3 - (SYM 78) Preferences of U.S. Veterans Making and Receiving Caring Cards: A Peer Approach to Suicide Prevention

Understanding participants’ treatment preferences is vital to ensuring that suicide prevention interventions are effective. Caring Cards is a peer-adaption of caring contacts for suicide prevention, in which people with lived experience of suicidal thoughts and behaviors make one-of-a-kind cards that are sent to peers currently experiencing suicidal thoughts. The present study used data from a feasibility/acceptability study of Caring Cards at a Veterans Affairs Medical Center to explore preferences for this type of suicide prevention intervention.

Participants were 80 Veterans with a past (card makers, n=30) or current (card recipients, n=50) high-risk indication of suicide risk. Card makers participated in a 3-month weekly 60–90-minute group therapy to create cards. Card recipients received these cards one time a month for six months. Survey and interview data was collected post-intervention.

Card makers preferred that the group was offered regularly (57.1%), would recommend the group to Veterans who have previously struggled (85.7%) and are currently struggling (76.2%), and would like to participate in future groups (85.7%) and receive cards themselves (61.9%). Card recipients preferred that receiving cards should be a regular service (67.6%), would recommend receiving cards to Veterans who have previously struggled (94.1%) and are currently struggling (94.1%), and would want to be a card maker (52.9%) and receive cards in the future (88.2%).

Pragmatic analysis interview responses revealed preferences related to participation length, card content and frequency, group formatting, accessibility, and maker preference. Both card makers and recipients expressed interest in continued participation in Caring Cards, with ideal time commitment ranging from one month to indefinitely. Preferences among card makers included improved access to both in-person and virtual groups, and flexible formatting (e.g., drop-in groups). Card recipients wanted to receive cards from other Veterans, and some wanted cards from known individuals (e.g., providers, family). Recipients also favored physical rather than digital cards, arriving in variable schedule.

The Caring Cards intervention specifically focuses on improving well-being, meaning-making, and fulfillment in one’s life – all of which are salient to suicide prevention. These data further support the importance of lived experience voices. By focusing on Veteran preferences, reducing the burden of suicidal thoughts and behaviors and, subsequently, cultivating joy, may be possible.