For veterans after suicide attempts, gender affects recovery needs

What care do veterans need when recovering after suicide attempts? The answer may be different for women compared to men veterans, reports a qualitative study in Medical Care, part of a special issue devoted to new research on suicide risk and prevention in women.

"The paths to recovery after a suicide attempt may vary by gender, especially among veterans," according to the new research by Lauren M. Denneson, Ph.D., of the HSR&D Center to Improve Veteran Involvement in Care (CIVIC) at VA Portland (Ore.) Health Care System. "Our data suggest that women emphasize relatedness whereas men emphasize competence." Their study appears in a supplement dedicated to "Advancing Knowledge of Suicide Risk and Prevention Among Women."

Women and men veterans have differing recovery needs after suicide attempts

Dr. Denneson and colleagues conducted in-depth interviews with 50 veterans with recent suicide attempts: 25 women and 25 men. "We asked participants what has been helpful, as well as what would be helpful, in their recovery from their suicide attempts," the researchers write.

While some responses were similar between groups, thematic analysis suggested some gender-related differences in recovery needs:

• Women veterans prioritized their connections with others. "They tended to find strength in helping others, despite being over-burdened themselves," Dr. Denneson and coauthors write. The women expressed a wish for mutually supportive relationships in which they could give as well as receive emotional support, as well as sharing knowledge and experiences.
• The women wanted to repair their self-worth through self-knowledge and development - they wanted to know "why they do, think, or feel the things they do." Women veterans stated a desire to feel "more secure and clear in their sense of self...related to a desire to increase their sense of self-worth."
• By comparison, men veterans were strongly focused on trying to live and do 'right' during their recovery. "It seemed as though the men had an idea in their mind of what living "right" meant to them personally, and they were striving towards this ideal," according to the authors.
• Although relationships were important to men as for women veterans, the men were motivated by feeling needed and accountable to others. They discussed the need to be there for their families or to contribute to "something bigger, outside themselves."
• Regardless of gender, the veterans expressed the desire for a stronger sense of purpose. Some felt the need for a clearer direction in their lives, or the importance of having and achieving goals. Many veterans talked about regaining some of the structure and purpose they felt during their military service.

The findings have implications for working with veterans recovering after a suicide attempt, Dr. Denneson and coauthors believe. For example, women might be more interested in groups or activities that connect them to others with similar experiences, or educational programs to help them better understand themselves or others. In contrast, men might benefit from goal-oriented approaches that set them up for successful experiences or make them feel accountable to a group.

The supplement, developed by the VA's Health Services Research and Development Service and Women's Health Research Network, presents 13 new research papers relevant to women's risk of suicide. "Suicide prevention among women has become especially important within the US Departments of Defense and Veterans Affairs, as higher rates of suicide among women veterans has been observed compared to women nonveterans," according to an introduction by Dr. Denneson and other supplement guest editors.

Broad topics include challenges and breaking barriers in gender and suicide prevention, identifying risk and facilitating recovery among women, and considering suicide risk across the lifespan. The guest editors conclude: "We look forward to seeing how investigators build upon the work published here; how healthcare operations, community partners, and policy leadership use these new findings to bolster prevention efforts; and how this work will elevate awareness of suicide among women with clinical providers and others."