The Office of Research and Development (ORD) is currently transforming from an organization that has been structured around research methods (basic science, clinical science, health service, rehabilitation) to one based on Veteran problem areas and diseases. Research in domains that are particularly important to Veteran health will be managed in discreet portfolios referred to as Actively Managed Portfolios (AMPs). Because suicide prevention is a priority area for the Department of Veterans Affairs, suicide prevention projects will be managed using the AMP model beginning October 1, 2024, and this AMP (referred to as the Suicide Prevention Actively Managed Portfolio (SP-AMP)) will serve as the home for all types of projects that seek to improve the understanding of suicide and prevent suicidal behavior. The SP-AMP will include suicide prevention projects that had previously been supported by all services (BL, CS, HS, & RRD), and moving forward, the SP-AMP will support investigations that utilize the full spectrum of research methods including preclinical, translational, clinical, and health services/implementation studies.
Investigators who are interested in submitting a project that is primarily concerned with improving our understanding of suicide or preventing suicidal behavior should submit their application to the SP-AMP for consideration. This interest in the SP-AMP would be indicated during the pre-application process when investigators are asked to designate the project’s responsiveness to an ORD Notice of Special Interest (NOSI). For FY25, the SP AMP intends to release two NOSIs. The primary NOSI will be a “broad” NOSI that is designed to capture the full range of suicide prevention studies. It is anticipated that majority of suicide prevention studies funded by ORD will be investigator-initiated projects that will be captured through this broad funding announcement. But, in addition to the broad NOSI, the SP AMP will release a more focused NOSI that is designed to support research in specific priority area(s) for the SP-AMP in the upcoming fiscal year.
The aim of the focused NOSI is to highlight the need to support research areas that might be particularly helpful in advancing treatment and prevention efforts and follows from one of the core capabilities of the AMP which is to is to establish a research agenda and prioritize research domains that could rapidly translate into improved treatment and prevention. To lead the development of the SP AMP research agenda and to determine priorities for the SP AMP portfolio, an Executive Steering Committee was formed and includes leaders from clinical partners, Veteran stakeholders, ORD, field investigators, and other funding agencies. The SP AMP Executive Steering Committee utilized a process created by VA Quality Enhancement Research Initiative (QUERI) that involved 3-steps in prioritization establishment. The steps in prioritization determination included (1) identifying existing priorities and implementation gaps, (2) soliciting stakeholders’ feedback about the importance of each topic area, and (3) allowing organizational leaders to review collected data and then rank/prioritize topics.
Utilizing the QUERI prioritization process, the SP AMP Executive Steering Committee first reviewed existing priorities published by governmental (e.g., CDC, DoD, VA) and non-governmental organizations (e.g., APA, American Suicide Foundation) that had vested interests suicide prevention. This review identified 156 separate suicide prevention priority statements. Through a systematic process of coding domains by key words located within each statement, the SP AMP team distilled the 156 priority statements into 11 research domain areas (e.g., identification of suicide risk; non-somatic suicide prevention interventions) that were to be considered by the Executive Steering Committee as candidate topics for prioritization. Utilizing both survey and focus-group methods, the SP AMP team then sought feedback from stakeholders, including Veteran groups with interest in suicide prevention, suicide prevention investigators, administrative leads in mental health and suicide prevention, and direct clinical staff involved in suicide prevention, on the relative importance of research topic domains. Information obtained from the stakeholders, along with an analysis of ORD’s current suicide prevention portfolio, was presented to the Executive Steering Committee who then completed a prioritization ranking exercise. [Meeting minutes, slides, materials, and recordings can be found below]
The results of this prioritization exercise showed that the committee strongly supports prioritization of Lethal Means Safety (LMS) research for the portfolio. As highlighted in the 2024 VA / DoD Suicide Prevention Clinical Practice Guidelines, ready availability of a firearm confers additional suicide risk and decreasing access to firearms can decrease suicide. However, there is limited evidence on the best approaches to promote firearm safety in Veterans. Because advances in LMS approaches to suicide prevention could prevent Veteran suicide death and because of the relative underfunding of this research domain, the SP AMP Executive Steering Committee recommended prioritization of this research domain through a separate focused NOSI for the upcoming funding cycles.
The resultant LMS NOSI is designed to promote research that could improve the state of the science for lethal means interventions, including lethal means safety counseling, LMS messaging, and other strategies that limit access to lethal means during periods of elevated suicide risk. This NOSI represents the manifestation of SP AMP priority setting process and is intended to provide opportunities to expand our LMS research in ORD. The NOSI will include suggestions offered by LMS experts on the type of projects that could advance the state of the science and lead to advancements in suicide prevention practice. And, of course, it is the intention that the LMS NOSI will support research that will ultimately lead to evidence-based interventions that will reduce suicide in the Veteran population.
Both the broad and specific NOSIs for the SP AMP will be released this summer and will be announced broadly and through multiple channels. Once released please contact Joe Constans (Joseph.Constans@va.gov) or your program officer with any questions about possible applications to the SP AMP.
For more information, visit the ORD Suicide Prevention AMP page: Suicide Prevention Research.
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