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Women veterans represent an underrecognized and growing population with unique suicide prevention needs. The Veterans Crisis Line (VCL) is available as a free crisis intervention resource for veterans and their supports 24 hours/day, 7 days/week. Whereas women make up the majority of callers to civilian crisis hotlines, women represent only approximately 15% of VCL veteran users. We know little about the ways in which VCL functions for the growing population of women veterans. The purpose of this study was to understand women veterans’ experiences with VCL and identify recommendations for strengthening VCL services specifically for this population.
Methods
We conducted in-depth qualitative interviews, via telephone, with 26 women veterans from across the country who had contacted VCL within the 12 months prior to study recruitment. Interviews were audio-recorded and transcribed verbatim. We used team-based inductive content analysis to code the transcript data and identify themes.
Results
A primary concern that led to hesitance and challenges around interacting with VCL was not knowing what to expect from the call, specifically with regards to responder gender, scope of services and alignment with veteran needs/desires, and potential unwanted consequences or intervention. Women expressed concerns about hearing a man’s voice due to trauma triggers from violence perpetrated by men; they recommended that VCL provide a way for women veterans to be able to select the gender of the responder who takes their call. Women also recommended that there be more information provided to potential callers about what to expect from the VCL call, including options for anonymity and choice around intervention. Further, participants recommended that VCL callers be provided with options with regards to follow-up contact from VCL after the VCL call; and that VCL responders have competence in responding to issues of gender-based violence.
Conclusions and Implications
Findings from this study highlight unique needs and considerations of women veterans and can be used to strengthen VCL services specifically for this population. The recommendations are consistent with principles of trauma-informed and gender-sensitive care, in particular around individual choice, information, and recognition of trauma triggers. The study is informed by input from a multi-stakeholder advisory board that includes veterans and program representatives, and the research team for this study works closely with VCL operations partners and leadership to ensure that findings can rapidly be implemented into policy and programming. Findings may also be applicable to services for women veterans beyond VCL and to suicide and crisis hotlines for other populations who may have similar concerns and needs.