# Preventing Suicide Among Female and Male Veterans Not Receiving VHA Services

> **NIH VA I01** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2020 · —

## Abstract

BACKGROUND: Veterans are at elevated and increasing risk for suicide, relative to civilians. In particular,
female Veterans are nearly twice as likely to die by suicide, compared to female civilians. In addition, 70% of
Veterans who died by suicide did not use any Veterans Health Administration (VHA) care in the year before
death. Consequently, female and non-VHA Veterans have been identified as two target populations in the VA
National Strategy for Veteran Suicide Prevention. Yet most suicide prevention research has focused on VHA
users and male Veterans. Knowledge is thus limited regarding whether VHA and non-VHA users differ with
respect to who dies by suicide, precipitating circumstances of death, and regarding gender differences within
these domains. Moreover, while mental health (MH) care offers an important opportunity to recognize and
intervene upon suicide risk, knowledge is limited regarding barriers to accessing MH or suicide-specific care,
particularly in relation to whether these differ by gender or VHA use. These gaps preclude determining the most
effective and patient-centered means of preventing suicide among both female and male Veterans, particularly
those who not using VHA care. SIGNIFICANCE/IMPACT: The present study has strong implications for
understanding and preventing suicide among non-VHA users and female Veterans, both of whom have been
vastly understudied. This is particularly crucial considering: (1) the 2016 Female Veteran Suicide Prevention Act,
which directs VA to determine the most satisfactory and effective MH and suicide prevention programing for
female Veterans; and (2) the 2019 Executive Order on a National Roadmap to Empower Veterans and End
Suicide, which directs VA to work side-by-side with communities to reduce suicide among all Veterans, not only
those using VHA services. This study will increase knowledge of female and male Veterans who died by suicide,
including circumstances surrounding death, and the extent to which suicide decedents accessed MH care prior
to death. Such knowledge can be garnered to tailor prevention efforts across Veteran groups. Moreover, by
engaging with living Veterans, this study will improve understanding of Veterans’ experiences and willingness to
seek MH care in general and when suicidal, while also informing the extent to which their experiences, barriers,
and preferences differ by gender and VHA use. This knowledge is timely and critical as VA seeks to engage
more Veterans in care. INNOVATION: This study will be the first to identify factors differentiating VHA and non-
VHA suicide decedents and to explore female and male Veterans’ experiences and preferences for seeking help
when suicidal. This study is also innovative in conceptualizing non-VHA users as comprising Veterans who were
lost-to-care and who never used any VHA care. SPECIFIC AIMS: This study uses mixed-methods to compare
three groups of Veterans (VHA users, never users, and lost-to-care) across three aims: (1) Id...

## Key facts

- **NIH application ID:** 9953765
- **Project number:** 1I01HX002757-01A2
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Claire Hoffmire
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9953765

## Citation

> US National Institutes of Health, RePORTER application 9953765, Preventing Suicide Among Female and Male Veterans Not Receiving VHA Services (1I01HX002757-01A2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9953765. Licensed CC0.

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