Objective: Suicide is a major public health problem, specifically among U.S. veterans, who do not consistently engage in mental health services, often citing stigma as a barrier. Complementary and Integrative Health (CIH) interventions are promising alternatives in promoting patient engagement and further, they may play a critical role in transitioning people into mental health care. Toward this goal, the Resilience and Wellness Center (RWC) was developed to break through the stigma barrier by addressing risk factors of suicide through multimodal CIH interventions via cohort design, promoting social connectedness and accountability among participants. Design: This is a program evaluation study at a large urban VA medical center, where assessments were evaluated from pre- to post-program completion to determine the effectiveness of an intensive multimodal CIH 4-week group outpatient intervention for suicide prevention. Outcome measures: Primary outcomes measured included group connectedness, severity of depression and hopelessness symptoms, suicidal ideation, sleep quality, and diet. Secondary outcomes included measures of post-traumatic stress disorder (PTSD), generalized anxiety severity stress/coping skills, pain, and fatigue. Results: The RWC showed high participant engagement, with an 84%–95% attendance engagement rate depending on suicide risk history. Data from 15 cohorts ( N = 126) demonstrate favorable outcomes associated with participation in this comprehensive program, as evidenced by a reduction in suicidal ideation, depression, and hopelessness, but not sleep quality and diet. In addition, in a subset of veterans with a history of suicidal ideation or attempt, significant improvements were noted in pain, PTSD/anxiety symptoms, and stress coping measures. Conclusions: The RWC shows that an intensive complement of CIH interventions is associated with a significant improvement with high veteran engagement. Findings from this program evaluation study can be used to aid health care systems and their providers in determining whether or not to utilize such multimodal CIH integrated interventions as an effective treatment for at-risk populations as a part of suicide prevention efforts.
Background: Complementary and integrative health (CIH) interventions show promise in improving overall wellness and engaging Veterans at risk of suicide. Methods: An intensive 4-week telehealth CIH intervention programming was delivered motivated by the COVID-19 pandemic, and outcomes were measured pre–post program completion. Results: With 93% program completion (121 Veterans), significant reduction in depression and post-traumatic stress disorder symptoms were observed pre–post telehealth CIH programing, but not in sleep quality. Improvements in pain symptoms, and stress management skills were observed in Veterans at risk of suicide. Discussion: Telehealth CIH interventions show promise in improving mental health symptoms among at-risk Veterans, with great potential to broaden access to care toward suicide prevention.
Suicide is a major public health problem in the US, specifically among Veterans. The Resilience and Wellness Center (RWC) is an innovative program focused on suicide prevention. The RWC targets vulnerable veterans by augmenting traditional treatments with complementary and integrative health interventions. One critical problem in suicide prevention is lack of engagement in traditional mental health programs, with stigma an oft-cited barrier. The RWC, an alternative paradigm, attempts to break through this barrier by addressing isolation through promoting group camaraderie and accountability, integral to the success of the program. This innovative program provides a unique opportunity to enhance life skills through Whole Health intervention, including: meditation, yoga, music therapy, exercise/dance etc. Specifically, the RWC is a four-week outpatient program, where admission is determined via hospital-wide consults. With a focus on Measurement Based Care, Veterans complete baseline and post-program assessments such as the Personal Health Questionnaire (PHQ9) and scales measuring: depression, hopelessness, sleep quality, and diet & nutrition. Data for 9 cohorts to date demonstrate significant improvements, with large treatment effects as evidenced by reduction in PHQ-9 totals and feelings of depression and hopelessness, especially for Veterans with histories of suicide attempts or ideation. Overall, Veterans found the RWC program experience favorable, with > 98% completing. The RWC can be rapidly deployed in the VHA by drawing on existing hospital services and clinics. According to participants, the RWC engages Veterans in building a partnership to pave the way towards a healthier, more sustainable lifestyle.
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