Veteran Perspectives of Barriers and Facilitators to Campaigns Promoting Help Seeking During Crisis.

The objective of this paper is to characterize barriers and facilitators reported by U.S. military veterans related to campaigns promoting help seeking during suicidal crisis. Individual telephone interviews (N = 40) were conducted from August 2018-April 2019 with a sample of veterans who had a recent non-fatal suicide attempt. Interview transcripts were analyzed using a constant comparison analytic strategy. Participants reported the four facilitators to message effectiveness: (a) potential reach of specific channels; (b) interruption of suicidal thoughts; (c) normalizing the suicidal experience and help seeking; and (d) modeling desired behavior change. Barriers that hindered campaigns were also identified and include (a) broad messages, (b) challenges in cognitive processing, (c) media avoidance and (d) a boomerang effect. This study underscores the significance of involving those with lived experience to identify factors that may improve or hinder message effectiveness.

VHA chaplaincy contact with veterans at increased risk of suicide.

OBJECTIVES: To examine the extent to which chaplains interact with military veterans at increased risk of suicide and select characteristics related to those at-risk veterans who present for chaplaincy services. METHODS: The nationwide network of chaplains affiliated with the Veterans Health Administration (n = 990) was e-mailed a letter inviting those who have contact with at-risk veterans to complete a survey. This letter included an Internet link, connecting respondents to an online survey collection service. One hundred eighteen chaplains (11.91%) responded to the survey. RESULTS: More than half of the respondents reported that veterans at increased risk of suicide constitute either <5% or 5% to 10% of the overall population of veterans under their care. At-risk veterans are most often identified based on open admission of suicidal behavior or red flags in their treatment file. Veterans typically do not look for chaplains from their own faith tradition, will seek care from >1 chaplain, and present at a moderate-to-high level of risk. CONCLUSIONS: The present study finds that some at-risk veterans look to chaplains for supportive services. The findings also allow for opportunities for future research.

An Exploration of Barriers to Suicide Prevention Messaging With US Veterans.

Background: Communication campaigns offer a portable intervention to effectively reach and engage target populations at risk for suicide including US veterans. Few studies have evaluated such efforts, and still fewer have examined factors that contribute to failed suicide prevention messaging. Aims: We aimed to examine characteristics of suicide prevention messages and persuasive processes that may underlie failed communicative intervention with US veterans. Method: Telephone interviews were completed with veterans (N = 33) from June to September 2016 using a semi-structured interview guide. Interview transcripts were coded by the authors with NVivo using a constant comparison analytic strategy. Results: Several reasons emerged for why suicide prevention messaging may fail to produce intended responses among veterans. Participants identified message features (e.g., language, images, messenger) and communication strategies that may diminish campaign effects. Limitations: Findings are not generalizable, are limited to participants who used VA healthcare and were not suicidal, and are subject to several biases. Conclusion: This work provides initial insights into barriers to effective message use with veterans.

Perceptions of Public Messaging to Facilitate Help Seeking during Crisis among U.S. Veterans at Risk for Suicide.

OBJECTIVE: The primary objectives of this study were to (1) examine how veterans at risk for suicide understand and interpret suicide prevention messages, and (2) identify message features that support (or hinder) help seeking behaviors. METHOD: Individual virtual interviews (N = 40) were conducted from August 2018 to April 2019 with a nationwide sample of veterans who had a recent non-fatal suicide attempt. Participants were exposed to three messages in public circulation that promote help seeking during crisis and an interview guide steered open-ended conversations on the mechanisms of persuasive communication. Interview transcripts were analyzed using a constant comparison analytic strategy in Atlas.ti. RESULTS: Preferences for particular kinds of messages and features emerged during interviews based on a need for novel, emotionally intense stimuli among veterans. Specifically, messages with solemn themes and darker, more provocative imagery were believed to be particularly potent for engaging those at high risk. Although the goal of promoting help seeking was discernable, actionable steps (crisis line use) were not clearly communicated potentially preventing messages from increasing help seeking behaviors. CONCLUSION: While messaging was perceived as capable of intervening to promote help seeking, participants reported distinct communication preferences and needs during periods of high risk. Findings underscore the significance of involving those with lived experience to inform the effective design and use of help seeking messaging targeting veterans at risk for suicide.HighlightsPublic messaging (campaigns) is a portable suicide prevention interventionCareful study is needed to effectively communicate help seeking messagesFindings inform the effective use of campaigns with veterans at risk for suicide.