Suicide Mortality Among Veterans Health Administration Care Recipients With Suicide Risk Record Flags

2021 ◽  
pp. appi.ps.2020007
Author(s):  
Tyler C. Hein ◽  
Talya Peltzman ◽  
Juliana Hallows ◽  
Nicole Theriot ◽  
John F. McCarthy
Keyword(s):  
Suicide Risk ◽  
Veterans Health Administration ◽  
Suicide Mortality ◽  
Veterans Health ◽  
Health Administration ◽  
Care Recipients

Association between acute psychiatric bed availability in the Veterans Health Administration and veteran suicide risk: a retrospective cohort study

2021 ◽  
pp. bmjqs-2020-012975
Author(s):  
Peter J Kaboli ◽  
Matthew R Augustine ◽  
Bjarni Haraldsson ◽  
Nicholas M Mohr ◽  
M Bryant Howren ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Suicide Risk ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Bed Occupancy ◽  
Increased Risk

BackgroundVeteran suicides have increased despite mental health investments by the Veterans Health Administration (VHA).ObjectiveTo examine relationships between suicide and acute inpatient psychiatric bed occupancy and other community, hospital and patient factors.MethodsRetrospective cohort study using administrative and publicly available data for contextual community factors. The study sample included all veterans enrolled in VHA primary care in 2011–2016 associated with 111 VHA hospitals with acute inpatient psychiatric units. Acute psychiatric bed occupancy, as a measure of access to care, was the main exposure of interest and was categorised by quarter as per cent occupied using thresholds of ≤85%, 85.1%–90%, 90.1%–95% and >95%. Hospital-level analyses were conducted using generalised linear mixed models with random intercepts for hospital, modelling number of suicides by quarter with a negative binomial distribution.ResultsFrom 2011 to 2016, the national incidence of suicide among enrolled veterans increased from 39.7 to 41.6 per 100 000 person-years. VHA psychiatric bed occupancy decreased from a mean of 68.2% (IQR 56.5%–82.2%) to 65.4% (IQR 53.9%–79.9%). VHA hospitals with the highest occupancy (>95%) in a quarter compared with ≤85% had an adjusted incident rate ratio (IRR) for suicide of 1.10 (95% CI 1.01 to 1.19); no increased risk was observed for 85.1%–90% (IRR 0.96; 95% CI 0.89 to 1.03) or 90.1%–95% (IRR 0.96; 95% CI 0.89 to 1.04) compared with ≤85% occupancy. Of hospital and community variables, suicide risk was not associated with number of VHA or non-VHA psychiatric beds or amount spent on community mental health. Suicide risk increased by age categories, seasons, geographic regions and over time.ConclusionsHigh VHA hospital occupancy (>95%) was associated with a 10% increased suicide risk for veterans whereas absolute number of beds was not, suggesting occupancy is an important access measure. Future work should clarify optimal bed occupancy to meet acute psychiatric needs and ensure adequate bed distribution.

scholarly journals Suicide Mortality Among Patients Treated by the Veterans Health Administration From 2000 to 2007

2012 ◽  
Vol 102 (S1) ◽  
pp. S98-S104 ◽  
Author(s):  
Frederic C. Blow ◽  
Amy S. B. Bohnert ◽  
Mark A. Ilgen ◽  
Rosalinda Ignacio ◽  
John F. McCarthy ◽  
...  
Keyword(s):  
Veterans Health Administration ◽  
Suicide Mortality ◽  
Veterans Health ◽  
Health Administration

scholarly journals Suicide Mortality Among Patients Receiving Care in the Veterans Health Administration Health System

2009 ◽  
Vol 169 (8) ◽  
pp. 1033-1038 ◽  
Author(s):  
J. F. McCarthy ◽  
M. Valenstein ◽  
H. M. Kim ◽  
M. Ilgen ◽  
K. Zivin ◽  
...  
Keyword(s):  
Health System ◽  
Veterans Health Administration ◽  
Suicide Mortality ◽  
Veterans Health ◽  
Health Administration

Suicide risk following a new cancer diagnosis among veterans in Veterans Health Administration care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12130-12130
Author(s):  
Kallisse R. Dent ◽  
Benjamin R. Szymanski ◽  
Michael J. Kelley ◽  
Ira Katz ◽  
John F. McCarthy
Keyword(s):  
Mental Health ◽  
Lung Cancer ◽  
Head And Neck ◽  
Suicide Prevention ◽  
Cancer Diagnosis ◽  
Suicide Risk ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Suicide Rates

12130 Background: Patients diagnosed with cancer are at an increased risk of adverse mental health outcomes including suicidal behavior. Suicide rates among Veterans are 50 percent greater than for non-Veteran US adults. To inform Veterans Affairs (VA) suicide prevention initiatives, it is important to understand associations between cancer and suicide risk among Veterans receiving VA healthcare from the Veterans Health Administration (VHA). Study aims were to assess associations between new cancer diagnoses and suicide among Veterans in VHA care to identify high risk diagnostic subgroups and risk-periods. Methods: We used a cohort study design, identifying 4,926,373 Veterans with VHA use in 2011 and either 2012 or 2013 and without a VHA cancer diagnosis in 2011. Incident cancer diagnoses, assessed between first VHA use in 2012-2013 and 12/31/2018, were characterized by subtype and stage using the VHA Oncology Raw Data. Data from the VA/Department of Defense Mortality Data Repository identified date and cause of death. Cox proportional hazards regression, accounting for time-varying cancer diagnosis, was used to evaluate associations between a new cancer diagnosis and suicide risk. An initial model adjusted for VHA regional network and patient age and sex. Cancer subtypes with significant associations with suicide were further assessed using a model that also adjusted for suicide attempts and mental health, tobacco use disorder, and other substance use disorder diagnoses in the prior year. Crude suicide rates following a new cancer diagnoses were calculated among Veterans with new diagnoses, 2012-2018 (N = 240,410). Rates were assessed up to 84 months following diagnosis. Results: On average, Veteran VHA users were followed for 6.0 years after their first VHA use in 2012-2013 and for 2.7 years following a new cancer diagnosis. Receipt of a new cancer diagnosis corresponded to a 43% (Adjusted Hazard Ratio [AHR] = 1.43, 95% CI: 1.29, 1.58) higher suicide risk, adjusting for covariates. The cancer subtype associated with the highest suicide risk was esophageal cancer (AHR = 5.93, 95% CI: 4.05, 10.51) and other significant subtypes included head and neck (AHR = 3.44, 95% CI: 2.65, 4.46) and lung cancer (AHR = 2.28, 95% CI: 1.79, 2.90). Cancer stages 3 (AHR = 2.29, 95% CI: 1.75, 3.01) and 4 (AHR = 3.45, 95% CI: 2.75, 4.34) at diagnosis were also positively associated with suicide risk. Suicide rates were highest in the first three months following a diagnosis (Rate = 128.3 per 100,000 person-years, 95% CI: 100.4, 161.6) and remained elevated through the first 12 months. Conclusions: Among Veteran VHA users, suicide risk was elevated following a new cancer diagnosis and was especially high in the initial 3 months. Additional screening and suicide prevention efforts may be warranted for VHA Veterans newly diagnosed with cancer, particularly among those diagnosed with esophageal, head and neck, or lung cancer or at stages 3 or 4.

scholarly journals Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care

2013 ◽  
Vol 103 (10) ◽  
pp. e27-e32 ◽  
Author(s):  
John R. Blosnich ◽  
George R. Brown ◽  
Jillian C. Shipherd, PhD ◽  
Michael Kauth ◽  
Rebecca I. Piegari ◽  
...  
Keyword(s):  
Gender Identity ◽  
Suicide Risk ◽  
Gender Identity Disorder ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration
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