Chaplain Training in Evidence-Based Practices to Promote Mental Health and Improve Care for Suicidality in Veterans and Service Members

Abstract

Objective

Chaplains are key care providers in a comprehensive approach to suicide prevention, which is a priority area for the U.S. Department of Veterans Affairs (VA) and the Department of Defense (DoD). In a cohort of 87 VA and military chaplains who completed the Mental Health Integration for Chaplain Services (MHICS) training–an intensive, specialty education in evidence-based psychosocial and collaborative approaches to mental health care–we assessed chaplains’ self-perceptions, intervention behaviors, and use of evidence-based practices, including Acceptance and Commitment Therapy (ACT), Problem-Solving Therapy (PST), and Motivational Interviewing (MI), in providing care for suicidality.

Method

Chaplains responded to a battery of items Pre- and Post-training and provided deidentified case examples describing their use of evidence-based practices in spiritual care for service members and veterans (SM/V) on various levels of a suicide prevention continuum.

Results

Post-training, chaplains reported increased abilities to provide care and mobilize collaborative resources. Over the course of MHICS, 87% of chaplains used one or more evidence-based practices with a SM/V at risk for suicide or acutely suicidal. Fifty-six percent of chaplains reported intervening with an acutely suicidal SM/V by using principles from ACT, 36% PST, and 48% MI. With persons at risk for suicide, 81% used principles from ACT, 66% PST, and 71% MI. Cases exemplified diverse evidence-based practice applications.

Conclusions

Findings indicate chaplains trained in evidence-based practices report effective application in caring for SM/V who are suicidal, thus offering a valuable resource to meet needs in a priority area for VA and DoD.

HIGHLIGHTS

• Chaplains provide essential care for SM/V who are at risk for suicide or acutely suicidal

• Training helps chaplains mobilize interdisciplinary and community resources in suicide care

• Evidence-based practices can effectively integrate within the scope of chaplaincy practice for suicide care

Keywords:

• Chaplain training
• suicidality
• evidence-based practice
• mental health
• veteran
• service member

ACKNOWLEDGMENTS

The authors wish to thank Heather King and George Jackson for their assistance in conducting this evaluation. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, or the U.S. government, or other affiliated institutions. Funding support for this evaluation was partially provided by the Defense Suicide Prevention Office (DSPO). Institutional support for this evaluation was provided by the Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC). The authors voice no competing interest in the conduct of this evaluation.

Additional information

Notes on contributors

Jennifer H. Wortmann

Jennifer H. Wortmann, Department of Veterans Affairs, Integrative Mental Health, Durham, NC, USA.

Jason A. Nieuwsma

Jason A. Nieuwsma, Department of Veterans Affairs, Integrative Mental Health, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

William Cantrell

William Cantrell, Department of Veterans Affairs, Mental Health and Chaplaincy, Durham, NC, USA.

Paola Fernandez

Paola Fernandez, Department of Veterans Affairs, Integrative Mental Health, Durham, NC, USA; Psychology Department, University of South Alabama, Mobile, AL, USA.

Melissa Smigelsky

Melissa Smigelsky, Department of Veterans Affairs, Mental Health and Chaplaincy, Durham, NC, USA.

Keith Meador

Keith Meador, Department of Veterans Affairs, Integrative Mental Health, Durham, NC, USA; Departments of Psychiatry and Health Policy, Center for Biomedical Ethics and Society, and Graduate Department of Religion, Vanderbilt University, Nashville, TN, USA