Understanding Community Factors Related to Veteran Suicide and Death by Self-Harm: An Introduction to the Sociocultural Death Investigation Tool 

America's Warrior Partnership

Veteran suicide is one of the most tragic issues of our time, and so many of us often wonder why they occur. We think about all the problems that could have been the cause; financial issues, marital issues, trauma, physical and mental health struggles, etc. The unfortunate truth is that it could be all or none of these things that led a veteran to that point, and right now professionals do not have enough information to be able to say what is causing this rise in veteran suicide numbers. In fact, most largescale attempts at curbing these numbers have been mostly unsuccessful. This is why Operation Deep Dive is so important!  

The more information we collect about individual cases, the better we will be able to identify patterns that are unique to each community. To do this, we will use the Sociocultural Death Investigation (SDI) tool, which has a very technical-sounding name but is actually very straightforward. It is a set of interview questions that explore different parts of a veteran’s life and their interactions within their community the year before they passed away 

Who we are interviewing: 

Interview participants include adult relatives, loved ones, friendsor co-workers of the veteranA veteran in our study is anyone who served in any branch for one day or more with any discharge status Interviews are taking place between 2019 and 2021 with individuals who have lost a veteran loved one between two to six months after they have passed away. The interview participant and the veteran must have lived within one of our target communities.  

What the SDI covers: 

The SDI is based on a similar tool called the Psychological Autopsy (PA), which has been used by experts since the 1970s to better understand clinical reasons why someone died by suicide. What makes the SDI different is that it asks about clinical issues and other risk factors that are about their community structures and organizational supports. For example, what places did they visit? Whom did they ask for help, if at all? What were their relationships like? These are all questions that will help us piece together what each veteran’s journey looked like in their community. 

The goal of the SDI: 

This doesn’t mean that we are looking for who or what we can blame for this unacceptable loss of lives. It means that we are putting on our detective hats to figure out where there are opportunities to create safety nets in societies to catch each veteran before they fall. We want to stop veteran suicide and self-harm using prevention plans drawn according to every community’s specific needs and trends. This is especially important because we know that a veteran who dies by suicide in Orange County, California may be impacted by problems that look completely different to veterans who take their own lives in Cincinnati, Ohio. We want to create communities where veterans thrive and are supported when they are in need, all over the United States. 

How the tool was developed:  

The SDI tool has been approved by the University of Alabama’s Institutional Review Board (IRB), an official body that makes sure all research conducted in the United States is legal and safe for participants and researchers. Also, the team responsible for developing the tool has many different types of professionals. It includes community-based research experts, veteran suicide and resiliency experts, a clinical psychiatrist, a medical doctor, a clinical psychologist and a Licensed Clinical Social Worker.  This mix of professionals has allowed the tool and study to remain well-rounded since the beginning. Furthermore, the team is very responsive to feedback and is prepared to incorporate any notes from communities as the tool is piloted. The full list of experts involved can be found at https://americaswarriorpartnership.org/team-opdd/ 

It is true that suicide prevention is complicated. However, Operation Deep Dive is using the SDI to take a newer, more holistic approach, and it is in this flexibility and openness to change that there is true hope for a future where veteran suicides could cease to exist. 

 In a follow-up post, we will share how we are conducting these interviews with loved ones who have lost a veteran 

– Zaynah Khan, Research Assistant