Understanding the Role of Chaplains in Veteran Suicide Prevention Efforts

Abstract

In 2007, the U.S. Department of Veterans Affairs (VA) initiated an intensive effort aimed at reducing suicidal behavior among Veteran populations (Kemp, 2014). At present, the number of Veterans who die by suicide is estimated at 18 to 22 per day, accounting for approximately 18% of all suicide completions in the United States (Centers for Disease Control and Prevention, 2014;Kemp & Bossarte, 2013). These high rates are thought to be due, at least in part, to the increased incidence of diagnosed mental health disorders in this group (LeardMann et al., 2013). Be that as it may, suicide is much more than just a mental health issue (Department of Health and Human Services, Office of the Surgeon General, & National Action Alliance for Suicide Prevention, 2012). Research finds that more than 50% of those who die by suicide do not have a psychiatric diagnosis (Bertolote & Fleischmann, 2002). This highlights the need for novel support options, not limited only to formal mental health services, which can be accessed by at-risk populations.All VA Medical Centers (VAMCs) staff clinical chaplains who provide spiritual and pastoral care services when requested by the Veteran. Pastoral care is sometimes defined as "a therapeutic modality distinguished by the dialogue of caregiver and careseeker that explores the possibility and implications of a religious definition of the latter's situation" (Furniss, 1994, p. 177). Spiritual care relates to "an appreciation of presence and purpose that includes a sense of meaning" and is inclusive of pastoral care (VandeCreek & Burton, 2001, p. 2). Most chaplains also provide a number of services not directly affiliated with any faith tradition, such as crisis intervention, emotional enabling, ethical consultation, deliberation, life review, patient advocacy, counseling, bereavement, and empathetic listening (Handzo et al., 2008). Unlike some community-level clergy or pastoral care providers, clinical chaplains are specially trained to support patients in health care settings.VA chaplains have assumed a unique place within the structure of services provided at VAMCs. As a matter of policy, the comprehensive health care package offered to Veterans is expected to include spiritual and pastoral care (i.e., when so requested by the patient; Department of Veterans Affairs, 2008a). Many Veterans will look to 553589S GOXXX10.

Spirituality and Moral Injury Among Military Personnel: A Mini-Review

“…Feelings of unease, self-condemnation, and distress can quickly surface (47, 58, 67). Currier and colleagues found that exposure to more traumatic MIEs is negatively correlated with a person’s ability to make meaning of trauma (67), be that meaning made of the MIE, the impact of the MIE on meaning systems, or attributions of the MIE (11, 47, 53, 55, 59–61, 65, 67, 58, 73). From a syndrome perspective of MI (53), perceived loss of life meaning has been identified as a core symptom within the spiritual conflict domain (61).…”

“…This may involve education, modified exposure, self-forgiveness, dialogue with a benevolent moral authority, reparation and forgiveness, (re)connection and (re)engagement with an S/R community, and integration throughout life (1, 11, 74, 76). Spirituality, which is identified as a treatment modality for MI (p. 704) (77), may enhance recovery and healing (11, 40, 46, 54, 55, 58–60, 63, 64, 68, 72, 73, 78).…”

“…S/R communities can be invaluable resources for military personnel and veterans recovering from MI. Faith-based communities can provide a place and space for members to connect; engage; practice patience, kindness, and forgiveness; spiritually integrate; and reconstruct meaning and purpose (11, 13, 18, 54, 61–65, 40, 68, 73). Conversely, some individuals may experience difficulty engaging in S/R communities due to feelings of guilt, shame, and perceived or real judgment.…”

Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy

“…There has been growing empirical interest into examining the contribution of chaplains to suicide prevention efforts targeting current and former military personnel (Kopacz et al., ; Nieuwsma et al., ). Chaplains in the VA health care system actively support veteran populations at increased risk of suicide (Kopacz, ).…”

Veterans, guilt, and suicide risk: An opportunity to collaborate with chaplains?

“…In this case, clinicians and chaplains must work closely together to reframe old understandings of self and incorrect understandings of religion and spirituality into one that continues to reinforce this newfound sense of hope. 38…”