Gender Differences in Barriers and Facilitators to Care among U.S. military Veterans at High Risk for Suicide: A Qualitative Study

Veteran engagement in care is imperative to suicide prevention. However, barriers to engaging veterans at risk for suicide in care remain a challenge, and women veterans may have unique experiences that promote or inhibit care-seeking behaviors. The goal of this study was to better understand barriers and facilitators to care among veterans at high risk for suicide and identify potential gender differences. We interviewed 25 women and 25 men veterans utilizing VHA health care across the United States (U.S.), who had a recent suicide attempt (6 months prior). Psychological safety was a dominant theme for veterans seeking and using VHA care. Women and men both needed to feel safe and comfortable in the VHA environment. Women described psychological safety as being able to let their guard down, while men desired to not feel judged for seeking care. Veterans felt a sense of comradery in the VHA environment; however, women did not always feel welcome as veterans. Findings suggest the need to attend to the psychological safety of women and men veterans at high risk of suicide in VHA. Strategies to attune VHA staff to trauma-informed care practices for women and expand trauma-informed care resources may facilitate care engagement.