Suicidal ideation and social exchanges among at-risk veterans referred for a behavioral health assessment

The current study examined the independent association between positive (e.g., emotional and instrumental support) and negative
(e.g., insensitive behavior, unwanted advice from others) social exchanges and suicidal ideation among veterans referred for
a behavioral health assessment.

The sample included 606 veterans [mean age = 54.96 (SD = 14.96)] referred by primary care for a clinical mental health/substance
abuse (MH/SA) assessment following a positive MH/SA screen. Data on sociodemographics, MH/SA conditions (e.g., depression,
PTSD, anxiety, and alcohol abuse), the self-reported frequency of positive and negative social exchanges, and suicidal ideation
were extracted from clinical interviews and evaluated.

Veterans were primarily male, non-married, and had adequate financial resources, and approximately half were White. 74.4 and
20.3 % met criteria for a MH/SA condition and suicidal ideation, respectively. Multiple logistic regression analyses revealed
that, adjusting for sociodemographics, physical functioning, and comorbid MH/SA conditions, veterans reporting more frequent
negative exchanges with network members were significantly more likely to report suicidal ideation. Positive exchanges, in
contrast, were not significantly related to the outcome. Inadequate finances and MH/SA conditions also were significantly
related to suicidal ideation.

Findings highlight the value of exploring the quality of social exchanges among veterans in primary care who screen positive
for behavioral health issues, as such information has the potential to inform screening and intervention efforts aimed at
reducing suicidal ideation.