Brief assessment for suicidal ideation in OEF/OIF veterans with positive depression screens.
OBJECTIVE
We describe processes, rates, and patient and system correlates of brief structured assessments (BSAs) for suicidal ideation among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with positive depression screens.


METHODS
Electronic Veterans Affairs (VA) medical record and Department of Defense data were used to identify individual-level and BSA-process variables for 1662 OEF/OIF veterans at three VA Medical Centers.


RESULTS
Overall, 1349/1662 (81%) veterans received BSAs for suicidal ideation within 1 month of depression screening; 94% of BSAs were conducted within 1 day. Stratified analyses revealed significant intersite differences in veteran demographics, instruments used, clinical setting and staff performing assessments, and correlates of assessment completion. At two sites, men were more likely to be assessed than women [odds ratio (OR)=2.15 (95% confidence interval {CI}=1.06-4.38) and 3.14 (CI=1.27-7.76)]. In a combined model adjusted for intrasite correlation, assessment was less likely during months 8-12 and 13-18 of the study period [OR=0.39 (CI=0.28-0.54) and OR=0.48 (95% CI=0.35-0.68), respectively] and more likely to occur among veterans receiving depression or posttraumatic stress disorder diagnoses on the day of depression screening [OR=1.83 (CI=1.36-2.46) and OR=1.50 (CI=1.13-1.98), respectively].


CONCLUSIONS
Most veterans with positive depression screens receive timely BSAs for suicidal ideation. Processes used for brief assessment for suicidal ideation vary substantially across VA settings.
Portland Center for the Study of Chronic, Comorbid Physical and Mental Disorders, Portland Veterans Affairs Medical Center, Portland, OR 97207, USA. steven.dobscha@va.gov
Steven K
SK
Dobscha
Kathryn
K
Corson
Drew A
DA
Helmer
Matthew J
MJ
Bair
Lauren M
LM
Denneson
Cynthia
C
Brandt
Anna
A
Beane
Linda
L
Ganzini
D000328:Adult; D055826:Afghan Campaign 2001-; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D059020:Suicidal Ideation; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D055815:Young Adult; D000092864:Suicide Prevention