Goodman Marianne, Strouse Madison, Boucher Caroline, Glatt Sofie, Jacobs James, Waliski Angie, Fonseca Emilia, Osterberg Terra, Patel Sapana
VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Front Psychiatry. 2025 Mar 18;16:1512523. doi: 10.3389/fpsyt.2025.1512523. eCollection 2025.
Despite the Veterans Administration (VA) designating suicide prevention as the number one clinical priority, Veteran suicide rates continue to rise. One sub-population at elevated risk are Veterans living in rural communities given their heightened availability of firearms coupled with more limited access to mental health services. Telehealth delivery of treatment is a potential solution for the provision of critical services to rural areas. Despite the expansive growth of virtual treatment after the pandemic, there exist few suicide-specific telehealth health services. Our community case study aims to address this gap by piloting a manualized suicide safety planning and firearm safety group, titled Project Life Force (PLF), delivered virtually to rural Arkansas. The project's goal was to specifically enhance rural Veteran engagement with telehealth delivery through the use of community-based lived-experience rural peers. We present the rationale and details of the PLF intervention with a focus on the community Veteran peer enhancement component. This case study presents an innovative treatment design of a group led by a clinician augmented by a peer recovery leader that facilitated detailed conversations of how to limit suicide risk, encouraged disclosure about suicide symptoms, and promoted suicide related coping including encouragement of help-seeking behavior and safer storage of firearms. While the inclusion of a peer recovery leader was felt to be instrumental to the PLF-PE group's success, special attention to the peer recovery leader is essential and includes specific training, regular supervision as well as attention and support regarding the psychological impacts of self-disclosure and assuming a leadership role. This case study highlights the invaluable role that lived experience peers can play in suicide prevention treatment efforts and lethal means safety and paves the way for continued development of this effort.
尽管退伍军人事务部（VA）将自杀预防指定为首要临床优先事项，但退伍军人的自杀率仍在持续上升。农村社区的退伍军人是一个高风险亚群体，因为他们更容易获得枪支，同时获得心理健康服务的机会更为有限。通过远程医疗提供治疗是为农村地区提供关键服务的一个潜在解决方案。尽管疫情后虚拟治疗有了广泛发展，但针对自杀的远程医疗服务却很少。我们的社区案例研究旨在通过试点一个名为“生命力量计划”（PLF）的自杀安全规划和枪支安全手册化小组来填补这一空白，该小组以虚拟方式为阿肯色州农村地区提供服务。该项目的目标是通过利用基于社区的有生活经验的农村同龄人，特别提高农村退伍军人对远程医疗服务的参与度。我们介绍了PLF干预措施的基本原理和细节，重点是社区退伍军人同龄人增强部分。本案例研究展示了一种创新的治疗设计，即由一名临床医生领导的小组，并由一名同伴康复领导者辅助，促进了关于如何降低自杀风险的详细讨论，鼓励披露自杀症状，并促进与自杀相关的应对措施，包括鼓励寻求帮助的行为和更安全地存放枪支。虽然人们认为纳入一名同伴康复领导者对PLF-PE小组的成功至关重要，但对同伴康复领导者给予特别关注至关重要，这包括特定培训、定期监督以及对自我披露和担任领导角色的心理影响的关注和支持。本案例研究强调了有生活经验的同龄人在自杀预防治疗工作和致命手段安全方面可以发挥的宝贵作用，并为这项工作的持续发展铺平了道路。
