# Understanding Impact of VHA's New Suicidal Ideation Screening Initiative: Veteran's Perspective

> **NIH VA I01** · PORTLAND VA MEDICAL CENTER · 2024 · —

## Abstract

Background: Population-based screening programs for suicidal ideation (SI) are becoming standard practice.
This year, VHA is implementing a new multi-stage SI screening and evaluation process, VA Risk-ID. However,
prior research has shown that Veterans often feel uncomfortable disclosing SI during screening, and that
Veterans frequently do not disclose SI at healthcare visits proximal to suicide. Further, there is almost nothing
known about how SI screening experiences may impact subsequent treatment engagement. Factors known to
be associated with treatment engagement include effective patient-clinician communication, therapeutic
alliance, and collaborative treatment planning. Negative perceptions of SI screening have the potential to
adversely affect Veteran comfort disclosing and discussing SI, as well as subsequent engagement in care.
Significance/Impact: Suicide prevention is VHA’s highest priority, and optimizing engagement of at-risk
Veterans in treatment is of critical importance. This project addresses key gaps: 1) It will generate knowledge
about both positive and potentially negative impacts of a population-based SI screening process; 2) It will
generate comprehensive information about SI screening from the perspective of patients; and 3) It will examine
the relationship between screening experiences and subsequent engagement in care.
Innovation: This project will use a mixed methods approach to characterize the “natural history” of the
treatment of Veterans screened for SI in primary care and mental health settings primarily from the perspective
of Veterans, from the point of initial depression or PTSD screening until 6 months after screening.
Specific Aims: (1) In a national, stratified random sample of Veterans screened in primary care and mental
health, using quantitative surveys, characterize Veteran experiences with VA Risk-ID screening and clinical
evaluation that takes place in response to screening; (2) Conduct semi-structured qualitative interviews with
Veterans and staff who participate in SI screening, with the goal of identifying ways to improve screening and
engagement after screening; (3) Among the group of Veterans screened in primary care, examine the extent to
which screening process variables are associated with mental health treatment utilization over 6 months.
Methodology: This 3-year mixed-methods project will utilize quantitative and qualitative data from a national,
stratified random sample of Veterans. In Aim 1, we will mail recruitment letters immediately after VA Risk-ID
screening to 2,000 Veterans screened in primary care and 2,000 Veterans screened in specialty mental health
who have not received mental health treatment in the prior 12 months. Respondents will be invited to complete
surveys including measures assessing satisfaction with screening, patient-care team interactions and
perceived barriers to care and disclosure. In Aim 2, informed by Aim 1 survey results, up to approximately 40
Veterans identifie...

## Key facts

- **NIH application ID:** 11145701
- **Project number:** 5I01HX002987-04
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Steven K Dobscha
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-12-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11145701

## Citation

> US National Institutes of Health, RePORTER application 11145701, Understanding Impact of VHA's New Suicidal Ideation Screening Initiative: Veteran's Perspective (5I01HX002987-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11145701. Licensed CC0.

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