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Abstract

Objective:

Suicide is a significant public health concern. About 48,000 individuals died by suicide in 2021 in the United States, and approximately one in 100 deaths globally are due to suicide. Continuing efforts in program development and evaluation are vital to preventing suicide. Multiple frameworks have been developed to reduce suicide rates, but they have not been compared to assess their comprehensiveness, nor have their components been classified.

Methods:

In 2019, the authors conducted a narrative review of the literature and identified four major frameworks for suicide prevention: the U.S. Department of Veterans Affairs (VA) Suicide Prevention Program, the Defense Suicide Prevention Program of the U.S. Department of Defense, Zero Suicide in Health and Behavioral Health Care, and the technical package developed by the Centers for Disease Control and Prevention. Program components for these frameworks were identified and classified by using two prevention strategy classification systems: the National Academy of Medicine’s (NAM’s) continuum-of-care model and the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) prevention model.

Results:

The cross-program comparison revealed that no single program included all components of suicide prevention programs. However, the VA program was the most comprehensive in terms of the number of components and their spread across prevention strategy classifications. The programs used few components categorized under NAM’s promotion or selective prevention strategy classifications. The SAMHSA prevention strategy classifications of information dissemination, community-based processes, and positive alternatives were also used infrequently.

Conclusions:

Organizations, health care systems, and policy makers may use these findings as they develop, improve, and implement suicide prevention programs.

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Supplementary Material

File (appi.ps.20230173.ds001.pdf)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 789 - 800
PubMed: 38807579

History

Received: 7 April 2023
Revision received: 8 November 2023
Accepted: 22 December 2023
Published online: 29 May 2024
Published in print: August 01, 2024

Keywords

  1. Program evaluation
  2. Administration and management
  3. Community mental health services
  4. Self-harm
  5. Suicide prevention

Authors

Affiliations

Bryann DeBeer, Ph.D. [email protected]
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Joseph Mignogna, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Margaret Talbot, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Edgar Villarreal, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Nathaniel Mohatt, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Elisa Borah, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Patricia D. Russell, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Craig J. Bryan, Psy.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Lindsey L. Monteith, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Kathryn Bongiovanni, L.C.S.W.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Claire Hoffmire, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Alan L. Peterson, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Jenna Heise, M.A.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Sylvia Baack, Ph.D., R.N.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Kimberly Weinberg, L.C.S.W.-S.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Marcy Polk, D.N.P.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).
Justin K. Benzer, Ph.D.
Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer).

Notes

Send correspondence to Dr. DeBeer ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

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