September 2023

In This Issue: HSR&D Research on Suicide Prevention

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

Feature Article

Takeaway: Suicide prevention can be enhanced when healthcare systems address adverse social determinants of health (SDH) such as housing instability, justice involvement, and unemployment. This study integrates a public health perspective to suicide prevention, viewing suicide risk and the complex needs of Veterans at risk of suicide through a lens of SDH.

Suicide prevention can be enhanced when healthcare systems address adverse social determinants of health (SDH) such as housing instability, justice involvement, and unemployment. This ongoing study (October 2020–June 2024) seeks to enhance prevention activities that occur “upstream” by examining how services that address SDH might also prevent suicide. It aims to:

• Determine whether VA services tailored to address SDH might also prevent suicide.
• Identify organizational assets and opportunities to improve how SDH-focused services address suicide risk among Veterans.
• Engage Veterans in identifying ways to integrate suicide prevention into VA programs that respond to SDH.

Methods

This study is using administrative data and the perspectives of providers (e.g., suicide prevention coordinators and staff of VHA Homeless, Justice, and employment programs) and Veterans to explore how addressing SDH can decrease suicide risk, taking into account the complex needs of Veterans who might be at risk for suicide. Methods include retrospective quantitative analyses, a questionnaire for staff and other key informants, and qualitative interviews with providers and Veterans.

Findings are not yet available.

Anticipated Impact

Findings will lead to actionable implementation projects, such as increased links to services that address SDH among Veterans with histories of suicidal crisis, as well as enhanced training for providers to integrate suicide prevention into services that address SDH, and vice versa. The study’s researchers have engaged several VA operations partners—Social Work, VHA Homeless and Justice programs, employment programs, and VA’s Office of Mental Health and Suicide Prevention—to facilitate information sharing and collaboration around SDH and suicide prevention in VA.

Principal Investigators

Ann Elizabeth Montgomery, PhD (left) and Gala True, PhD (right)

Ann Elizabeth Montgomery, PhD, is part of the Birmingham (AL) VA Health Care System and VA’s National Center on Homelessness Among Veterans. Gala True, PhD, is with the South Central Mental Illness Research, Education, and Clinical Center at the Southeast Louisiana Veterans Health Care System in New Orleans, LA.

Recent related publications by these investigators

Robinson M, Holliday R, Montgomery AE, et al. Establishing a research agenda for suicide prevention among Veterans experiencing homelessness. Frontiers in Psychology. February 7, 2022;13:683147.

Montgomery AE, Rahman AKMF, True JG, et al. The importance of context: Linking Veteran outpatients screening positive for housing instability with responsive interventions. Administration and Policy in Mental Health. January 1, 2021;48(1):23–35.

View study abstract.