{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:38:29Z","timestamp":1792075109321,"version":"4.4.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11-12","funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This evaluation examined the role of safety plans, one of a host of clinical suicide prevention interventions available for veterans through the United States Department of Veterans Affairs\u2019 national network of health care facilities managed by the Veterans Health Administration (VHA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Interviews were conducted with veterans who had experienced suicidal ideation or a suicide attempt since enrolling in the Department of Veterans Affairs health care system (N\u2009=\u200929). Topics included negative life experiences, triggers for suicidal ideation or a suicide attempt, ability to recall and utilize safety plans in crisis, safety plan elements found most and least useful, and improvements to safety planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen (62.07%) of the veterans in the sample had attempted suicide. Drug use was by far the most triggering and overdose was the most negative life event to subsequent ideation or attempt. Although all at-risk veterans should have a safety plan, only 13 (44.38%) created a safety plan, whereas 15 (51.72%) could not recall ever creating a safety plan with their provider. Among those who did recall making a safety plan, identifying warning signs was the most remembered portion. The most useful safety plan elements were: recognizing warning signs, supportive people and distracting social settings, names and numbers of professionals, giving the veteran personal coping strategies, options for using the plan, and keeping their environment safe. For some veterans, safety plans were seen as insufficient, undesirable, not necessary, or lacking a guarantee. The suggested improvements included involving concerned significant others, specific actions to take in a crisis, and potential barriers and alternatives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Safety planning is a critical component in suicide prevention within VHA. However, future research is needed to ensure safety plans are accessible, implemented, and useful to veterans when in crisis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usad144","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T21:39:11Z","timestamp":1684445951000},"page":"e3289-e3294","source":"Crossref","is-referenced-by-count":15,"title":["Veteran Experiences With Suicide Ideation, Suicide Attempt, and Social Support in Safety Planning Within the Department of Veterans Affairs"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2218-9484","authenticated-orcid":false,"given":"Monica M","family":"Matthieu","sequence":"first","affiliation":[{"name":"School of Social Work, Saint Louis University , St. Louis, MO 63103, USA"},{"name":"U.S. Department of Veterans Affairs, Central Arkansas Veterans Affairs Health Care System, HSR&D Center of Innovation: Center for Mental Healthcare & Outcomes Research , North Little Rock, AR 72118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra B","family":"Morissette","sequence":"additional","affiliation":[{"name":"Department of Psychology, One UTSA Circle, The University of Texas at San Antonio , San Antonio, TX 78249, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Clafferty","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, Central Texas Veterans Affairs Health Care System , Waco, TX 76711, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5861-007X","authenticated-orcid":false,"given":"Linda","family":"Degutis","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, Yale University , New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2196-0724","authenticated-orcid":false,"given":"Ciara M","family":"Oliver","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, Central Arkansas Veterans Affairs Health Care System, HSR&D Center of Innovation: Center for Mental Healthcare & Outcomes Research , North Little Rock, AR 72118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Adkins","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, Central Arkansas Veterans Affairs Health Care System, HSR&D Center of Innovation: Center for Mental Healthcare & Outcomes Research , North Little Rock, AR 72118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryann B","family":"DeBeer","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, Eastern Colorado Veterans Affairs Health Care System, VA Rocky Mountain MIRECC for Suicide Prevention , Aurora, CO 80045, USA"},{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus , Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"2023110723512297400_R1","article-title":"2022 National Veteran Suicide Prevention Annual Report","volume-title":"Office of Mental Health and Suicide Prevention","author":"U.S. Department of Veterans Affairs, Office of Mental Health and Suicide Prevention","year":"2022"},{"key":"2023110723512297400_R2","article-title":"Suicide Prevention Program","volume-title":"Veterans Health Administration","author":"Department of Veterans Affairs","year":"2021"},{"key":"2023110723512297400_R3","article-title":"VA\/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide","volume-title":"Department of Defense","author":"Department of Veterans 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for suicide prevention with veterans","volume":"41","author":"DeBeer","year":"2019","journal-title":"J Ment Health Couns"},{"key":"2023110723512297400_R7","volume-title":"Content Analysis: An Introduction to Its Methodology","author":"Krippendorff","year":"2012","edition":"3rd"},{"key":"2023110723512297400_R8","doi-asserted-by":"crossref","DOI":"10.4135\/9781529682571","volume-title":"Qualitative Content Analysis in Practice","author":"Schreier","year":"2012"},{"issue":"6","key":"2023110723512297400_R9","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/j.beth.2017.11.005","article-title":"Evaluating the effectiveness of safety plans for military veterans: do safety plans tailored to veteran characteristics decrease suicide risk?","volume":"49","author":"Green","year":"2018","journal-title":"Behav Ther"},{"issue":"5","key":"2023110723512297400_R10","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1027\/0227-5910\/a000348","article-title":"Perspectives of 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