Clinical Outcomes of Telehealth-Based Cognitive Behavioral Therapy for Suicide Prevention in the US Department of Veterans Affairs.

Betthauser LM, Walker JA, van Engelen L, Lhermitte S, Ilgen M, Hoff R, Stacy M. Clinical Outcomes of Telehealth-Based Cognitive Behavioral Therapy for Suicide Prevention in the US Department of Veterans Affairs. Suicide & Life-Threatening Behavior. 2025 Oct 1; 55(5):e70044, DOI: 10.1111/sltb.70044.

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• RCS 19-333 – Research Career Scientist Award

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Abstract:

INTRODUCTION: US Veterans are at higher risk for suicide compared to the general population. Access to evidence-based practices for suicide prevention (EBP-SPs) is limited; however, emerging research supports the delivery of EBP-SPs through telehealth. The Veterans Health Administration''s (VHA) Suicide Prevention (SP) 2.0 Clinical Telehealth Program aims to increase nationwide access to EBP-SPs for Veterans with recent suicidal self-directed violence (SSDV). This paper describes initial outcomes of SP 2.0''s Cognitive Behavioral Therapy for SP (CBT-SP). METHODS: From April 2021 to September 2023, SP 2.0 provided EBP-SPs to Veterans via telehealth. Veterans were eligible if they were enrolled in VHA care and engaged in SSDV (suicide attempts and/or preparatory behavior) in the past 12?months. CBT-SP was provided via VHA''s telehealth platform, accessible to all 139 VA Health Care Systems in the US. Outcomes were captured via electronic health records and analyzed using logistic regression and generalized linear models. Significance was set at p? < 0.003. RESULTS: Veterans (N? = 2712) received an average of 8.54 CBT-SP sessions. Models demonstrated improvements in suicide-related coping, depression, suicidal thought intensity, hopelessness, urge and intent to kill self, and self-efficacy. CONCLUSION: Providing CBT-SP via telehealth is feasible and Veterans demonstrated several improvements. Implications and future research directions are discussed.