Suicidality and veterans with a history of traumatic brain injury: precipitants events, protective factors, and prevention strategies.

OBJECTIVES To increase understanding regarding precipitating and preventative factors of suicidal behavior and to highlight past experiences and recommendations regarding services aimed at suicide prevention among Veterans with a history of traumatic brain injury (TBI). STUDY DESIGN Qualitative. PARTICIPANTS Sample of 13 Veterans with a history of TBI, and a history of clinically significant suicidal ideation or behavior. METHOD In-person interviews were conducted and data were analyzed using a hermeneutic approach. RESULTS Shared precipitants noted included loss-of-self post-TBI, cognitive sequelae, and psychiatric and emotional disturbances. Common protective factors noted included social supports, a sense of purpose regarding the future, religion and spirituality, and mental health care. Means of improving care were also identified (e.g., increasing the availability of services and mental health professionals' knowledge regarding TBI, providing more structured treatment). CONCLUSIONS Findings highlight potential areas of importance in the assessment and treatment of suicidal Veterans with a history of TBI. Recommendations regarding means of improving care are also presented.