Project Details


Despite the enrichment of VA suicide prevention services and implementation of the nationalsuicide hotline, Veteran suicide completions have risen to 22 per day and suicide attemptsnumbered over 15,000 in 2012. These data underscore the urgency of developing additionalinterventions targeting suicidal Veterans. One potential avenue to further suicide treatment andrehabilitation efforts is to develop strategies that maximize family support, however almost nofamily interventions exist for suicidal Veterans. The construction of a Suicide Safety Plan (SSP);a “best practice,” is mandated throughout the VA system, and a vital component of the VA’scoordinated effort at suicide prevention and recovery. Our pilot data on patterns of SSP use insuicidal Veterans highlighted the importance of sharing the plan with family or close friends.However, respondents also noted significant obstacles in their ability to reach out to otherswhen in distress. To our knowledge, there are currently no recommended guidelines ormechanisms for involving family in safety planning, despite its inclusion as a step of the plan.“Safe Actions for Families to Encourage Recovery” (SAFER) a novel suicide safety planningfamily intervention has been designed to fill this critical gap and provide a mechanism tocommunicate about safety planning. SAFER, a 4-session, family intervention, combineseducation about suicide and suicide safety planning with communication skills training fromevidence-based practices. The aim is to facilitate communication about suicide safety planningand to develop both a Veteran and family member safety plan.Data from this project will test the intervention’s feasibility, acceptability and preliminary efficacyin a Stage II (Rounsaville et al, 2001) small-scale randomized clinical trial in 60 moderate suiciderisk Veterans and their family members. The comparison condition will be safety planningwithout family involvement plus weekly check-in phone calls. Primary Veteran outcomes includereducing suicidal ideation/behavior. Secondary Veteran outcomes include reducing suicidalcognitions (hopelessness, perceived burdensomeness, thwarted belongingness) anddepression and improving subjective social support. Family member primary outcomes includereducing caregiver burden and secondary outcomes of improving suicide-related coping andfamily empowerment.

Effective start/end date1/03/1729/02/20


  • U.S. Department of Veterans Affairs: $124,876.00


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