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

• Published in: Medical care Vol. 61; no. 1; pp. 50 - 53
• Main Authors: Krishnamurti, Lauren S, Agha Aneeza, Denneson, Lauren M, Montgomery, Ann E, Chhatre Sumedha, Dichter, Melissa E
• Format: Journal Article
• Language: English
• Published: Philadelphia Lippincott Williams & Wilkins Ovid Technologies 01-01-2023
• Subjects: Acceptance tests; Crises; Gender; Gender aspects; Gender differences; Mental health; Military personnel; Military psychology; Prevention; Public health; Risk; Risk taking; Sex differences; Suicide; Veterans
• ISSN: 0025-7079; 1537-1948
• DOI: 10.1097/MLR.0000000000001789

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.