A peer veteran approach to the caring letters suicide prevention program: Preliminary data.

Caring Letters is a prevention program aimed at reducing suicide risk; however, clinical trials indicate mixed results among military and veteran samples. The present study aimed to pilot a new version of the Caring Letters intervention that was adapted to military culture in order to emphasize peer support. The supportive letters, traditionally sent from clinicians, were written by peer veterans (PVs) who volunteered from local Veteran Service Organizations (VSOs). PVs (n = 15) attended a 4-hr workshop to learn about Caring Letters and write six letters to a veteran with a recent hospitalization for suicide risk (hospitalized veterans [HVs]; n = 15 completed a baseline assessment). Letters from PVs were sent to HVs once a month for 6 months following discharge from the psychiatric inpatient unit. The study used a limited efficacy approach to examine feasibility outcomes including implementation procedures, participant recruitment and retention rates, and barriers and facilitators. Acceptability measures examined HV satisfaction, perceived privacy and safety, and PV workshop satisfaction. Among HVs, results suggested that suicidal ideation improved from baseline to follow-up (g = 3.19). Results suggested resilience scores improved among HVs (g = 0.99). Results also suggested a possible reduction in stigma associated with mental health treatment among PVs at 1-month postworkshop assessment. Interpretation of the results is limited by the design and sample size, but the results provide preliminary support for the feasibility and acceptability of a PV approach to Caring Letters. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Peer-Written Caring Letters for Veterans after a Suicidal Crisis.

OBJECTIVE: In the evidence-based suicide prevention intervention, Caring Letters, healthcare providers send brief, caring messages to patients following psychiatric inpatient care, a time of elevated suicide risk. However, recent studies with military populations have found mixed results. An adaptation of Caring Letters employed a peer framework in which veterans from the community wrote brief caring messages to veterans discharging from psychiatric inpatient treatment after a suicidal crisis. METHODS: The present study utilized content analysis to assess 90 caring messages generated by 15 peer veterans recruited from veteran service organizations (e.g., American Legion). RESULTS: Three themes emerged: (1) Shared Military Service, (2) Care, and (3) Overcoming Adversity. Peer-generated content varied in how the coded themes were expressed in the messages. CONCLUSION: These veteran-to-veteran caring messages may bolster belongingness, social support, and destigmatize mental health struggles, and have the potential to augment existing Caring Letters effects and interventions.HIGHLIGHTSVeterans commonly wrote about shared military services, care, and adversities.Supportive messages from peers may be tied to social support.Our analyses support possible benefits for veterans receiving caring messages.

Blister Packaging Medication Increases Treatment Adherence in Psychiatric Patients.

OBJECTIVE: To evaluate whether blister packing medications would improve prescription medication adherence in psychiatric patients. It was hypothesized that patients in the blister pack (BP) condition would be more adherent to their daily medications than those in the dispense as usual condition. METHODS: This was a randomized trial involving up to 1 year of monthly follow-up assessments. Participants were recruited from an urban Veterans Affairs (VA) Medical Center in the Western United States. Inclusion criteria for participants included being diagnosed with a major affective disorder, posttraumatic stress disorder, schizophrenia, or a combination of these disorders; being 18 to 89 years of age; receiving prescription medications from the VA pharmacy; and being considered competent to manage their own medications. Of the 303 patients who consented to participate, 277 were randomized to 1 of the 2 study conditions, and 243 were retained in the study. The sample was 87% male, 47% white, with a mean age of 54.4 years. All medications prescribed and dispensed by the VA were either repackaged in monthly BPs or dispensed in standard pill vials. RESULTS: The primary hypothesis was supported. Patients in the BPs condition showed evidence of better adherence at 12-month follow-up, as well as larger increases in adherence from 1 month to 12 months. CONCLUSIONS: Psychiatric patients adhere better to prescription medication regimens when receiving their medications in BP.

Suicide Attempt Characteristics Among Veterans and Active-Duty Service Members Receiving Mental Health Services: A Pooled Data Analysis.

Past suicidal behaviors are among the strongest and most consistent predictors of eventual suicide and may be particularly salient in military suicide. The current study compared characteristics of suicide attempts in veterans (N = 746) and active-duty service members (N = 1,013) receiving treatment for acute suicide risk. Baseline data from six randomized controlled trials were pooled and analyzed using robust regression. Service members had greater odds of having attempted suicide relative to veterans, though there were no differences in number of attempts made. Service members also had higher rates of premilitary suicide attempts and nonsuicidal self-injury (NSSI). Veterans disproportionately attempted suicide by means of overdose. In veterans, combat deployment was associated with lower odds of lifetime suicide attempt, while history of NSSI was associated with greater attempt odds. Neither was significantly associated with lifetime suicide attempt in service members. Implications for suicide assessment and treatment are discussed.