Peer-Written Caring Letters for Veterans after a Suicidal Crisis

Abstract

Objective

In the evidence-based suicide prevention intervention, Caring Letters, healthcare providers send brief, caring messages to patients following psychiatric inpatient care, a time of elevated suicide risk. However, recent studies with military populations have found mixed results. An adaptation of Caring Letters employed a peer framework in which veterans from the community wrote brief caring messages to veterans discharging from psychiatric inpatient treatment after a suicidal crisis.

Methods

The present study utilized content analysis to assess 90 caring messages generated by 15 peer veterans recruited from veteran service organizations (e.g., American Legion).

Results

Three themes emerged: (1) Shared Military Service, (2) Care, and (3) Overcoming Adversity. Peer-generated content varied in how the coded themes were expressed in the messages.

Conclusion

These veteran-to-veteran caring messages may bolster belongingness, social support, and destigmatize mental health struggles, and have the potential to augment existing Caring Letters effects and interventions.

HIGHLIGHTS

• Veterans commonly wrote about shared military services, care, and adversities.

• Supportive messages from peers may be tied to social support.

• Our analyses support possible benefits for veterans receiving caring messages.

Keywords:

• Caring letters
• content analysis
• peer support
• suicide prevention

ACKNOWLEDGEMENTS

We thank George Sayre for their expertise in qualitative analysis and providing helpful resources during the analysis.

DISCLOSURE STATEMENT

The opinions and assertions expressed in this work are those of the authors and do not necessarily represent the official policy or position of the institutions, the Department of Veterans Affairs, or the U.S. Government. None of the authors have any conflicts of interest to disclose.

Additional information

Funding

This work was supported by the University of Washington, Department of Psychiatry and Behavioral Sciences under Grant [65-4657].

Notes on contributors

Andrew T. Ton

Andrew T. Ton, VA Puget Sound Health Care System, Seattle, USA.

Sarah P. Carter

Sarah P. Carter, VA Puget Sound Health Care System, Seattle, USA.

Rebecca Leitner

Rebecca Leitner, VA Puget Sound Health Care System, Seattle, USA.

Lori A. Zoellner

Lori A. Zoellner, Department of Psychology, University of Washington, Seattle, WA, USA.

Natalie Mizik

Natalie Mizik, University of Washington, Seattle, WA, USA.

Mark A. Reger

Mark A. Reger, VA Puget Sound Health Care System, Seattle, WA, USA.