Gender Differences in Connecting Veterans to Care Through the Veterans Crisis Line

A Mixed Methods Evaluation of Referrals to Suicide Prevention Coordinators

Bibliographic Data

ID9099665
AuthorsLauren Sealy Krishnamurti (0000-0002-3496-2246, VA Pittsburgh Healthcare System, corresponding author), Aneeza Agha (US Department of Veterans Affairs, Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA), Lauren M Denneson (0000-0003-3972-6098, VA Portland Health Care System), Ann Elizabeth Montgomery (0000-0002-4420-3526, University of Alabama at Birmingham), Sumedha Chhatre (0000-0002-4718-0198, University of Pennsylvania), Melissa E Dichter (0000-0003-4579-1400, US Department of Veterans Affairs, Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA, corresponding author)
Year2023
Volume61
Issue1
Pages50-53
Publication date2023-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001789
PMID36477620
OpenAlexW4310868771
LanguageEN
Citations received1
References cited8

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

Family medicine · Health care · Loneliness · Medical emergency · Poison control · Psychiatry · Referral · Suicide prevention · Veterans Affairs · Medicine · Opioid Use Disorder Treatment · Posttraumatic Stress Disorder Research · Suicide and Self-Harm Studies · Gerontology

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