2 - (SYM 52) Supporting Veteran Suicide Prevention via Family Members: An Opportunity for Va's Coaching into Care Service?

Veterans are at significantly higher risk for suicide than the general population, yet many are not connected to mental health care and their family members are unsure how to help. Family members frequently call crisis lines with concerns about a Veteran’s need for mental health care. Family members may be uniquely positioned to help support Veterans in times of crisis. However, whether family members are willing to assist in suicide prevention activities and the level of detail they have about their Veteran’s suicidal thoughts and behaviors is unknown. This descriptive study informs the question of whether there is an opportunity to conduct suicide prevention through a VA, non-crisis telephone service, Coaching Into Care (CIC), that helps family members to encourage Veterans to seek mental health care. We examined whether the callers to this service were close family members, aware of the Veterans’ suicidal ideation and plans, and whether they were willing to engage in an intervention to lower the Veteran’s risk of suicide.

Incoming callers to CIC (N=1395) across a 6-month period were sampled, yielding 239 cases (17%) in which the caller indicated that the Veteran reported current or past suicidal ideation or prior hospitalization for suicide risk. Nearly 80% of callers indicated the Veteran was from the post-911 period of service. Most callers (70%) were close family members (30.3% spouses/intimate partners, 41% parents or siblings). In 40.8% of the cases, the Veterans were reportedly already in mental health care, but callers remained concerned about suicide risk. The callers reported the following about the veterans they were concerned about: 62.7% had current suicidal ideation, 16.7% had past suicidal ideation, 35.8% had access to lethal means, and 25% had current suicidal intent. 

Most callers wanted support getting the Veteran to engage in mental health care or in directly addressing the risk of suicide of the Veteran. A large majority (84.8%) were open to intervention in addressing their concerns. A small minority of callers (10.2%) reported feeling burdened by the Veteran’s suicidal risk. Many callers engaged in only one call despite repeated efforts at re-engaging them.

Study findings suggest that the family member callers to Coaching Into Care would be good candidates for an intervention to lower the risk to suicide of the Veteran about which they were calling. A pilot program originating from this work designed to improve Veteran family member knowledge about suicide and self-efficacy discussing suicide is in development.