for some topics, speaking with a woman responder is critical. Comments and recommendations regarding responder gender came up spontaneously (i.e., without prompting from the interviewer) in the overwhelming majority of interviews. Participants also recommended that: there be enhanced marketing of VCL to women Veterans, including the scope and function of VCL services; that VCL callers be provided with options with regards to follow-up contact from VCL after the VCL call; and that VCL responders have training and competence in general therapeutic skills and specific skills and knowledge with regards to responding to issues of gender-based violence. Finally, women Veteran participants noted VCL as a critical resource and recommended that the service continue to: be available to women Veterans as a place to receive support and referrals, as well as a place to just talk, especially in the middle of the night and when other resources are not available; offer options to call or text/chat; offer option to remain anonymous.

Implications:
Findings from this study of women Veterans’ perspectives on recommendations for strengthening VCL for women Veterans offers concrete suggestions for improving both marketing and functioning of VCL, noting unique and specific needs of women Veteran callers.

Impacts:
Findings from this study can be used to further strengthen VCL services for the specific population of women Veterans. Qualitative data from individual interviews offers the voice and perspective of women Veterans who have experience with VCL services.