Protective Factors for Suicide: A Multi-Tiered Veteran-Driven Community Engagement Project

Objective: It is well known that veterans experience elevated rates of mental illness and suicide as compared to the general population. However, at-risk veterans often do not utilize traditional mental-health services due to inaccessibility, cost, and perceived stigma. This project was designed to employ community engagement methods in order to accomplish two objectives: uncover accessible, existing factors protective against suicidality in veterans and develop a related comparative effectiveness research (CER) question. Methods: Over 70 stakeholders of various backgrounds from the veteran community participated in discussion groups and engagement activities over a period of 33 months, split into three tiers. Results: Stakeholders identified 11 existing protective factors and generated a CER question regarding the effectiveness of peer-to-peer support vs. peer to peer plus service dog support. Recognition of these factors, which are not identified or analyzed by traditional research models, supports the need for more investigation into community-endorsed approaches. Conclusions: Evaluating and disseminating such strategies may lead to successful interventions that are more readily adopted by veterans, thereby reducing the burdens of mental illness and suicide in this population.