Mitigating Suicide Risk During the Military-to-Civilian Transition: The VA Veteran Sponsorship Initiative
Year: 2026
Type: article
Abstract: A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public-private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of -0.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public-private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition.
Authors: Joseph C. Geraci, David E. Goodrich, Erin P. Finley, Amanda L. Reed, Michael Eastman, Danielle Bracco, A. Solomon Kurz, Emily R. Edwards, Christine Eickhoff, Chien J. Chen, Andrea MacCarthy, Brian Roeder, Chris Paine, Alberto Feliciano, Brigid Connelly, Eric Andrew Nelson, Sarah Rachael Karkout, Nicholas Ahari, Nicholas R. Lindner, Jack Besser, Megan McFadyen-Mungall, Madeleine Allen, Samantha Gitlin, Matthew R. Augustine, Travis Bellotte, Leah Smith, Smita Badhey, Balavenkatesh Kanna, Brian Westlake, Meenakshi Zaidi, Rakeshwar S. Guleria, Brian P. Marx, Nicolle Marinec, Jason Wesbrock, Andy Cox, Kevin D. Admiral, Richard W. Seim, Ronald C. Kessler, Marianne Goodman
Institutions: Doris Miller Department of Veterans Affairs Medical Center, James J. Peters VA Medical Center, Central Texas Veterans Health Care System, VA Heart of Texas Health Care Network, Columbia University, Icahn School of Medicine at Mount Sinai, University of Pittsburgh, VA Pittsburgh Healthcare System, Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, United States Department of Veterans Affairs, Uniformed Services University of the Health Sciences, VA Eastern Colorado Health Care System, Boston University, VA Boston Healthcare System, VA Ann Arbor Healthcare System, VA Center for Clinical Management Research, Ann Arbor VA Medical Center, United States Army, Harvard University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,016
Award: G1649633608
OpenAlex ID: W7154753232
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