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Together With Veterans (TWV) is a community-based suicide prevention program for rural Veterans. TWV involves partnering with rural Veterans and their communities to implement community-based suicide prevention. For more info, visit our website.
Website
Clinical Practice Guidelines (CPGs) are research informed recommendations on how to diagnose and treat a medical or psychiatric condition. Visit our updated CPG website for resources, including webinars and recommendations, specific to the CPG For Patients at Risk for Suicide.
Suicide Risk Management Consultation Program
Postvention
Visit the Uniting for Suicide Postvention (USPV) website to explore resources for community, providers, and workplaces who are healing after suicide loss. To learn more about postvention consultation, please reference the SRM Postvention Factsheet.
Promotion Strategies
A promotion-level intervention is used to target the entire population and aims to promote mental health and enhance an individual's ability to achieve well- being.
- For more information on the VA Chaplain program, please go to: https://www.patientcare.va.gov/chaplain/index.asp
- The National Action Alliance has developed a program, "Faith. Hope. Life. Celebrating Reasons to Live." For more information, visit: https://theactionalliance.org/faith-hope-life
- Four two-hour modules are available on VHA TRAIN using the following Course IDs: 1056278, 1056303, 1056248, 1056299. Access VHA TRAIN and create a free account using this link: https://www.train.org/vha/
- The PsychArmor training platform has numerous free courses on military culture and can be accessed here: https://psycharmor.org/military-culture-school/
- The American Medical Association suggests that all healthcare providers screen patients for Veteran or Veteran family member status. "Have You Ever Served in the Military?" can be accessed here: https://www.haveyoueverserved.com/
UNIVERSAL PREVENTION STRATEGIES
Universal preventive interventions apply to the general population and focus on taking proactive measures to prevent suicide.
- The Zero Suicide Toolkit provides additional information regarding creating a culture of suicide prevention within an organization. This video entitled "Leading Change Toward Better Suicide Care Management," outlines ways to involve organizational leaders in Zero Suicide implementations: https://zerosuicide.edc.org/toolkit/lead
- The National Action Alliance for Suicide Prevention (Action Alliance) resource, "Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe," can be accessed here: https://theactionalliance.org/resource/recommended-standard-care
- Order additional promotional and educational materials from the Rocky Mountain MIRECC: https://www.mirecc.va.gov/visn19/orderform/orderform.asp
- The VA community toolkit provides a host of mental health, suicide prevention, and additional resources to help Veterans who are struggling: https://starttheconversation.veteranscrisisline.net/toolkit
- The VA and the Office of Mental Health and Suicide Prevention training, "Suicide Prevention Partnerships: Safe Firearm Storage," course ID 1087336, can be located on the VHA Train platform: https://vha.train.org/vha/
- More information and resources regarding lethal means safety are located on the Rocky Mountain MIRECC's website: https://www.mirecc.va.gov/visn19/lethalmeanssafety/
- For more information regarding VA's suicide prevention program, including quality improvement practices, go to: https://www.mentalhealth.va.gov/about/guidebook.asp
- Zero Suicide offers a worksheet to assist health and behavioral health organizations in developing a quality improvement approach to suicide care: https://zerosuicide.edc.org/resources/resource-database/zero-suicide-data-elements-worksheet
- The VHA TRAIN learning platform contains courses such as Overview Suicide Risk Management (Course ID 1089347), and Operation S.A.V.E training (Suicide prevention training for all staff; Course ID 10916250) at this link: https://www.train.org/vha/home
- The Suicide Prevention Resource Center offers a resource for help you find an online gatekeeper training appropriate for your setting: https://sprc.org/online-library/qpr-gatekeeper-training-suicide-prevention
- The VA conducts the largest national analysis of Veteran suicide rates, and findings are available to the public in annual downloadable reports. https://www.mentalhealth.va.gov/suicide_prevention/data.asp
- The Department of Defense Suicide Event Report is available at this link: https://health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Department-of-Defense-Suicide-Event-Report
- Provide support to Veterans with responsible media. Take a look at the VA's Social Media Safety Toolkit for Veterans, Their Families, and Friends: https://www.mentalhealth.va.gov/suicide_prevention/docs/OMH-074-Suicide-Prevention-Social-Media-Toolkit-1-8_508.pdf
- Reporting on Suicide offers Recommendations for reporting on suicide: The Centers for Disease Control and Prevention offers a free version of the CDC Social Media Toolkit at this site: https://reportingonsuicide.org
- What is military sexual trauma (MST)? Go to: https://www.ptsd.va.gov/understand/types/sexual_trauma_military.asp#:~:text=Military%20sexual%20trauma%2C%20or%20MST%2C%20is%20the%20term,they%20need%20in%20order%20to%20recover%20from%20MST.
- Download the Mobile App: Beyond MST. Go to: https://www.ptsd.va.gov/appvid/mobile/beyondMST.asp
- The VA website has MST overview, treatment options, coping strategies, and resources. Go to https://www.mentalhealth.va.gov/msthome/index.asp
- Training on "Caring for our Veterans who experienced military sexual trauma (MST)" on VHA TRAIN (course ID: 1091099). Go to https://vha.train.org/vha/welcometo sign up for a free account.
PREVENTION STRATEGIES
A selective preventive intervention is targeted at individuals or subgroups, based on a biological or social risk factor that indicates suicide risk is significantly higher than average.
- National Center for PTSD provides resources on treatment options for PTSD: https://www.ptsd.va.gov/
- For more information on addressing co-occurring mental health conditions in Zero Suicide, see the Zero Suicide Toolkit Treat section: https://zerosuicide.edc.org/toolkit/treat
- To find a list of local Vet centers, visit this link: https://www.va.gov/find-locations/?facilityType=vet_center
- The VA provides several resources for family members: https://www.mentalhealth.va.gov/families/index.asp
INDICATED PREVENTION STRATEGIES
An indicated preventive intervention is aimed at individuals who are considered at high risk due to a prior suicide attempt or current suicidal ideation, but whose symptoms are not yet severe or prolonged enough to meet diagnostic criteria.
- The VA Safety Plan Worksheet can be a helpful resource for clinicians and is available here: https://www.healthquality.va.gov/guidelines/MH/srb/PHCoEPatientSafetyPlanSelfPrint3302020508.pdf
- Download the Safety Plan Pocket Guide: https://www.mentalhealth.va.gov/docs/vasafetyplancolor.pdf
- The Crisis Response Plan is also an effective tool in reducing suicidal behavior. For more information go to: Suicide - Crisis Response Planning to Prevent Suicide. https://crpforsuicide.com/
- Lethal Means Safety Training is available on the VHA TRAIN platform, Training ID: 1075258. To access this resource, click on this link: https://www.train.org/vha/course/1075258/
- Counseling on Access to Lethal Means (CALM) course is available here: https://zerosuicide.edc.org/resources/resource-database/counseling-access-lethal-means-calm
- The VA REACH website provides more information and resources on lethal means safety: https://www.va.gov/reach/lethal-means/
- The VA Rocky Mountain MIRECC provides numerous resources on lethal means safety that can be accessed through this link: https://www.mirecc.va.gov/visn19/lethalmeanssafety/safety/
- For the Veterans Crisis Line, call: 988 and press 1. For more information on the Veterans Crisis Line go to: Veterans Crisis Line
- The Veterans Crisis Line also provides services via chat. To chat with the Veterans Crisis Line, go to: Veterans Crisis Line Chator send a text message to: 838255.
- For Veteran family members, the National Suicide Prevention Lifeline is available for suicide prevention and mental health crisis assistance by texting 988 or online chat: https://988lifeline.org/chat/
- To read more about root cause analysis and how it is performed in the VA, please see the VA's root cause analysis website for a step-by-step standard operating procedure for conducting a root cause analysis: https://www.patientsafety.va.gov/professionals/onthejob/rca.asp
- You can view current data on the Department of Defense Suicide Event Report (DoDSER) site at this link: https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Department-of-Defense-Suicide-Event-Report
- Assessment and Management of Patients at Risk for Suicide (2019) - VA/DoD Clinical Practice Guidelines
- Information regarding training in Brief Cognitive Behavioral Therapy for Suicide Prevention is available here: https://crpforsuicide.com/training
- The Zero Suicide model recommends continued contact with at-risk individuals. For more information see: TRANSITION: Interventions for Suicide Risk: https://zerosuicide.edc.org/toolkit/transition
MIXED PREVENTION STRATEGIES
Depending on the method being used, the level of intervention required, and the population targeted, multiple strategies and/or classifications may be applied to a strategy. Mixed prevention interventions include:
- The Columbia-Suicide Severity Rating Scale (C-SSRS; Posner et al., 2011) toolkit is available online on the Zero Suicide website: https://zerosuicide.edc.org/resources/resource-database/columbia-suicide-severity-rating-scale-c-ssrs
- See the Rocky Mountain MIRECC Assessment Tools page for further information on suicide risk assessment tools: Rocky Mountain MIRECC for VA Suicide Prevention - MIRECC / CoE
- VA's Caregiver Support Line (CSL) is 1-855-260-3274 and the VA Caregiver Support Program directory can be found at: https://www.caregiver.va.gov/support/New_CSC_Page.asp
- Access guidance for families and friends to talk with Veterans about mental health and substance abuse challenges through the Coaching Into Care - MIRECC / CoE
- To access VHA TRAIN trainings on suicide prevention, simply make an account online at www.train.org/vha/home. Involving Family and Loved Ones in Suicide Prevention Efforts, Course ID 1096884
- Review the Peer Support Specialist Toolkit: Implementing Peer Support Services in VHA. A toolkit designed to help Veterans successfully engage in their mental health and substance use treatment: https://www.mirecc.va.gov/visn4/docs/Peer_Specialist_Toolkit_FINAL.pdf
- The VA team can connect you to your local VA suicide prevention coordinator, or go to https://www.veteranscrisisline.net/find-resources/local-resources/
- Learn the challenges and risks that Veterans face, and how to communicate concern to connect in advance of a crisis. Download the "Identifying Signs of Stress" Fact Sheet. https://starttheconversation.veteranscrisisline.net/pdf/identifying-signs-of-stress/
- The Patient Health Questionnaire - 9 (PHQ-9; Kroenke et al., 2001; VA, 2019) is a 9-item measure used to assess for depression and suicidal ideation. For scoring instruction, visit: https://www.mirecc.va.gov/visn19/cpg/recs/2/
- For more information regarding strategies for remaining in contact with high-risk patient: https://zerosuicide.edc.org/toolkit/transition
- For additional information on the VA's pilot of Caring Contacts: https://www.mirecc.va.gov/visn19/cpg/recs/13/
