3 - (SYM 30) Enhancing Suicide Risk Assessment and Prevention Among Military-connected Clients: Insights from a Mixed-methods Study

Veterans are 1.5 times more likely to die by suicide than their civilian counterparts. While universal screening has been shown to increase mental health care enrollment in this community, significant barriers persist in the assessment, identification, and management of suicide risk. Risk assessment tools are critiqued as being perfunctory and unable to capture the full context of risk by military and veteran mental health patients, who may hesitate to disclose symptoms. However, clinical judgement is subjective and highly variable across clinicians. Early identification of risk is a crucial element of suicide prevention, facilitating targeted interventions.

This presentation offers an overview of our recent study to enhance Cohen Veterans Network’s (CVN) suicide prevention ecosystem.  CVN serves veterans, military service members, and their family members, including a disproportionate number of women veterans. We share findings from a mixed methods study exploring experiences of elevated risk clients to better understand risk profiles, resource constraints, and care experiences. Descriptive statistics are used to characterize prevalence of factors relating to suicide risk among our client population and various subgroups, while the relationship of these variables to suicide risk is assessed through logistic regression. Semi-structured interviews with former clients elicited insights into real treatment experiences within CVN’s suicide prevention ecosystem. Results underscore the significant impact of social determinants of health and trauma histories in predicting elevated risk of suicide among our military-connected clients as well as the disproportionate burden of these factors among gender and ethno-racially minoritized clients. Insights from former clients highlight important aspects of care that facilitate risk assessment and management. Several aspects of the CVN care model were highlighted as effective assessment and management tools, including our elevated risk pathway, integrated case management, cultural competency training, and the thoughtful integration and delivery of screening measures that maintains clinician-client connection and conveys genuine concern.

Military-affiliated clients at elevated risk for suicide struggle with a constellation of challenges which impact suicide risk and require comprehensive treatment. By better understanding these risks as well as client care experiences we can improve assessment practices and targeted clinical interventions for this at-risk community.