Examining suicide disparities among rural-dwelling Hispanic Veterans: A quality improvement project

Abstract: Background: Over the last decade rural Hispanic Veterans have had the largest percent increase in suicide rate amongst all Veterans. Despite these alarming statistics, suicide among Hispanic Veterans remains relatively understudied and little is known about their needs and how to prevent suicide in this population. We describe a one-year quality improvement project that examined the unique needs of rural Hispanic Veterans and identified gaps in community suicide prevention. Methods: A mixed methods iterative approach was utilized to conduct a needs assessment of community suicide prevention services and resources available to rural Hispanic Veterans in the Veterans Health Administration’s Veterans Integrated Services Network (VISN) 8. We followed the Substance Abuse and Mental Health Services Administration Needs Assessment model. Five counties and Puerto Rico met the criteria for having a high-density population of rural-dwelling Hispanic Veterans in VISN 8. We obtained demographic data, conducted an online search of mental health and suicide prevention resources, and conducted interviews with stakeholders to assess the needs of rural Hispanics Veterans and gaps in community suicide prevention services and resources. Results: We identified five themes related to the suicide prevention’s needs and gaps in services: (1) lack of adequate information; (2) disruptions in social support network; (3) limited or lack of access to services; (4) risky behaviors; and (5) natural disasters. Conclusion: Responding to inequities with traditional approaches have not been successful with underserved communities, such as rural and minority populations. While some of the needs we found mimic those of other rural populations, there are additional drivers impacting the needs in the rural Hispanic Veteran population. For example, while most rural areas lack accessible services, Hispanics living in rural area also need culturally relevant services. Understanding the unique needs of Hispanic Veterans in rural communities and the gaps in services in these areas can help in the development of tailored suicide prevention efforts, potentially improve the well-being of rural Hispanic Veterans, and mitigate suicide disparities.