Suicide Prevention Study: Letter of Intent

Group Preference

The topic of the proposed study is the areas of improvement in the current post-traumatic stress disorder therapy to enhance suicide prevention in the veteran population. Since the study aims at broadening the scope of evidence-based methods of counseling for veterans by means of changing behavioral patterns and facilitating the social reintegration of this vulnerable population, the assignment to the Behavioral Health & Social Reintegration [RRD4] group would be preferred.


Suicide is one of the most frequently reported causes of death in the veteran population, which is closely intertwined with PTSD prevalence in ex-combatants post-deployment (Horwitz et al., 2018). A high mortality rate indicates the insufficient quality of care, which must be improved to meet the needs and requirements of this vulnerable population.

The purpose of the proposed research study is to investigate the therapeutic opportunities of cognitive-behavioral PTSD-centered therapy for suicide prevention in veterans. The particular objectives to be pursued through the study include:

  • Obtaining veteran-perceived drawbacks in the quality of therapy services they obtained in outpatient facilities;
  • Obtaining veteran-perceived strengths of therapy services they obtained in outpatient facilities that helped veterans overcome PTSD-related challenges;
  • Identifying the factors that contribute to suicide ideations in combat veterans as reported by the participants;
  • Finding areas for therapy improvement to meet the identified needs of the vulnerable veteran population.

The general research question that is planned to be answered by the proposed study is:

RQ: How can PTSD therapy improve the quality of suicide prevention in veterans?

The specific research questions include:

  • RQ1: How do veterans with PTSD and suicide ideation having obtained professional help perceive the drawbacks in care?
  • RQ2: How do veterans with PTSD and suicide ideation having obtained professional help perceive the strengths in care?
  • RQ3: What factors contribute to suicide ideations in combat veterans, as reported by the participants?


Veterans in the USA are disproportionately exposed to psychological challenges related to pain and trauma received during combat. These issues result in mental disorders, the most prevalent of which is PTSD and suicide. According to Horwitx et al. (2018), “approximately 20 veteran suicide deaths per day” are being registered across the United States (p. 711). Such a high mortality rate is associated with the devastating level of the psychological burden of military war experiences intertwined with the difficulties of social reintegration. Much research is devoted to the investigation of the intersection between PTSD and suicidal ideations (Forehand et al., 2019; Horwitx et al., 2018; Wilks et al., 2019). These studies found that the individuals within the vulnerable veteran population suffering from PTSD are likely to attempt suicide after deployment.

At the same time, research has been devoted to investigating the most effective methods of therapy capable of reducing the symptoms of PTSD and minimizing suicidal rates among veterans (Finley et al., 2020; Garcia et al., 2011; Maguen et al., 2019). Such therapies as Cognitive-Behavioral Therapy, Evidence-Based Psychotherapy, Cognitive Processing Therapy, and others have been developed to address the tentative mental health issues in veterans with PTSD (Finley et al., 2020; Garcia et al., 2011). However, there are additional factors that influence the effectiveness of the enlisted therapy methods, which significantly depend on the veteran’s perception of treatment and their mental health. Indeed, as stated by Garcia et al. (2011), many veterans drop out of intervention programs without completing and achieving anticipated results. Perception-specific factors, such as provider, intervention characteristics, patients’ symptoms, and organizational context, have been identified as influential for the effective completion of therapy by veterans (Finley et al., 2020). Therefore, the relevance of perception-oriented research is very high and might contribute to the improvement of mental health care provided to this vulnerable population.

The currently proposed study aims at identifying the drawbacks and strengths of the mental health services based on a variety of therapy methods available to veterans from VA facilities. The findings will allow for detecting the imperfections in the provided service quality and improve therapy according to the needs of the population. This research will enhance the scope of evidence on PTSD and suicide relationships and provide a solid basis for care improvement that will ultimately minimize suicide rates in veterans.

Methods and Research Plan

This study will be conducted using a qualitative descriptive design. The choice of qualitative method is validated by the exploratory nature of the study that is aimed at clarifying and explaining the issues of therapy quality improvement from the perspective of a veteran’s perception. The population will include both male and female ex-combatants who have had and currently experience PTSD. A non-randomized sampling strategy will be utilized to include participants that comply with the study requirements. A sample of 20 individuals residing in Hawaii, having combat experience, and receiving outpatient or inpatient mental health therapy services for PTSD and suicide treatment will be recruited for the study.

Questionnaires will be used as the method of data collection. A set of questions will be presented to the participants to obtain information on their perceived attitudes toward the quality of care they receive, the drawbacks, strengths, and possible areas for improvement. Personal experiences of the veterans will be prioritized in the questions to collect the answers that pertain to the needs this population has in terms of psychological care. The descriptive approach will be utilized to analyze, synthesize, and interpret the data collected from the questionnaires. The findings will be tested for validity and reliability using the method of triangulation.

The planned duration of the research process is 5-6 months. The actions planned to be performed are presented in the table:

Activity Description Duration
Literature review Collecting evidence from the currently published literature on the problem Three weeks
Questionnaire development Synthesizing literature findings to create questionnaire questions in agreement with the research purpose, objectives, and research questions One week
Participant recruitment Finding and contacting veterans; obtaining their informed consent for participation Five weeks
Questionnaire Conducting questionnaires with the participants using online means Three weeks
Questionnaire analysis Analyzing participants’ answers, systematizing and categorizing them Three weeks
Findings interpretation Evaluation of findings against the research questions to draw conclusions Two weeks
Writing a research paper Integration of all data collected, analyzed, and interpreted throughout the research life cycle to present in an article Three weeks

Key Personnel

Name Institution Role Expertise

Resources Needed for the Study with Associated Costs

Project History

The proposed study is a new project that is based on the researchers’ prior investigatory experience in the field of PTSD treatment and opioid crisis management in the veteran population. Previously conducted research in the field of anti-opioid policies and initiatives aimed at the investigation of veterans’ experiences within the realm of pain management and mental health issues will be a valuable contribution to the successful conducting of the proposed research.

Research Site

The State of Hawaii, USA.

PI’s Experience

As a student enrolled in the Ph.D. program at the University of Manoa, I have had extensive experience in conducting research in the field of social work and mental health services. The needs and problems of veterans are of significant importance to me because I am a veteran, too. My personal experience of post-deployment reintegration into society, the psychological challenges of adapting to civilian life, and managing pain and trauma allow me to apply my knowledge to the academic field. Being aware of the most relevant issues from the inside perspective, I have the expertise of applying the military context to the research. My goal is to serve the veteran community by means of relevant and credible research capable of improving the quality of care and meeting the needs and requirements specific to the vulnerable population of ex-combatants.

Within the scope of my academic performance, I have conducted a Master’s research on the topic of opioid crisis mitigation strategies, participated in group research aimed at investigating community needs during the time of the COVID-19 pandemic, conducted several quantitative research studies in the areas of non-profit organizations’ work serving veterans, veteran academic performance, and pain-management strategies. I have successfully conducted several group projects, in which I managed to apply my decision-making, problem-solving, and effective communication skills to ensure that the project benefits from the collaborative efforts of the group. Thus, I believe I might contribute to group work on research and would perform to the best of my ability to contribute to the successful accomplishment of the project goals. To pursue my goal of serving the veteran population as a social work researcher, I would appreciate this opportunity to collaborate with the US Department of Veteran Affairs to expand the scope of my expertise and apply my experience and knowledge to improve the quality of care for veterans.

Cited References

Finley, E. P., Garcia, H. A., Ramirez, V. A., Haro, E. K., Mignogna, J., DeBeer, B., & Wiltsey-Stirman, S. (2020). Treatment selection among post-traumatic stress disorder (PTSD) specialty care providers in the Veterans Health Administration: A thematic analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 12(3), 251.

Forehand, J. A., Peltzman, T., Westgate, C. L., Riblet, N. B., Watts, B. V., & Shiner, B. (2019). Causes of excess mortality in veterans treated for post-traumatic stress disorder. American Journal of Preventive Medicine, 57(2), 145-152.

Garcia, H. A., Kelley, L. P., Rentz, T. O., & Lee, S. (2011). Pretreatment predictors of dropout from cognitive behavioral therapy for PTSD in Iraq and Afghanistan war veterans. Psychological Services, 8(1), 1-11.

Horwitz, A. G., Held, P., Klassen, B. J., Karnik, N. S., Pollack, M. H., & Zalta, A. K. (2018). Post-traumatic cognitions and suicidal ideation among veterans receiving PTSD treatment. Cognitive therapy and research, 42(5), 711-719.

Maguen, S., Li, Y., Madden, E., Seal, K. H., Neylan, T. C., Patterson, O. V., DuVall, S. L., Lujan, C., & Shiner, B. (2019). Factors associated with completing evidence-based psychotherapy for PTSD among veterans in a national healthcare system. Psychiatry Research, 274, 112-128.

Wilks, C. R., Morland, L. A., Dillon, K. H., Mackintosh, M. A., Blakey, S. M., Wagner, H. R., VA Mid-Atlantic MIRECC Workgroup, & Elbogen, E. B. (2019). Anger, social support, and suicide risk in US military veterans. Journal of Psychiatric Research, 109, 139-144.

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NursingBird. "Suicide Prevention Study: Letter of Intent." June 3, 2022.