
- Vol 32 No 8
- Volume 32
- Issue 8
Improving Understanding of Veteran Suicide Relative to VHA Service Use
The authors summarize findings from the first study to compare suicide risk for veterans who do and those who do not use VA services.
BRIEF COMMUNICATION
[[{"type":"media","view_mode":"media_crop","fid":"29389","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_2680231362948","media_crop_h":"163","media_crop_image_style":"-1","media_crop_instance":"4154","media_crop_rotate":"0","media_crop_scale_h":"118","media_crop_scale_w":"100","media_crop_w":"138","media_crop_x":"96","media_crop_y":"21","style":"float: right;","title":" ","typeof":"foaf:Image"}}]]Recently, the first study that compared suicide risk for veterans who do and those who do not use Veterans Health Administration (VHA) services was
• A comparison of suicide risk for the broad veteran population and civilian adults
• A comparison of suicide risk for veterans who access VHA services and those who do not
• Insight into important sex differences in these relationships
VA-archived suicide data collected in partnership with data from US states made the analysis possible. The VA state suicide database compiles death certificate records obtained directly from participating states for all adult suicide decedents, regardless of their military history; veteran status is carefully validated.2
There is an immediate need to better understand suicide risk and trends over time in female veterans as well as in younger veterans. Woman veterans are the fastest-growing veteran subgroup, and
The goal of our study was to analyze data from 173,969 suicide decedents from the states participating in the VA’s archive of suicide data. One-quarter of the suicide decedents were veterans; 20% did not use VHA services and 5% did use VHA services in the year before their death. Participating states were geographically diverse and the range in state suicide rates was comparable to that of all US states and territories. The study methods included the computation of crude suicide rates, direct age-adjusted suicide rates, and standardized mortality ratios by year (2000 to 2010) for the 4 groups studied: US civilians, all veterans, VHA-accessing veterans, and non–VHA-accessing veterans (overall and stratified by sex).
Some
When VHA utilization and sex were considered simultaneously, it became clear that the greatest excess suicide risk was found among female veterans who did not use VHA services, when compared with their non-veteran peers. Conversely, female veterans who accessed VHA services had consistently and significantly fewer suicide attempts/completions than female veterans who had not accessed care during the study period. In 2000, the suicide rate was higher among male veterans who accessed VHA services than among veterans outside the VHA, but this relative rate declined from 2000 to 2003; since 2003, male veterans accessing VHA services have fared better than their peers who did not use VHA services.
Taken together, one plausible explanation for these findings is that the
Disclosures:
Dr Hoffmire is with the VISN 19 Rocky Mountain MIRECC for Suicide Prevention, US Department of Veterans Affairs, Denver. Dr Bossarte is with the Office of Public Health, US Department of Veterans Affairs, Washington, DC. Dr Hoffmire and Dr Bossarte are also with the department of psychiatry at the University of Rochester in Rochester, NY. The authors report no conflicts of interest concerning the subject matter of this article.
References:
1. Hoffmire CA, Kemp JE, Bossarte RM. Changes in suicide mortality for veterans and nonveterans by gender and history of VHA service use, 2000-2010. Psychiatr Serv. 2015 May 1; [Epub ahead of print].
2. Hoffmire CA, Bossarte RM. A reconsideration of the correlation between veteran status and firearm suicide in the general population. Inj Prev. 2014;20:317-321.
3. Kemp J. Suicide data report update, 2014. Department of Veterans Affairs, Mental Health Services, Suicide Prevention Program; January 2014.
4. Coffey MJ, Coffey CE, Ahmedani BK. Suicide in a health maintenance organization population. JAMA Psychiatry. 2015;72:294-296.
Articles in this issue
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Introduction: Impulsivity-A Transdiagnostic Traitabout 10 years ago
Impulse Control, Impulsivity, and Violence: Clinical Implicationsabout 10 years ago
Impulsivity and Suicide Risk: Review and Clinical Implicationsabout 10 years ago
Implications of Impulse Control Disorder in Parkinson Diseaseabout 10 years ago
From Impulsivity to Addiction: Gambling Disorder and Beyondabout 10 years ago
Telepsychiatry: Watching Your Back While Staying in the Blackabout 10 years ago
Tai Chi Is a Biological Treatment for Depressionabout 10 years ago
Psychopharmacological Options for Treating ImpulsivityNewsletter
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