Suicide among veterans is a critical issue, with U.S. veterans being 1.7 times more likely to die by suicide than their civilian peers. This alarming statistic emphasizes the urgency of bolstering suicide prevention efforts in our veteran and military communities. Cohen Veterans Network (CVN) recently released research aimed at enhancing suicide prevention efforts, supported by a grant from Face the Fight, a coalition established to raise awareness and support for veteran suicide prevention. This research offers vital insights that could help improve clinical practices and training when it comes to suicide prevention.
Understanding Client Experiences in Suicide-Focused Mental Health Care
Researchers conducted two distinct but related studies of CVN’s suicide assessment and prevention ecosystem. First, they utilized qualitative interviews to examine client perspectives on suicide risk management processes across the network. Among the findings:
- Building Trust and Connection: Clients’ development of connection and trust with their therapist was an essential element of therapy, creating a safe environment in which clients felt secure enough to share their experiences with suicidal thoughts and behaviors.
- Safety Planning and Standardized Measures: Despite initial hesitancies, clients found safety planning and standardized measures to be beneficial when they were collaboratively implemented and meaningfully incorporated into therapeutic encounters.
- Skill Building: In-session skill building, and practice empowered positive change.
- Lethal Means Counseling: Lethal means counseling was better received when clinicians were direct in their approach.
“The significance of cultivating a therapeutic relationship that is understanding, supportive, and collaborative cannot be overstated,” says Dr. Tracy Neal Walden, Chief Clinical Officer at Cohen Veterans Network. “By emphasizing empathy and encouraging open dialogue, our clinicians establish a strong foundation for effective intervention. With the support of Face the Fight, these valuable insights help us advance the field by enhancing clinical practice around suicide prevention.”
Identifying Key Risk Predictors
The second study analyzed electronic health record data to identify predictors of clinically elevated suicide risk among veterans and active duty clients. The findings include:
- Mental Health Conditions: Depression and PTSD were strongly predictive of elevated suicide risk.
- Trauma Exposure: A range of trauma exposures including adverse childhood experiences, military sexual trauma, and recent serious traumatic events were also predictive of suicide risk.
- Social Drivers of Health: Importantly, several social determinants of health including housing and employment insecurity, and lack of social support were also linked to increased suicide risk.
These observations underscore the complex interplay of mental health conditions, trauma, and social determinants in predicting suicide risk among military members and veterans. “Our findings highlight the urgent need for comprehensive support systems that address mental health, and psychological trauma, as well as social, environmental and resource challenges faced by veterans and active duty service members,” says Dr. David Linkh, Director of CVN-IQ. “By understanding the multifaceted nature of suicide risk, we can develop more effective prevention and intervention strategies tailored to the unique experiences of these populations.”
The Role of Social-Environmental Challenges
To further explore the impact of social drivers of risk among vulnerable client sub-groups, the research team then conducted a comprehensive analysis of the unique social-environmental challenges faced by minoritized clients across Cohen Clinics. This work illuminates the significant role of case management in mitigating the impacts of these social risks through coordinated care and linking clients to necessary resources.
Learn more about the research.