title: Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide.
abstract: A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow-up (n = 168; 57%). Fifty-three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide.
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA.|Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Denneson
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Kovas
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA.|Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Britton
authors.affiliation: Department of Social Welfare, University of California - Los Angeles Luskin School of Public Affairs, Los Angeles, CA, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Kaplan
authors.affiliation: Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Bentson H
authors.initials: BH
authors.lastname: McFarland
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR, USA.|Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dobscha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003644:Death Certificates; D004282:Documentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D018570:Risk Assessment / Q000458:organization & administration; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*