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Health Services Research & Development

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HSR&D In Progress

March 2022

In This Issue: HSR&D Research on Social Determinants
» Table of Contents


Can Services to Address Veterans’ Social Determinants of Health Reduce Suicide Risk?

Feature Article


Takeaway: Results of this study are expected to lay the groundwork to develop implementation trials to bolster VA and community social support services as non-medical components of suicide prevention for Veterans, including increasing linkages to services for social determinants of health (SDH) among Veterans with histories of suicidal crisis, as well as enhanced suicide prevention training for providers to integrate into SDH services.


The rate of suicide among Veterans is approximately 50% higher than among non-Veterans, despite accessible and effective suicide prevention strategies offered by VA. This indicates a continued need to identify Veterans at risk for suicide and provide interventions to prevent suicide. Suicide prevention can be enhanced when healthcare systems integrate dynamic social determinants of health, such as housing instability, justice involvement, and unemployment. Therefore, the goal of this ongoing study (October 2020 – June 2024) is to address prevention activities that occur “upstream” by examining how services addressing SDH may also prevent suicide among Veterans, which are key objectives in VA’s National Strategy for Preventing Veteran Suicide 2018–2028. This study aims to:

  • Determine whether VA services tailored to address social determinants of health may also have an added benefit of preventing suicide mortality;
  • Identify organizational assets and opportunities to improve how SDH-focused services address suicide risk among Veterans; and
  • Engage Veterans in identifying ways to integrate suicide prevention into VHA programs that respond to social determinants of health.

Methods

The proposed research is a concurrent mixed-methods design. Retrospective quantitative analyses will examine how VA services tailored to Veterans’ social determinants of health (i.e., housing instability, justice involvement, unemployment) may protect against suicide mortality and morbidity. A mixed methods environmental scan will include a questionnaire of staff/key informants and qualitative interviews. Qualitative interviews with Veterans with a history of suicide risk will explore how services to address SDH respond to those needs.

Findings

None to report at this time.

Anticipated Impact

Results of this study are expected to lay the groundwork to develop implementation trials to bolster VA and community social support services as non-medical components of suicide prevention for Veterans, including increased linkages to services for SDH among Veterans with histories of suicidal crisis, as well as enhanced SDH training for providers to integrate suicide prevention into services. Moreover, investigators have convened an array of VA operations partners—Social Work, VA Homeless and Justice Programs, employment programs, and VA Office of Mental Health and Suicide Prevention—to facilitate removing siloes around social determinants of health and suicide prevention, amplifying VA’s current infrastructure to bolster suicide prevention.

Principal Investigators:  Gala True, PhD, is part of the South Central MIRECC, Southeast Louisiana Veterans Health Care System, and Ann Elizabeth Montgomery, PhD, MSW, MPA, is part of VA Birmingham Health Care in Birmingham, AL

Publications

None to report at this time.

View study abstract

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