(PS11-38) Examining the Effect of Gender and Group Composition on Treatment Engagement Among Female-identifying Veterans in Mindfulness-based Cognitive Therapy for Suicide Prevention (MBCT-S)

Background

Preventing Veteran suicide remains the top clinical priority for the Veterans Health Administration (VHA). The risk of suicide for Veterans far exceeds that of civilians, with suicide rates of female-identifying Veterans over double those of their civilian counterparts. While VHA has enacted numerous interventions aimed at preventing Veteran suicide, treatment engagement has emerged as a significant barrier, with many Veterans declining services or dropping out prior to treatment completion. For female-identifying Veterans receiving group treatments, a range of factors may impact engagement, including the intervention’s sensitivity to gender specific challenges and female Veterans’ comfort in predominantly male groups.

Existing research has examined predictors of treatment engagement for Veterans receiving individual services; however, minimal research focuses on female Veterans’ experiences in group treatment and even less examines group interventions focused on suicide prevention. Given the disparities in risk, our study attempts to identify factors that may impact the experience of female Veterans at risk of suicide who are engaged in group treatments. 

Present Study

The present study will examine the relationship among gender, group composition, and treatment completion in a Mindfulness-Based Cognitive Therapy for Suicide Prevention (MBCT-S) psychotherapy group. MBCT-S is a telehealth-based eight-week group intervention that integrates Mindfulness-Based Cognitive Therapy (Segal, Teasdale, & Williams, 2002) and Safety Planning Intervention (Stanley & Brown, 2012) to provide Veterans at high suicide risk with mindfulness skills to identify warnings signs and prevent suicidal crises. This intervention has been shown to reduce both suicide attempts and psychiatric hospitalizations and is currently being delivered to Veterans in New Jersey, New York, and Texas by clinicians in the NJ and NY Harbor VA Healthcare Systems.

The aims of this study are to: 1) Assess the relationship between Veteran gender and treatment engagement in MBCT-S. 2) Evaluate group gender composition on the relationship between gender and treatment engagement in MBCT-S.

Methods

Data from a sample of Veterans (N=147; 39 female Veterans, one female spouse of a Veteran) who have participated in an MBCT-S group will be analyzed. Veterans in the sample are enrolled across nine VA systems spanning New York, New Jersey, and Texas. Data on Veteran gender identity and other demographic variables will be analyzed to determine the relationship between gender and treatment engagement controlling for other relevant factors. Group composition (% of female Veterans enrolled in each group) will also be analyzed as a potential moderator of the relationship between gender and treatment engagement.

Discussion

Findings will discuss the potential utility of adapting suicide prevention efforts to meet the specific needs of female Veterans. Factors impacting differences in engagement will be discussed as well as modification to suicide prevention treatment and groups that may improve treatment engagement. Limitations and future directions for research will be discussed.