An exploratory analysis of self-reported protective factors against self-harm in an enrolled veteran general mental health population

Abstract

Introduction: The purpose of this study is to characterize self-reported protective factors against suicideor self-harm within free-response comments from a harm-risk screening. Materials and Methods: Veterans enrolled inDepartment of Veterans Affairs mental health care were administered a self-harm and suicide screening as part of thebaseline assessment in an ongoing implementation trial. Veterans indicated if they had thoughts of harming themselvesand if so, what kept them from acting on them. Responses were coded based on established Centers for DiseaseControl protective factor categories. Descriptive analyses of demographic factors (such as age, gender, and race), clinical factors, and quality of life measures were conducted across groups depending on levels of self-harm risk. Results:Of 593 Veterans, 57 (10%) screened positive for active thoughts of self-harm or suicide. Those with thoughts of selfharm had lower quality of life scores and higher rates of depression diagnoses. Of those individuals, 41 (72%) reportedprotective factors including Personal Resources (17%), Community Resources or Relationships (68%), and Otherincluding pets and hobbies (15%). Those with stated protective factors had higher rates of employment and lower ratesof PTSD diagnoses. Conclusion: This is one of the first open-response studies of harm-risk protective factors, allowingfor a patient-centered approach that prioritizes the individual's voice and values. New protective factors emergedthrough the open-response format, indicating important factors that kept Veterans safe from self-harm or suicide suchas pets and hobbies. Increasing focus on strengths and positive aspects of Veterans' lives that serve as protective factors may ultimately improve mental health treatment and prevention of suicide and self-harm.