Gender Differences in Connecting Veterans to Care Through the Veterans Crisis Line: A Mixed Methods Evaluation of Referrals to Suicide Prevention Coordinators

Lauren S. Krishnamurti, Aneeza Agha, Lauren M. Denneson, Ann E. Montgomery, Sumedha Chhatre, Melissa E. Dichter

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Suicide is a major public health crisis within the US military veteran community, with distinct gender differences in suicide risk and behavior. The Veterans Crisis Line (VCL) is a component of the Veterans Health Administration (VHA) suicide prevention program; through VCL, veterans may be referred to a VHA Suicide Prevention Coordinator (SPC) to arrange follow-up care. Research shows that engagement with an SPC is a strong protective factor in reducing veteran suicide risk. Methods: We evaluated SPC referral acceptance and assessed correlates of SPC referral decline using VCL administrative data for contacts: (1) made between January 1, 2018, through December 31, 2019; (2) by veterans contacting VCL on their own behalf; (3) with gender identified; and (4) current thoughts of suicide. Then, among a subsample of 200 veterans, evenly distributed by gender, we examined data from call synopsis notes to identify reasons given for veterans declining an SPC referral. Results: We found it was generally callers rated as lower risk by responders, and callers with loneliness as a reason for contacting VCL, who more frequently declined the SPC referral. An analysis of reasons given for declining SPC referral found that concerns with/about Veterans Affairs care were a key concern, particularly among women veterans articulating specific negative care experiences. Other reasons for referral decline included managing the veteran's needs directly on the call or via alternative resources. Conclusion: The VCL as an intervention provides an important opportunity to re-engage vulnerable veterans into care, one that may be more challenging for women veterans.

Original languageEnglish (US)
Pages (from-to)50-53
Number of pages4
JournalMedical care
Volume61
Issue number1
DOIs
StatePublished - Jan 1 2023

Keywords

  • gender differences
  • mental health
  • referral outcomes
  • suicide prevention
  • Veterans Crisis Line

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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