Women Veterans’ Perspectives on Suicide Prevention in Reproductive Health Care Settings: An Acceptable, Desired, Unmet Opportunity

Hoffmire, Claire A.; Brenner, Lisa A.; Katon, Jodie G.; Gaeddert, Laurel A; Miller, Christin; Schneider, Alexandra L.; Monteith, Lindsey L.

doi:10.1016/j.whi.2022.01.003

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…Informing veterans that there is an option to decline to respond to screening is also important, especially given that this has different clinical repercussions (e.g., prompts providers to offer rescreening) than a negative screen. Similarly, our findings emphasize the importance of providers rescreening their women veteran patients for MST, which may be particularly beneficial as rapport and trust are established (Hoffmire et al, 2022).…”

Section: Clinical Policy and Research Implicationssupporting

confidence: 62%

“…Our findings also suggest that women veterans who have experienced any MST type may be at increased risk for experiencing suicidal ideation, but that those who have experienced military sexual assault may be at particularly heightened risk for suicidal ideation and suicide attempt following military service. Additional findings from the qualitative aims of this broader study suggest that women veterans perceive suicide risk management and prevention in VA RHC settings to be acceptable and desired, yet this is a largely unmet opportunity (Hoffmire et al, 2022). Although prior literature provides considerations for trauma-informed suicide prevention with women veterans (Monteith et al, 2022) and survivors of MST (Holliday et al, 2020), understanding of how to address suicide risk among women MST survivors in RHC settings is needed, as there may be unique considerations for suicide prevention in such settings.…”

Section: Discussionmentioning

confidence: 96%

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Military Sexual Trauma Among Women Veterans Using Veterans Health Administration Reproductive Health Care: Screening Challenges and Associations with Post-Military Suicidal Ideation and Suicide Attempts

Monteith

Kittel

Schneider

et al. 2023

J Interpers Violence

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Military sexual trauma (MST) is highly prevalent among women veterans. Research among MST survivors has focused on individuals receiving care in specific settings, such as mental health services. There is a dearth of knowledge regarding MST prevalence and associations in other settings commonly accessed by women veterans, including reproductive healthcare settings. We examined MST prevalence (overall, by MST type and extent of underreporting) and associations with suicidal ideation and suicide attempts, among women veterans accessing Veterans Health Administration (VHA) reproductive health care. Our sample included 352 post-9/11 women veterans who used VHA reproductive health care in Fiscal Year (FY) 2018 and participated in a cross-sectional survey. Approximately 68.7% screened positive for MST, including 44.9% who reported experiencing military sexual assault. Notably, 30.8% reported MST on the survey, but had a negative MST screen for their most recent MST screen in their VHA medical record. Both military sexual harassment and assault were associated with increased prevalence of experiencing suicidal ideation following military service; however, a significant association among military sexual harassment, past-month suicidal ideation, and post-military suicide attempts was not detected. Military sexual assault was uniquely associated with past-month suicidal ideation and post-military suicide attempts. As MST and underreporting are highly prevalent among women veterans using VHA reproductive health care, rescreening for MST within this population is essential. A trauma-informed approach is recommended irrespective of prior MST screening results and may facilitate suicide prevention in this population. Addressing barriers to MST disclosure and preventing MST and its sequelae remain critical.

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Section: Clinical Policy and Research Implicationssupporting

confidence: 62%

Section: Discussionmentioning

confidence: 96%

Military Sexual Trauma Among Women Veterans Using Veterans Health Administration Reproductive Health Care: Screening Challenges and Associations with Post-Military Suicidal Ideation and Suicide Attempts

Monteith

Kittel

Schneider

et al. 2023

J Interpers Violence

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“…While specific methods of integrating these findings into clinical practice require additional research, prior work can provide some guidance. Research among women Veterans, including those with access to firearms, suggests that trust and rapport may be critical to facilitating discussions of firearm access and suicide risk, as well as shifting firearm storage practices [69]. In addition, providers can consider assessing the Veteran's stage of change and appropriately matching motivational interviewing approaches to help Veterans in storing their firearms safely [70].…”

Section: Plos Onementioning

confidence: 99%

“Feel the need to prepare for Armageddon even though I do not believe it will happen”: Women Veterans’ Firearm Beliefs and Behaviors during the COVID-19 Pandemic, Associations with Military Sexual Assault and Posttraumatic Stress Disorder Symptoms

Monteith

Miller²,

Polzer³

et al. 2023

PLoS ONE

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Aims Firearm purchasing increased within the U.S. during the coronavirus disease 2019 pandemic. While rates of firearm ownership and suicide are elevated among women Veterans compared to women non-Veterans, no studies have examined if and how firearm beliefs and behaviors changed among women Veterans during the pandemic. We examined women Veterans’ changes in firearm beliefs and engagement in firearm behaviors during the early pandemic era. Method 3,000 post-9/11 era women Veterans were invited to participate in a survey. 501 respondents (May-December 2020) comprised the sample for this concurrent nested mixed-method analysis. Thematic analysis and log-binomial regression were used. Results 13.88% (n = 69) of women Veterans in our sample reported changes in their firearm beliefs; 22.15% (n = 109) reported engaging in firearm behaviors. The most prevalent reported behaviors were making household firearms more accessible (16.13%) and purchasing ammunition (11.97%). Smaller percentages reported carrying a firearm more frequently (6.71%), loading previously unloaded firearms (5.69%), or purchasing a firearm (4.24%). Thematic analysis suggested firearm behaviors were likely driven by a perceived increased need to protect oneself, family, and property due to: (1) uncertainties brought on by the pandemic; (2) pandemic-related threats necessitating self-defense, preparedness, and self-sufficiency; (3) political, social, and racial unrest and protests. PTSD symptom severity and military sexual assault history were associated with higher prevalence of changes in firearm beliefs and engagement in firearm behaviors during the pandemic. Discussion Consideration of women Veterans’ prior experiences and pandemic-related factors may be necessary to contextualize firearm discussions and inform future research. Given associations of military sexual assault and PTSD symptoms with firearm beliefs and behaviors, it may be crucial to ensure that such discussion are trauma-informed.

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“…Recent studies have also found that women find (and in some cases prefer) mental health support from their reproductive healthcare providers (Hoffmire et al 2022;Hall et al 2017). Limiting reproductive healthcare services will result in women not getting the mental health support they need.…”

Section: The Influence Of Reproductive Healthcare Access On Women's R...mentioning

confidence: 99%

The Impact of Abortion Restrictions on Women’s Mental Health: A State-Level Analysis

Johnson¹

2023

Preprint

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This study examines the impact abortion restrictions and bans have on women's mental health in the United States. Using state-level data, I ran several regressions to determine the effect of states' abortion policies on the rate of frequent mental distress in women. Even while controlling for poverty and exploring the possible mechanism of pregnancies wanted later or unwanted ending in birth as accounting for this relationship, it became apparent abortion laws in a state account in part for the rate of frequent mental distress in women. I conclude by reflecting on the impact of bodily autonomy and state surveillance on women and urge states to protect abortion to preserve the health of women and children.

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Women Veterans’ Perspectives on Suicide Prevention in Reproductive Health Care Settings: An Acceptable, Desired, Unmet Opportunity

Cited by 12 publications

References 28 publications

Military Sexual Trauma Among Women Veterans Using Veterans Health Administration Reproductive Health Care: Screening Challenges and Associations with Post-Military Suicidal Ideation and Suicide Attempts

Military Sexual Trauma Among Women Veterans Using Veterans Health Administration Reproductive Health Care: Screening Challenges and Associations with Post-Military Suicidal Ideation and Suicide Attempts

“Feel the need to prepare for Armageddon even though I do not believe it will happen”: Women Veterans’ Firearm Beliefs and Behaviors during the COVID-19 Pandemic, Associations with Military Sexual Assault and Posttraumatic Stress Disorder Symptoms

The Impact of Abortion Restrictions on Women’s Mental Health: A State-Level Analysis

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