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Quantifying relational change in community organisations participating in a Veteran suicide prevention learning collaborative: a social network analysis
  1. Bryann B DeBeer1,2,
  2. Patricia D Russell1,2,
  3. Joseph Mignogna1,2,
  4. Nathaniel Mohatt3,4,
  5. Elisa Borah5,
  6. Craig J Bryan6,7,
  7. Lindsey Monteith1,8,
  8. Alan Peterson9,10,
  9. Andy Zheng11,
  10. Sara Sprong12,
  11. Kathryn Bongiovanni13,
  12. Edgar Villareal14,
  13. Claire A Hoffmire1,2,
  14. Jenna Heise15,16,
  15. Sylvia Baack17,
  16. Kimberly Weinberg18,
  17. Marcy Polk19,
  18. Tabitha Alverio2,
  19. Meredith Mealer1,2,
  20. Juliana Scheihing1,
  21. Justin Benzer20,21,
  22. Danielle Varda11
  1. 1Veterans Integrated Services Network 19 Rocky Mountain Mental Illness Research Education and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
  2. 2Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  3. 3Booz Allen Hamilton, Arlington, Virginia, USA
  4. 4Division of Prevention and Community Research, Yale School of Medicine, New Haven, Connecticut, USA
  5. 5The University of Texas, Austin, Texas, USA
  6. 6The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  7. 7Veterans Integrated Services Network 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
  8. 8Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  9. 9Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, San Antonio, Texas, USA
  10. 10Research and Development Service, VA South Texas Veterans Health Care System, San Antonio, Texas, USA
  11. 11Visible Network Labs, Denver, Colorado, USA
  12. 12Independent Contractor, Denver, Colorado, USA
  13. 13VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Health Care System, Harlingen, Texas, USA
  14. 14VHA Office of Mental Health and Suicide Prevention, Denver, Colorado, USA
  15. 15Suicide Prevention Center, Albany, New York, USA
  16. 16Education Development Center, Zero Suicide Institute, Waltham, Massachusetts, USA
  17. 17Michael E DeBakey VA Medical Center, Houston, Texas, USA
  18. 18Central Texas VA Health Care System, Temple, Texas, USA
  19. 19Portland VA Medical Center, Portland, Oregon, USA
  20. 20VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA
  21. 21Department of Psychiatry, The University of Texas Dell Medical School, Austin, Texas, USA
  1. Correspondence to Dr Bryann B DeBeer, Veterans Integrated Services Network 19 Rocky Mountain Mental Illness Research Education and Clinical Center for Suicide Prevention, Aurora, Colorado, USA; bryann.debeer{at}


Background Veteran suicide remains a significant issue, as 17.5 Veterans die by suicide each day. The US Department of Veteran Affairs (VA) has implemented a robust suicide prevention program within its integrated behavioural health system. Further, the VA has increasingly contributed to suicide prevention in community settings, where a large proportion of Veterans receive health care and social services. One component integral to preventing suicide among Veterans receiving community services is ensuring that organisations are equipped with the latest evidence-based Veteran-specific suicide prevention strategies.

Methods The Patient Safety Center of Inquiry-Suicide Prevention Collaborative piloted a Veteran suicide prevention learning collaborative in the Denver/Colorado Springs, CO region, spanning 16 months as a multimodal initiative to integrate community organisations and assist them in implementing Veteran suicide prevention strategies used within VA. Agencies completed social network analysis surveys at baseline (T1), year 1 (T2) and 16 months (T3) to examine social networks, partnerships and collaborations among community organisations and the VA over time.

Results The quantity of learning collaborative relationships increased from 30 at T1 to 41 at T3 while the quality of relationships deepened over time from awareness and cooperative to more coordinated and integrated.

Conclusion Improvement in relationship quantity and quality facilitates community organisation engagement in collaborating to strengthen their Veteran suicide prevention programming. Learning collaboratives work with the individual organisation for intraorganisational facilitation of implementing suicide prevention strategies and engage and enhance interorganisational partnerships. This multimodal intervention can engage community organisations and provide a stronger safety net for Veterans at risk for suicide.

  • Suicide/Self?Harm
  • Social Network Analysis
  • Dissemination
  • Public Health
  • Implementation / Translation

Data availability statement

Data are available on reasonable request. Not applicable.

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Data availability statement

Data are available on reasonable request. Not applicable.

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  • Contributors BBD is the primary investigator on the grant that funded the study and was responsible for the study design and all aspects of the study. BBD is the guarantor of the study and is responsible for the overall content. BBD, PDR, JM, AZ, SS, DV, SB, KB, LM and CAH authored the writing of the manuscript. PDR, JM, NM, EB, CJB, LM, AP, KB, EV, CAH, JH, SB, KW, MP, MM and JB are coinvestigators who have conceptualised the design of the study. AZ, SS and DV are responsible for the social network analysis survey, data analysis and conceptualised tables and figures. TA and JS have assisted with data collection and project coordination. All authors contributed to the final manuscript and read and approved the current version of the paper.

  • Funding This project was funded by the US Department of Veterans Affairs: VA National Center for Patient Safety. Grant award number: N/A

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.