Public Messaging to Increase Treatment Seeking for Veterans at Risk for Suicide

Public Messaging to Increase Treatment Seeking Among Veterans at Risk for Suicide During Transition From Military Service

The risk for suicide increases by nearly 50% in the first year that service members transition from the military to civilian life underscoring the need for effective strategies to facilitate help seeking among Veterans vulnerable to self-directed violence. Yet despite a great need for treatment, more than half of returning Veterans at risk for suicide do not initiate mental health services. VA has embarked on the regular use of communication campaigns as part of a public health approach designed to reach the larger Veteran population with messages promoting help seeking. However, what types of messages effectively change beliefs and behaviors for at-risk Veterans resistant to seek treatment is unclear. The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. This represents the first study to systematically develop public messaging strategies for populations at risk for suicide.

The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. A four-year mixed methods study that uses a sequential embedded design will be used to collect data from nationwide samples of Veterans at risk for suicide not in mental health treatment who separated from the DoD in the past year. Informed by the Theory of Planned Behavior, individual interviews will first be conducted to guide the design of effective public messages that will be subsequently tested in an RCT to determine exposure effects among targeted audience vs. waitlist control. Messages will be disseminated to study participants during the trial by a smartphone app. Research staff will collect assessments by telephone at baseline, 1- and 2-months post-randomization. Potential participants will primarily be identified using data available from the VA/DOD Identity Repository (VADIR) and recruited by invitational mailing and follow-up telephone calls. If the intervention is found effective, the investigators will work with the VA operational partner to include messages in future outreach approaches to prevent Veteran suicide and use findings to improve current communication performance measures.

Inclusion Criteria:

• U.S. Veteran that separated from military service in the past 36 months or less (any discharge type);
• >18 years old;
• experiencing suicide risk;
• low intent to seek help;
• capable of understanding the goals of the study;
• willing and able to provide verbal consent;
• smartphone ownership and willing to download/use study mobile app

Exclusion Criteria:

• currently (or in the past 12 months) in formal mental health treatment services;
• deemed impaired during eligibility screening;
• currently institutionalized