A Systematic Review of Suicide Prevention Programs for Operation Enduring Freedom and Operation Iraqi Freedom

                                                                                                                                   ABSTRACT     

Title:  A Systematic Review of Suicide Prevention Programs for Operation Enduring Freedom and Operation Iraq Veterans   

Background: In this country, there is concern for the mental health of the returning OEF/OIF Veterans who have been sent to participate in the present conflict.  According to Veterans Health Administration (VHA), everyday twenty-two Veterans take their own lives ("About Cochrane systematic reviews and protocols," 2014).  Important variables that contribute to poor mental health in veterans include:  a debilitating physical injury or exposure to stressful environments, loss of institutional structure that necessitates decision-makings, and lack of a home or family to assist with integration back into society.  Frequently these situations contribute to suicidal thoughts and behavioral conditions such as anxiety, Post-Traumatic Stress Disorder (PTSD), depression, and chronic pain (Bossarte, Claassen, & Knox, 2010).  Therefore, reviewing the literature for ways to reducing OEF/OIF Veterans suicide is essential given the increase rate of Veterans suicides.                                                              

Aims:  The aim of this study is to identify what suicide assessment and prevention intervention programs can help reduce suicide in OEF/OIF Veteran patients.

Design:  Systematic Review

Search strategies:  A literature search was performed using a variety of electric databases. 

CINHAL, OVID, MEDLINE, and Cochrane database of system reviews and Cochrane                         

 library were searched from 2010-2015 using key words suicide prevention programs,

OEF/OIF Veterans, suicide in Veterans, PTSD in Veterans, and depression in Veterans.  In the

search, the terms were individually searched and also in various combinations.  Studies were

selected based on inclusion – exclusion criteria that were formulated.  Data was selected 

independently  from their methodological quality assessed using the Caldwell framework.                                                                                                                      

Results:  Of the 303 citations identified from searching the databases and 3 were manually

searched, 294 studies were retrieved for full review; 7 met the inclusion criteria and were

reviewed while 53 were excluded for not meeting inclusion criteria. 

Findings:  Seven studies fell within the inclusion criteria were then submitted to a data

extraction and appraisal process based on a framework developed by Caldwell (Bettany-Saltikov,

2012). The Caldwell framework involves a checklist of the following seven steps:  author, aim of

study, sample size, design, data collection, analysis, and findings (Bettany-Saltikov, 2012).   

Conclusion:  Upon completion of an extensive Systematic Review, the existing literature reveals  

Veterans may not always receive high-quality care.  Providers working with Veterans in the

 VHA were more inclined to meet the VA standard of care.  The literature recommended

community providers are offered training on suicide prevention to expand access to evidence-

based approaches to  have a positive impact on suicide prevention in the future in the Veterans

population (Bagalman,

 2015).