(PS8-38) Ecological Predictors of Suicide Ideation Among Veterans Seeking Mental Health Services Associated with Military Sexual Trauma

Abstract Text:

Introduction: Suicide risk in Veterans presents a critical public health issue, with the experience of military sexual trauma (MST) linked to a 75% increase in suicide rates relative to Veterans with no MST history (U.S. Department of Veterans Affairs, Office of Suicide Prevention). Past work has reported strikingly high rates of both suicide attempts (SA; 40%) and suicide ideation (SI; 75%) following MST (Monteith et al., 2019). These alarmingly high rates of SI, SA, and suicide deaths highlight a crucial need to identify risk and protective factors. Ecological factors have been shown to impact wellbeing following MST. Notably, past work highlights several ecological factors that differ between subgroups of Veterans with MST, suggesting differential access to these resources (Grau et al., 2022). The availability of resources such as social support, economic stability, and a spiritual or cultural belief system may serve as protective factors against suicide risk. However, this possibility has not yet been explored in individuals with MST history.

Methods: Veterans (N = 582, 69.2% female) seeking MST-specific mental health care at a Midwestern VA PTSD Specialty Clinic presented for semi-structured evaluations and treatment planning. As part of routine clinical care, Veterans were evaluated for current suicide ideation (32.6% endorsement) and completed assessments related to economic/legal factors (stable living environment, economic sufficiency, legal involvement), spiritual/cultural beliefs (belonging to spiritual organization, religious and cultural beliefs prohibiting suicide), social/community factors (having peer relationships, past year exposure to intimate partner violence, meaningful caregiving roles, engagement in meaningful work).

Results: Data were analyzed with a two-step process. First, to evaluate factors associated with current SI, chi-square and Mann Whitney U analyses evaluated between group differences. Among evaluated factors, stable living environment (V = .11), sufficient economic resources (V = .15), spiritual beliefs prohibiting suicide (V = .09), cultural beliefs prohibiting suicide (V = .10), peer relationships (V = .2), and meaningful work (V = .13) were associated with decreased risk of SI with small-to-medium identified effects. Second, a logistic regression analysis was performed using factors identified as significantly associated with SI in the first step. This resulted in a significant model (Nagelkerke R² = .11, p < .001) with having a group of peers (Wald = 14.1, p</em> < .001) and possessing cultural beliefs that prohibit suicide (Wald = 5.81, p = .016) identified as significant predictors though overall explanatory power was small.

Discussion: In line with past work showing high rates of SI in Veterans with MST, almost 1/3 of this sample reported current SI. Potential protective factors included economic and housing stability, spiritual and cultural beliefs, and social factors. Notably, the strongest predictors of decreased SI were the presence of a peer group and cultural beliefs prohibiting suicide. Although effect sizes were small, these findings suggest meaningful connections with others and one’s culture may be protective factors against suicide risk in Veterans with MST history.