Session
Community engagement and partnerships in veterans suicide prevention
APHA 2022 Annual Meeting and Expo
Abstract
Feasibility and Acceptability of Gatekeeper Training for Close Supports of Military Veterans: Mixed Methods Study
APHA 2022 Annual Meeting and Expo
Background: Gatekeeper training is a suicide prevention strategy that relies on social connections to identify and assist individuals at risk for suicide. In collaboration with the Department of Veterans Affairs (VA), PsychArmor Institute developed VA SAVE (Signs; Ask; Validate; Encourage/Expedite), a brief gatekeeper training designed to assist military veterans. While this training is disseminated extensively within the VA and to the general public, no published research has examined the impact of VA SAVE. The aim of this pilot study was to determine the feasibility and acceptability of a remote clinical trial of VA SAVE.
Methods: We conducted a social media campaign using sponsored Facebook posts (ads) to close supports (family and friends) of veterans. Participants were automatically randomized to an online video version of VA SAVE or a video training unrelated to suicide prevention. We followed participants for six months, conducted qualitative interviews with a subgroup, and used a mixed methods framework to integrate quantitative and qualitative findings.
Results: Among 214 participants, 61% were spouses or partners of veterans, 96% had ever worried that someone they knew was thinking about suicide, 44% worried that someone they knew was thinking about suicide in the prior month, and 48% knew at least one veteran who had died by suicide. The vast majority of participants (81.3%) completed at least one follow-up survey at Month 3 or later, and 72.4% completed follow-up at the Month 6 study endpoint. Themes from interviews (n=15) indicated three barriers (e.g., ad text referring to “research, Facebook as an ad platform) and five facilitators (e.g., emphasizing the benefit of receiving training, prior exposure to suicide) to study participation. Satisfaction with VA SAVE was high (CSQ-8 median = 27 [IQR=24-31]), usability was rated excellent, and 71.6% of participants watched at least 70% of the SAVE training video.
Conclusion: Close supports of veterans found VA SAVE to be a feasible and acceptable suicide prevention training to assist veterans at risk for suicide. Several strategies may further enhance study participation when conducting a fully remote trial of gatekeeper training.
Abstract
The Governor’s Challenge to Prevent Veteran Suicide: Partnering with States to Strengthen Social Connectedness
APHA 2022 Annual Meeting and Expo
Background/Context
In 2019, the suicide rate for Veterans was 1.5 times the rate for non-Veteran adults. The Department of Veterans Affairs (VA) has adopted a public health address suicide for all Veterans, not just those who come the VHA for care.
Description
As part of its public health approach, VA has developed a Community-Based Interventions for Suicide Prevention (CBI-SP) model. The Governor’s Challenge to Prevent Suicide among Service Members, Veterans, and their Families (Governor’s Challenge) is one part of the CBI-SP model.
The Governor’s Challenge is a partnership between VA and Department of Health and Human Services Substance Abuse and Mental Health Services Administration and brings together key state leaders to form an interagency team dedicated to addressing Veteran suicide at the state level. Governor’s Challenge teams form strategic action plans, that are based on three priority areas:
•identify service members, Veterans, and their families and screen for suicide risk
•promote connectedness and improve care transitions
•increase lethal means safety and safety planning.
Teams are provided with technical assistance to develop and implement their action plans. As of 2022 35 states had begun or completed the action planning and implementation phases with a total of 308 strategies. The remaining 15 states and five territories have been invited to join in 2022.
Lessons Learned
Balancing the provision of guidance while allowing for flexibility and tailored approaches for each state has been critical, since each states’ needs and resources vary widely. Process measures will be presented.
Recommendations/Implications
While all engaged states remained active during the last two years, additional work remains to fully implement planned actions and to engage remaining states. Additional resources, in terms of personnel and grant funding would facilitate additional state efforts in working to end Veteran suicide. CBI-SP can bring VHA staff to bear on state efforts at the local level as communities work to implement the same unifying model adapted to local needs and resources.
Abstract
The Governor’s Challenge to Prevent Veteran Suicide: Collaborative Partnerships to Strengthen the delivery of services to our Service Members, Veterans and their Families (SMVF)
APHA 2022 Annual Meeting and Expo
Background/Context
In 2020, the Pennsylvania Department of Military and Veteran Affairs (DMVA) joined the Governor’s Challenge. In this same year Pennsylvania announced the launch of their community-based outreach program, titled PA VETConnect. The principle behind PA VETConnect was to foster relationships with federal, state and local government partners and community providers who can fill gaps in service and provide support in the communities where our SMVF live, work and thrive.
Description
The Pennsylvania Governor’s Challenge Team is composed of a diverse cadre of experts from a variety of professional disciplines, federal, state and government, hospitals, educational institutions and community partners. Our team, coupled with the expertise from VA and Department of Health and Human Services Substance Abuse and Mental Health Services Administration, comprise an eclectic team dedicated to addressing Veteran suicide at the state level. The Pennsylvania Governor’s Challenge team has developed a comprehensive 5-year Implementation plan that is based on the three priority areas of the PREVENTS strategy:
•identify service members, Veterans, and their families and screen for suicide risk
•promote connectedness and improve care transitions
•increase lethal means safety and safety planning.
Lessons Learned
Our PA VETConnect initiative incorporates Regional Program Outreach Coordinators (RPOCs) and Veteran Service Specialists (VSSs) as the “boots on the ground contact teams that are responsible to build relationships, vet service providers and to connect SMVF with providers who can meet their needs in the communities where they live. Our RPOCs are fully integrated with the VISN 4 CEPCs.
Recommendations/Implications
In March of 2022 USDVA Secretary McDonough presented the Lincoln Pillar of Excellence Award to Pennsylvania for their work with PA VETConnect. Pennsylvania is working closely with our VISN 4 partners to gather data, implement grass roots suicide prevention initiatives like “Together with Veterans and the CDC Cooperative Grant Agreement in 15 counties in NW Pennsylvania. Our Governors Challenge team is a model of collaboration, cooperation and service delivery that sets the standard for excellence in Pennsylvania.
Abstract
Community Engagement and Partnership Coordinators: A Force Multiplier Working with Communities Towards Ending Veteran Suicide
APHA 2022 Annual Meeting and Expo
Background/Context
In 2019, the suicide rate for Veterans was 1.5 times the rate for non-Veteran adults. The Department of Veterans Affairs (VA) has adopted a public health approach to address suicide for all Veterans, not just those who come to the VA for care.
Description
VA’s Community-Based Interventions for Suicide Prevention (CBI-SP) program offers Community Engagement and Partnership Coordinators (CEPC) as a unifying force for all community-based efforts. CEPCs collaborate at the community, state and regional levels to facilitate coalition building and spread evidence-based suicide prevention strategies tailored to each locality’s Veteran population.
With CEPC support, community-led coalitions form strategic action plans based on three CBI-SP priority areas:
Identifying Service members, Veterans and their Families (SMVF) and screening for suicide risk.
Promoting connectedness and improving care transitions.
Increasing lethal means safety and safety planning.
Lessons Learned
In 2020, CBI-SP initiated a phased implementation of the CEPC program, which is set to be fully implemented across the VA healthcare system during this year.
As of April 1st 2022, more than 400 coalitions have been engaged.
CEPCs successfully engage communities in establishing coalitions to address the three CBI-SP priority areas.
Sustainable coalition efforts are community-led, rather than VA-driven. CEPCs observe and learn about their communities on a continual basis, including use of an initial landscape analysis built upon foundational elements of diversity, equity and inclusion. Increased collaboration across community sectors and within systems of care is pivotal to improving population health outcomes.
Recommendations/Implications
CEPCs have already achieved short-term goals that include strengthening community-based suicide prevention systems and increased engagement with SMVF. We anticipate that CBI-SP will contribute to higher rates of Veteran help-seeking and engagement in care, increased community collaboration regarding Veteran services, widened networks for suicide prevention and safer storage of lethal means. Long-term benefits will include reduced suicide deaths and attempts among the SMVF population and reduced impact on communities.