Robinson Maurand, Holliday Ryan, Monteith Lindsey L, Blosnich John R, Elbogen Eric B, Gelberg Lillian, Hooshyar Dina, Liu Shawn, McInnes D Keith, Montgomery Ann Elizabeth, Tsai Jack, Grassmeyer Riley, Brenner Lisa A
Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, United States.
Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Front Psychol. 2022 Feb 7;13:683147. doi: 10.3389/fpsyg.2022.683147. eCollection 2022.
Suicide among Veterans experiencing or at risk for homelessness remains a significant public health concern. Conducting research to understand and meet the needs of this at-risk population remains challenging due to myriad factors (e.g., clinical complexity including multimorbidity, difficulty monitoring risk across systems). To address this challenge, the United States Department of Veterans Affairs (VA) convened the Health Services Research and Development (HSR&D) Suicide Prevention in Veterans Experiencing Homelessness: Research and Practice Development meeting, bringing together subject-matter experts in the fields of homelessness and suicide prevention, both from within and outside of VA. During the meeting, attendees identified 10 potential research priorities at the intersection of suicide prevention and homelessness. After the meeting, Delphi methodology was used to achieve consensus on the relative importance of the identified research domains. Through this iterative Delphi process, agreement was reached regarding the need to increase understanding of barriers and facilitators to suicide risk assessment and emergency intervention for Veterans experiencing homelessness by examining the perspectives of both Veterans and healthcare providers. Elucidating the complex relationships between risk periods, subgroups, suicide means, and drivers of suicide among Veterans experiencing homelessness was also considered a top priority. This article documents the Delphi process and provides a research agenda for researchers, funding agencies, and policymakers to prioritize the most relevant and potentially impactful research domains aimed at preventing suicide among Veterans experiencing or at risk for homelessness.
经历过无家可归或面临无家可归风险的退伍军人自杀问题仍然是一个重大的公共卫生问题。由于众多因素(例如,包括多种疾病的临床复杂性、跨系统监测风险的困难),开展研究以了解和满足这一高危人群的需求仍然具有挑战性。为应对这一挑战,美国退伍军人事务部(VA)召开了“经历无家可归的退伍军人自杀预防:研究与实践发展”卫生服务研究与发展(HSR&D)会议,汇聚了VA内外无家可归和自杀预防领域的主题专家。会议期间,与会者确定了自杀预防与无家可归交叉领域的10个潜在研究重点。会议结束后,采用德尔菲法就已确定的研究领域的相对重要性达成共识。通过这一迭代的德尔菲过程,就需要通过审视退伍军人和医疗服务提供者双方的观点来加深对经历无家可归的退伍军人自杀风险评估和紧急干预的障碍与促进因素的理解达成了一致。阐明无家可归退伍军人的风险期、亚组、自杀手段和自杀驱动因素之间的复杂关系也被视为首要任务。本文记录了德尔菲过程,并为研究人员、资助机构和政策制定者提供了一个研究议程,以便对旨在预防经历无家可归或面临无家可归风险的退伍军人自杀的最相关且可能产生影响的研究领域进行优先排序。