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• Continue the development and advancement of research Author Contributions
to allow the VHA and DoD, as well as the entire field SC conceived the study concept and coordinated the man-
of psychology and counseling, to use multiple culture- uscript completion. JD analyzed prevention and military
specific norming samples in psychometrics, thereby practices. KD completed all style formatting. All authors con-
making them more accurate in screening and diagnosis. tributed to the manuscript draft, read, and approved the final
• Implement the inclusion of cultural factors in assess- manuscript.
ing risk factors and in developing interventions to im-
prove both proactive and reactive suicide prevention References
outcomes. 1. Federal Register. Executive Order No. 13,861 84 Fed. Reg. 8585.
• VHA and DoD acknowledgment of LGBT factors that 5 March 2019. https://www.federalregister.gov/documents/2019
increase the risk of suicide behaviors. There is a need /03/08/2019-04437/national-roadmap-to-empower-veterans-and
-end-suicide. Accessed 4 August 2021.
for further research and development of both proactive 2. World Health Organization. Suicide. 17 June 2021. https://www.who
and reactive suicide prevention programs that address .int/news-room/fact-sheets/detail/suicide. Accessed 4 August 2021.
resource and support barriers for LGBT MSMV. 3. Centers for Disease Control and Prevention. Preventing suicide. 22
May 2021. https://www.cdc.gov/violenceprevention/suicide/fastfact
.html. Accessed 4 August 2021.
Future Studies 4. American Public Health Association. Suicide prevention. https://
www.apha.org/-/media/Files/PDF/topics/Suicide_Prevention.ashx.
Executive order No. 13.861 by Past-President Trump specifi- Accessed 4 August 2021.
cally aims to empower veterans and eradicate suicide. Veteran 5. US Department of Veteran Affairs. 2019 National veteran sui-
1
cide prevention annual report. 19 September 2019. https://www
empowerment is essential because it involves veterans becom- .mentalhealth.va.gov/docs/data-sheets/2019/2019_National_
ing more confident in governing their civilian lives after con- Veteran_Suicide_Prevention_Annual_Report_Stone_Cover_Letter
cluding their military service, which is a major life adjustment. .pdf. Accessed 4 August 2021.
This article thoroughly investigated the elimination of veteran 6. McCarthy JF, Blow FC, Ignacio RV, et al. Suicide among patients
suicide through collaborative suicide reduction services, but in the Veterans Affairs health system: rural-urban differences in
rates, risks, and methods. Am J Public Health. 2012;102(Suppl 1):
there is minimal attention to the empowerment of veterans. S111–S117.
Future studies should examine best practices to empower vet- 7. Naifeh JA, Ursano RJ, Kessler RC, et al. Suicide attempts among
erans with respect to the guiding principles of the military. The activated soldiers in the U.S. Army reserve components. BMC Psy-
chiatry. 2019;19(1):31.
integration of the DoD and its services, to support a unified 8. Villatte JL, O’Connor SS, Leitner R, et al. Suicide attempt charac-
identity and a strategic campaign to increase mental wellness, teristics among veterans and active-duty service members receiving
may be instrumental in providing the framework for empow- mental health services: A pooled data analysis. Mil Behav Health.
ering veterans and ending suicide. 2015;3(4):316–327.
9. Rodrigues CC, Leite MF, Queirós M. Sexual minorities: The termi-
nology. Euro Psych. 2017;41(S1):848.
Many suicide prevention campaigns have focused on reducing 10. Newport F. In U.S., estimate of LGBT population rises to 4.5%. Gal-
the stigma of mental health treatment and other barriers to lup. 22 May 2018. https://news.gallup.com/poll/234863/estimate
care. Future studies could focus on developing and organizing -lgbt-population-rises.aspx. Accessed 4 August 2021.
a similar endorsement between Veteran Affairs, clinical mental 11. Rand Corporation. Sexual orientation and U.S. military personnel
health professionals, and the Veteran Empowerment Organi- policy: An update of RAND’s 1993 study. https://www.rand.org
/pubs/monographs/MG1056.html. Accessed 4 August 2021.
zation to reduce stigma and encourage veteran empowerment. 12. American Psychiatric Association. Mental health disparities:
The collaboration of these three entities may be beneficial in LGBTQ. 2017. https://www.psychiatry.org/File%20Library/
increasing veterans’ help-seeking behaviors and therefore re- Psychiatrists/Cultural-Competency/Mental-Health-Disparities
ducing veteran suicide. /Mental-Health-Facts-for-LGBTQ.pdf. Accessed 4 August 2021.
13. Blosnich JR, Brown GR, Shipherd JC, et al. Prevalence of gender
identity disorder and suicide risk among transgender veterans uti-
Although social isolation is identified as a significant concern lizing veterans health administration care. Am J Public Health.
for suicidality, military connectedness in relation to veteran 2013;103(10):e27–e32.
suicide has received limited attention in the literature. The 14. National Center for Transgender Equality. The report of the 2015
examination of this relationship may also be significant in U.S. transgender survey. December 2016. https://transequality.org
/sites/default/files/docs/usts/USTS-Executive-Summary-Dec17.pdf.
contributing to suicide reduction in veterans and improving Accessed 4 August 2021.
veteran empowerment. Investigating best practices in military 15. Flores AR, Herman JL, Gates GJ, Brown TN. How many adults
connectedness to reduce suicide may also support veterans’ identify as transgender in the United States? The Williams Insitute.
June 2016.
overall promotion of mental health awareness and well-being. 16. Brown GR, Jones KT. Mental health and medical health dispari-
ties in 5135 transgender veterans receiving healthcare in the Vet-
The researchers also notated a limited amount of literature erans Health Administration: a case-control study. LGBT Health.
related to USMV, homelessness, and the elevated risk for sui- 2016;3(2):122–131.
cide. The most relevant study reviewed focused on homeless 17. Blosnich JR, Mays VM, Cochran SD. Suicidality among veterans:
implications of sexual minority status. Am J Public Health. 2014;
veterans in Tel Aviv, Israel. The aforementioned study infers 104 Suppl 4(Suppl 4):S535–S537.
66
that homeless veterans were at an increased risk for suicide. 18. Drapeau CW, McIntosh JL. U.S.A. suicide 2017: Official final data.
It would be worthwhile for future studies to focus on the re- American Association of Suicidology. 10 December 2018. https://
lationship between military connectedness, homelessness, and suicidology.org/wp-content/uploads/2019/04/2017datapgsv1
-FINAL.pdf
increased risk of suicide for USMV. 19. Tucker RP. Suicide in transgender veterans: prevalence, prevention,
and implications of current policy. Perspect Psychol Sci. 2019;14
Disclosures (3):452–468.
The authors were unable to identify any conflicts of inter- 20. US Department of Veterans Affairs. Suicide among veterans and
est, nor will we receive any financial compensation for this other Americans 2001–2014. 3 August 2016. https://www.mental
health.va.gov/docs/2016suicidedatareport.pdf. Accessed 4 August
manuscript. 2021.
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