Factors Influencing Suicide Risk Assessment and Management in VA Primary Care Clinics: A Qualitative Study of Provider Perspectives

ABSTRACT

This study obtained the perspectives of 11 providers employed in Veteran Affairs (VA) primary care clinics across 4 states regarding the factors that influence the assessment and management of suicide risk. Qualitative data was analyzed using a hybrid inductive-deductive thematic analysis approach. Themes highlighted the impact of a trusting patient–provider relationship, multidisciplinary team-based care, education about suicide prevention from integrated behavioral health providers, reliable access to mental health care, and VA system-wide suicide prevention efforts in supporting generalists' ability to effectively assess and manage veterans' suicide. Recommendations for enhancing evidence-based care for suicide risk in primary care are discussed.

KEYWORDS:

• Veterans
• suicide
• assessment
• management
• primary care
• qualitative research

Acknowledgments

We extend gratitude to the providers who offered their time and shared their experiences with us. We also thank the Rocky Mountain MIRECC qualitative research core for consultation regarding qualitative methods and analysis. Data collection, analysis, and writing occurred during Megan L. Petrik's postdoctoral fellowship at the Rocky Mountain MIRECC. Manuscript preparation also was completed during Megan L. Petrik's employment at the University of Minnesota. A portion of the writing of this manuscript was supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs.

Ethics approval and consent to participate

This study was approved by the Colorado Multiple Institutional Review Board (#15–1471). Participants provided informed consent prior to participating in this study.