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Introduction

On March 28 and 29, 2022, the Board on Behavioral, Cognitive, and Sensory Sciences at the National Academies of Sciences, Engineering, and Medicine held a virtual symposium entitled Community Interventions to Prevent Veteran Suicide: The Role of Social Determinants, which was the product of a collaboration begun in June 2020 between the U.S. Department of Veterans Affairs (VA) and the National Academies aimed to address “social, cultural, and economic factors influencing suicide risk among veterans, and to in turn identify best practices for suicide prevention, intervention, and postvention at the community level,” said Matthew Miller (Department of Veterans Affairs Suicide Prevention Program). He went on to explain that the symposium’s focus on the social determinants of health as they relate to veteran suicide prevention was built around three central tenets adopted by Miller’s team at the VA. The first of these tenets is that suicide is preventable. The second tenet is that suicide prevention will require a public health approach wherein challenges are addressed via policies, procedures, and programs that address the needs of the entire population as well as those at highest risk; promote equitable distribution and access to clinical care and support; and address the role of social and ecological risk and prevention factors. The third tenet highlights the importance of each participant’s contribution in the work of suicide prevention. Miller expressed hope that the symposium would “inspire and invigorate each of us regarding the meaningful and unique roles every one of us and each of us can play.”

In his overview of the symposium agenda, planning committee chair Timothy Strauman (Duke University) highlighted the two central goals

articulated in the Statement of Task: to gain a clearer picture of the social determinants that might move veterans toward distress and suicide risk, and to identify existing best practices for suicide prevention and treatment used in community-based interventions that could be employed to help reduce suicide risk in veterans in particular. Strauman noted that the identification of new opportunities for prevention would also be part of the agenda, with the goal of generating “new ideas that are doable, exciting, and inspiring,” a process meant to “help jumpstart what we think is a new chapter in preventing suicide for veterans,” said Strauman. (See Box 1-1 for Statement of Task.)

STRUCTURE OF SYMPOSIUM AND PROCEEDINGS

The symposium took place virtually over two days. The first day featured a combination of presentations, panel discussions, and question and answer sessions as participants “hear[d] from experts on the social, cultural, and economic determinants of suicide risk, particularly among veterans, as well as from experts who are engaged in community-based preventive interventions that are targeting those determinants,” according to Strauman. The second day saw participants divided into groups to discuss community prevention as it relates to a specific population of veterans; a reporting session and discussion where each breakout group shared their work with the larger group; and finally, a synthesis of the symposium sessions by the Planning Committee. This proceedings follows the structure of the symposium. Chapters 2 through 6 cover the presentations made over the course

of the first day of the symposium. The following chapters cover the second day, with summaries of the reports from each breakout group in Chapters 7 and large-group discussion of this material in Chapter 8. Chapter 8 also includes the synthesis generated in the final session of the symposium.

This proceedings has been prepared by the symposium rapporteur as a factual summary of what occurred at the symposium. The planning committee’s role was limited to planning and convening the symposium. The views contained in the proceedings are those of individual symposium participants and do not necessarily represent the views of all symposium participants, the planning committee, or the National Academies of Sciences, Engineering, and Medicine.

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