Suicide prevention randomized controlled trial pilot: Rural veterans receiving mental health community care.

Objective: Suicide is a concern in rural veterans, particularly following acute mental health admission. Rural veterans can experience barriers accessing treatment, including mental health treatment. The MISSION Act of 2018 aims to alleviate some challenges through access to Community Care, which has since raised concerns about suicide prevention effort discrepancies and barriers between Veterans Affairs (VA) and non-VA providers. Despite concerns, limited studies exist of suicide prevention strategies in rural Veterans receiving acute mental health Community Care. Methods: We conducted a pilot study of the suicide prevention program, VA Brief Intervention and Contact Program (VA BIC), in rural veterans who accessed acute mental health Community Care across Northern New England. VA BIC supports treatment engagement and health-promotion behaviors in veterans after Community Care discharge. We developed a process to recruit eligible veterans into a three-month study of VA BIC. We assessed the feasibility of VA BIC in Community Care veterans and collected mental health outcome pilot data. Results: Among 44 eligible and reachable patients, 45.5% (N=20) consented. Retention was high with 95.0% of patients completing all assessments. Among the 10 VA BIC participants, adherence was high with 90% completing all eight visits and 100% completing six visits. Suicidal ideation, hopelessness, social connectedness, and suicide-related coping trended towards improvement in the VA BIC group at follow-up. Conclusions: It is feasible to study VA BIC following discharge from acute mental health Community Care, and the intervention may benefit veterans. Future studies should confirm the efficacy of VA BIC in reducing suicide risk in non-VA settings.