Concerned Significant Other Engagement Guide: All Hands on Deck for Improving Research on Veteran Suicide Prevention

The Concerned Significant Other (CSO) Engagement Guide was developed to enhance the involvement of CSOs—veterans’ family members, caregivers, and peers—in suicide prevention research and clinical practices. CSOs are often underutilized in veteran care, despite their critical role in bridging gaps between military and civilian healthcare systems. This guide stems from the “All Hands on Deck” initiative, which included a virtual convening and work groups to identify barriers and strategies for engaging CSOs in veteran suicide prevention.

This project utilized a multi-step approach to engage stakeholders:

• Advisory board included 16 members comprising CSOs, researchers, providers, and veterans.
• A two-day event in 2020 with 78 participants (CSOs, researchers, and providers) was hosted to discuss engagement strategies and barriers in suicide prevention.
• Follow-up discussions with 7–14 participants per session were held monthly from December 2020 to March 2021, to refine themes and recommendations.
• Data was collected through meeting recordings and researcher notes to inform the guide’s development.

The project identified several key insights:

• Systemic and provider limitations hindered CSOs’ involvement in research and care.
• Transparent, person-centered care and collaborative engagement with CSOs were highlighted as effective strategies.
• Researchers must co-create study questions with veterans and CSOs and ensure findings are communicated effectively.
• Strategies include building partnerships, improving cultural competency in military-informed care, and addressing high-risk behaviors through better crisis management and safety planning.

The findings underscore the importance of integrating CSOs into veteran care and research. Providers and researchers are encouraged to:

• Actively involve CSOs in developing and implementing care strategies.
• Build cultural competency in military-informed care to better support veterans and their families.
• Enhance outreach efforts by leveraging trusted community organizations and platforms.
• Prioritize collaborative research approaches that include CSOs from study design to dissemination.

By addressing these areas, the guide aims to improve both the quality of veteran care and the effectiveness of suicide prevention efforts.