September 2023

In This Issue: HSR&D Research on Suicide Prevention

Preventing Suicide Among Female and Male Veterans Not Receiving VHA Services

Feature Article

Takeaway: Compared to female civilians, female Veterans are twice as likely to die by suicide. Most Veterans who have died by suicide did not use VHA healthcare in the year prior to their death, but knowledge is limited regarding possible differences between VHA and non-VHA users with respect to who died by suicide and barriers to mental healthcare. This study is among the first to identify factors that differentiate VHA and non-VHA suicide decedents and to explore female and male Veterans’ experiences and preferences for seeking help when suicidal.

Compared to female civilians, female Veterans are twice as likely to die by suicide. Most Veterans who have died by suicide did not use VHA healthcare in the year prior to their death. However, because most Veteran-focused suicide prevention research has focused on VHA users and male Veterans, knowledge is limited regarding possible differences between VHA and non-VHA users with respect to who died by suicide, precipitating circumstances of death, and gender differences within these domains. Knowledge is also limited regarding barriers to accessing mental health (MH) care.

This ongoing study (June 2020–May 2024) is among the first to identify factors that differentiate VHA and non-VHA suicide decedents and to explore female and male Veterans’ experiences and preferences for seeking help when suicidal. Researchers will compare three groups of Veterans (recent VHA users, never VHA users, and those lost to care) and gender differences across the following aims:

• Identify factors that differentiate Veteran suicide decedents (e.g., circumstances of death, MH care use).
• Examine differences in Veterans’ willingness to seek MH care, barriers to MH care, and MH care experiences.
• Describe and compare Veterans’ experiences, preferences, and barriers to help-seeking when suicidal.

Methods

Data from national sources have been combined for Veteran suicide decedents to evaluate circumstances of death (e.g., interpersonal and socioeconomic stressors, MH problems), as well as VHA MH care use (for VHA and lost-to-care decedents). Living Veterans have been surveyed to explore their willingness to seek MH care, barriers to doing so, and MH care experiences. Veterans with a history of suicidal ideation and/or suicide attempt have been interviewed to explore their experiences, preferences, and barriers to obtaining help when suicidal.

Findings will be reported at INQQUIRE-VETS - MIRECC / CoE (va.gov) as they become available.

Anticipated Impact

Findings are expected to increase knowledge of female and male Veterans who died by suicide, including circumstances surrounding death, and the extent to which suicide decedents accessed MH care prior to death. In addition, findings are expected to facilitate opportunities for implementing patient-centered, gender-sensitive suicide prevention strategies for Veterans, including those who have not recently used VHA services. Stakeholder input will be obtained to propose actionable clinical and policy changes.

Principal Investigators

Lindsey L. Monteith, PhD (left) and Claire Hoffmire, PhD (right)

Lindsey L. Monteith, PhD, and Claire Hoffmire, PhD, are part of the Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention in Aurora, CO.

Recent related publications by these investigators

Hoffmire CA, Brenner LA, Katon J, Monteith LL, et al. Women Veterans’ perspectives on suicide prevention in reproductive healthcare settings: An acceptable, desired, unmet opportunity. Women’s Health Issues. July 1, 2022;32(4):418–425.

Monteith LL, Holliday R, Dichter ME, Hoffmire CA. Preventing suicide among women Veterans: Gender-sensitive, trauma-informed conceptualization. Current Treatment Options in Psychiatry. June 15, 2022;9(3):186–201.

Monteith LL, Holliday R, Hoffmire CA, et al. Female Veterans’ willingness to seek Veterans Health Administration and non-Veterans Health Administration services for suicidal thoughts and mental health concerns. Medical Care. February 2021;59:S23–S30.

View the study abstract.