September 2022

In This Issue: Women's Health Research

Advancing Suicide Prevention for Female Veterans

Feature Article

Takeaway: This study aims to develop and test explanatory models of female and male risk for repeat suicidal self-directed violence over 12 months, and to identify similarities and differences in healthcare utilization patterns, coping strategies, and symptom change over time among female and male Veterans at risk for attempting suicide.

The suicide rate among female Veterans increased 63% between 2000 and 2014—significantly more than the 30% increase observed in male Veterans during this period. Despite a large volume of work examining risk factors, barriers to care, and care utilization among Veterans, little research has examined these issues as they relate to women. Further, data on female risk for suicide and females’ healthcare utilization is needed to direct valuable suicide-prevention resources and help VA address this growing concern.

Using a large, national sample of female and male Veterans with recent nonfatal suicidal self-directed violence (SSV), this ongoing HSR&D study (May 2018–April 2023) aims to:

• Develop and test explanatory models of female and male risk for repeat SSV over 12 months.
• Identify similarities and differences in healthcare-utilization patterns, coping strategies, and symptom change over time in female and male Veterans at risk for SSV.

Methods

This study is guided by a public health framework to facilitate examination of a range of risks for SSV. Using VA data, researchers will identify and enroll up to 30 female and 30 male Veterans for whom a nonfatal SSV event was recorded in a suicide-behavior report. These 60 Veterans will participate in qualitative interviews to gather data on their perspectives and experiences with suicidal thoughts and SSV, their recovery needs and experiences with the recovery process, barriers and facilitators to care, and how clinicians and the healthcare system could better identify and address the needs of Veterans like them. Following these interviews, at least 480 female and 480 male Veterans will be recruited to complete health and psychosocial measures at baseline, six, and 12 months to assess and document all SSV events. Self-report questionnaires will be informed by the earlier qualitative findings and include psychosocial and health-related measures such as coping efficacy, interpersonal conflict, positive relations with others, trauma, occupational problems, barriers to care, and mental health symptoms. Researchers will then identify differential responses to healthcare use and how certain health and psychosocial variables cluster together by gender.

Findings

None yet available.

Anticipated Impact

Findings will support the selection of intervention targets and the identification of high-priority services and barriers to care for female Veterans at risk for SSV. This work also has the potential to benefit the broader population of female Veterans with mental health conditions or other risk factors for SSV.

Principal Investigator: Lauren M. Denneson, PhD, MS, is a core investigator with HSR&D’s Center to Improve Veteran Involvement in Care (CIVIC) in Portland, OR.

Publications

Denneson L, McDonald K, Tompkins K, et al. Elucidating the chronic, complex nature of suicidal ideation: A national qualitative study of Veterans with a recent suicide attempt. Journal of Affective Disorders Reports. December 15, 2020;2(100030).

Denneson L, Tompkins K, McDonald K, et al. Gender differences in recovery needs after a suicide attempt: A national qualitative study of US military Veterans. Medical Care. February 1, 2021;59:S65–S69.