Mitigating Suicide Risk During the Military-to-Civilian Transition: The VA Veteran Sponsorship Initiative

A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public-private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of -0.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public-private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition.

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Publication Details

Journal
International Journal of Environmental Research and Public Health
Published
2026-04-17
DOI
https://doi.org/10.3390/ijerph23040519
Primary Topic
Suicide and Self-Harm Studies
Type
article
Field-Weighted Citation Impact
0.00

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article

Mitigating Suicide Risk During the Military-to-Civilian Transition: The VA Veteran Sponsorship Initiative

Joseph C. Geraci, Nicolle Marinec, Brian P. Marx, A Solomon Kurz et al.
International Journal of Environmental Research and Public Health
Suicide and Self-Harm Studies
article

Mitigating Suicide Risk During the Military-to-Civilian Transition: The VA Veteran Sponsorship Initiative

Joseph C. Geraci, Nicolle Marinec, Brian P. Marx, A Solomon Kurz, Brigid Connelly, Rakeshwar S. Guleria, Eric Andrew Nelson, Erin P. Finley, Matthew R. Augustine, Kevin D. Admiral, Meenakshi Zaidi, Andrea A. MacCarthy, Danielle Bracco, Jason Wesbrock, David E. Goodrich, Marianne Goodman, Richard W. Seim, Christine Eickhoff, Brian Roeder, Chien J. Chen, Emily R. Edwards, Madeleine Allen, Michael Eastman, Nicholas R. Lindner, Ronald C. Kessler, Travis Bellotte, Amanda L. Reed, Andy Cox, Brian Westlake, Smita Badhey, Jack Besser, Nicholas Ahari, Chris Paine, Alberto Feliciano, Megan McFadyen-Mungall, Leah Smith, Samantha Gitlin, Sarah Rachael Karkout, Balavenkatesh Kanna
article en

Abstract

A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public-private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of -0.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public-private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition.

International Journal of Environmental Research and Public HealthVol. 23(4)
Boston University (US), Harvard University (US), Howard University (US), Uniformed Services University of the Health Sciences (US), University of Pittsburgh (US), VA Boston Healthcare System (US), United States Army (US), Doris Miller Department of Veterans Affairs Medical Center (US), VA Ann Arbor Healthcare System (US), National Center for PTSD (US), VA Center for Clinical Management Research (US), James J. Peters VA Medical Center (US), Central Texas Veterans Health Care System (US), VA Pittsburgh Healthcare System (US), VA Eastern Colorado Health Care System (US), Center for the Study of Healthcare Provider Behavior (US), Foundation for Healthcare Advancement (US), Mental Health Association of Westchester County (US), Columbia University (US), Icahn School of Medicine at Mount Sinai (US)
U.S. Department of Veterans Affairs, U.S. Army, NIH Clinical Center
Partnerships for the goals
Openalex Percentile: Top 19%
Suicide and Self-Harm Studies
DOIOpen Access PDFOpenAlex
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