Preventing Suicidal Self-Directed Violence Among Survivors of Military Sexual Trauma: Understanding Risk and Applying Evidence-Based Principles

Abstract

Military sexual trauma (MST), which is defined as sexual harassment and/or assault during a person's military service, is associated with suicidal self-directed violence. Suicide risk assessment and intervention with survivors of MST should be patient-centered and informed by an understanding of the impact of interpersonal trauma and military service on the survivor's lived experience. Considerations for assessing and intervening upon suicide risk with survivors of MST are discussed, with a particular focus on safety planning, lethal means safety, and psychotherapy. We conclude by discussing necessary future research in suicide prevention in this population. [ Psychiatr Ann . 2020;50(10):437–443.]

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

“…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.…”

Childhood Sexual Abuse and Military Sexual Trauma Interact to Increase Suicide Risk: Results from a Nationally Representative Veteran Sample

“…Yet understanding of healthcare access and engagement in the community among veteran MST and CSA survivors remains limited. As such, increased efforts to increase collaboration and synergy between VA and community entities may be helpful (Foynes et al, 2018), especially as it relates to ensuring appropriate provision of evidence-based suicide prevention programming (Holliday et al, 2020). While findings do support that sexually revictimized veterans are more likely to experience suicidal thoughts and behaviors, numerous studies suggest that veterans with such experiences generally respond well to mental health treatment.…”

“…Yet understanding of healthcare access and engagement in the community among veteran MST and CSA survivors remains limited. As such, increased efforts to increase collaboration and synergy between VA and community entities may be helpful (Foynes et al, 2018), especially as it relates to ensuring appropriate provision of evidence-based suicide prevention programming (Holliday et al, 2020).…”

“…For example, veterans who experience childhood and military sexual violence often have similar treatment outcomes to those who did not (Chard, 2005; Holder et al, 2019). Moreover, empirically-supported suicide risk assessment and intervention (e.g., Safety Planning) can be integrated into such treatments without impacting fidelity (Holliday et al, 2019, 2020). In doing so, providers can potentially attenuate survivors’ suicide risk, with minimal evidence of iatrogenic effect (Brown et al, 2019; Roberge et al, 2021).…”

“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

“…As survivors of military sexual trauma, particularly sexual assault, are already at elevated risk for suicidal thoughts and behaviors [52], these findings underscore the import of ensuring that lethal means safety initiatives include sufficient focus on firearms among women Veteran military sexual trauma survivors and that traumainformed approaches are considered when doing so [53]. Further information relevant to this topic is available elsewhere [53][54][55][56].…”