Relationship Checkups to Reduce Veteran Suicide Risk

This study compares two approaches to working with Veterans that have a mix of mental health and relationship concerns in primary care. One approach is a 3-session couple-based program called the Brief Relationship Checkup (BRC). BRC has shown promise improving relationship health in Air Force primary care (including some mental health symptoms related to relationship functioning) but has never been tested for individuals with significant mental health concerns. The other approach is a high-quality delivery of three sessions of Co-Located Collaborative Care (CCC) with the Screened Veteran only. This program is the current standard of care for Veterans reporting mental health concerns in primary care (including mental health concerns related to their relationship) but has never been tested for individuals struggling with relationship concerns. The goal is to compare the benefits of the couples-based program vs. the individual-based program when it comes to reducing suicide risk factors at the relationship level and the individual level.

Inclusion Criteria: 1. BOTH PARTNERS must be age 18 or over 2. BOTH PARTNERS must demonstrate sufficient knowledge of English and cognitive capacity to understand the study through comprehension of consent questions 3. BOTH PARTNERS must self-identify as "in a committed relationship" with their partner for at least 6-months. 4. AT LEAST ONE PARTNER must report at least mild relationship distress on a relationship satisfaction screen (CSI-4). 5. AT LEAST ONE PARTNER must be a VHA-enrolled Veteran who screens positive on a VA Primary Care Mental Health Screen for ONE OR MORE of the following conditions: Depressed Mood, Unsafe drinking, Posttraumatic stress, or Suicidal Ideation. Exclusion Criteria: 1. EITHER PARTNER reports that they are already engaged in ongoing couple or family therapy. 2. EITHER PARTNER reports severe intimate partner violence in the last year. 3. EITHER PARTNER reports ongoing or upcoming legal conflicts between one another (e.g., custody dispute; restraining order; divorce proceedings) 4. EITHER PARTNER reports experiencing suicidal intent requiring hospitalization. 5. EITHER PARTNER experiences past-month psychosis or mania. 6. EITHER PARTNER has completed therapy with the PI, Dr. Dev Crasta, within the last 5 years.