# Evaluating the Use of Peer Specialists to Support Suicide Prevention

> **NIH VA I21** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

Preventing suicide is a top priority for the Veterans Health Administration (VHA). Despite ardent and sustained
efforts over the last decade, the suicide rate for VHA patients remains significantly higher than civilians and non-
VHA using Veterans. Suicide prevention efforts for high risk VHA patients focus on clinical (e.g., mental health)
and service use (e.g., case management) factors. What has yet to be tested is an approach that targets factors
in community living, which are better conceptualized as rehabilitative in nature. For it is not only mental and
physical illnesses that heighten suicide risk in VHA patients, but also struggles with their sense of self-worth,
meaning, and social connections in the community. To help patients with high risk of suicide, this application
proposes to adapt and test a promising approach called PREVAIL, which uses ‘Peer Specialists’ (i.e., Veterans
with psychiatric disabilities who have been trained to help others with similar conditions). Peer Specialists do not
devalue clinical care but engage in rehabilitative tasks of building a life of self-respect and connectedness in
one’s local community by offering empathy, hope, and advice based personal experience of mental health
recovery. PREVAIL is promising, but still has not demonstrated clinical effectiveness and requires adaptation to
address the unique characteristics of Veterans and the VA health care system. This project proposes to use
Intervention Mapping, a multi-method, systematic approach using diverse stakeholders, to adapt and pilot
PREVAIL. The VHA is the single, largest employer of Peer Specialists and research shows that they can enhance
standard clinical care in mental health, physical health, and rehabilitative outcomes. However, Peer Specialists
have only just begun to be deployed in suicide prevention efforts. The primary aims of this study are to: 1) Use
Intervention Mapping to identify which components of PREVAIL require adaptation to reduce suicidal ideation in
high risk VHA patients and to identify implementation strategies useful for the VHA system; and 2) Pilot test the
feasibility and acceptability of the adapted PREVAIL, rehabilitative measures, and suicide-related outcomes for
use in a rigorous prospective study. With guidance from a steering committee comprised of researchers, VHA
leadership, and patients, needs assessment interviews with diverse VHA staff, Peer Specialists, and patients
will be conducted to inform the adaptation. Based on results from the needs assessment and the literature on
suicide prevention, psychiatric rehabilitation, and peer-based approaches, the steering committee will help adapt
PREVAIL. Twelve high suicide risk Veterans with unipolar or bipolar depression will participate in a 3-month “pre-
pilot” and provide feedback on how the adapted PREVAIL may be revised. After making any necessary
modifications to the intervention, a second group of 12 high suicide risk Veterans with unipolar or bipolar
depressi...

## Key facts

- **NIH application ID:** 10012014
- **Project number:** 1I21RX003291-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** MATTHEW CHINMAN
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10012014

## Citation

> US National Institutes of Health, RePORTER application 10012014, Evaluating the Use of Peer Specialists to Support Suicide Prevention (1I21RX003291-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10012014. Licensed CC0.

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