Suicide Risk Among Women Veterans in Distress

Perspectives of Responders on the Veterans Crisis Line

Published in: Women's Health Issues, 2016

Posted on RAND.org on September 19, 2016

by Rajeev Ramchand, Lynsay Ayer, Virginia Kotzias, Charles C. Engel, Zachary Predmore, Patricia A. Ebener, Jan Kemp, Elizabeth Karras, Gretchen L. Haas

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Research Questions

  1. How do the concerns of women callers to the Veterans Crisis Line (VCL) differ from those of men callers?
  2. What is the level of suicide risk among women callers to the VCL?

Background

Women veterans are at increasingly high risk of suicide, but little is known about the concerns and needs of this population. This is, in part, owing to the low base rate of suicide and the inability to conduct retrospective interviews with individuals who died. In this study, we used a qualitative approach to gain insight about the concerns and nature of comments regarding suicidal ideation and intent among women veterans calling the Veterans Crisis Line (VCL).

Methods

Fifty-four VCL call responders were interviewed in the spring of 2015. They were asked about the concerns and level of suicide risk of women veteran callers with whom they have spoken and about the ways in which women callers are similar to or different from men callers. Interviews were transcribed and thematic analyses were conducted to examine patterns or themes emerging from the data.

Findings

Military sexual trauma and non-suicidal self-harm were two commonly reported concerns of women veteran callers according to responders. VCL responders also noted differences between men and women veteran callers, including differences in clinical presentation, suicidal means, and protective factors.

Conclusions

Our findings shed light on potential avenues to prevent suicide among women veterans, although we spoke to VCL responders about their impressions, rather than to women veterans themselves. Efforts to 1) prevent and treat the consequences of military sexual trauma, 2) recognize, prevent, and treat non-suicidal self-harm, and 3) restrict access to lethal means most commonly reported among women veteran callers may be helpful to mitigate suicide risk in this vulnerable group of veterans.

Key Findings

  • Veterans Crisis Line (VCL) call responders report that, for women who call the VCL, military sexual trauma was a dominant concern; mental health issues, such as post-traumatic stress disorder (PTSD), and family and financial issues were also commonly mentioned.
  • Call responders report that men tended to call the VCL in anger or rage, whereas women would call while in a state of sadness, depression, or despair.
  • Women callers' most often cited reasons for wanting to die were hopelessness, PTSD, and loneliness.
  • The extent of suicidal intent and motivation was difficult to determine in this study, but call responders reported the presence of deliberate self-harm (self-poisoning or injury) among callers.

Recommendation

Strategies worthy of future study to reduce suicide among female veterans may entail incorporating guidelines for asking about self-harm into suicide risk assessments and developing strategies for restricting access to suicide means (such as pills that can be used for overdose) for women veterans receiving mental health treatment.

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