Suicide risk factors among veterans: Risk management in the changing culture of the department of veterans affairs |
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Authors: | Michael T Lambert MD D Robert Fowler MD |
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Institution: | (1) Mental Health Service (116A), Department of Veterans Affairs North Texas Health Care System, 4500 South Lancaster Road, 75216 Dallas, TX;(2) Department of Psychiatry, University of Texas Southwestern Medical School at Dallas, Dallas, USA |
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Abstract: | Suicide risk management in the Department of Veterans Affairs (VA) health care system is particularly challenging because
of both patient characteristics and aspects of the delivery system. The prototypical suicide-prone person is an older white
male with alcoholism, depression, physical problems, and poor psychosocial support. This describes a large portion of the
veteran patient population. Suicide risk factors that are common in VA patients include male gender, older age, diminished
social environment support (exemplified by homelessness and unmarried status), availability and knowledge of firearms, and
the prevalence of medical and psychiatric conditions associated with suicide. A variety of characteristics of the VA system
complicate suicide management. Efforts under way to emphasize ambulatory care and decrease the VA culture of reliance on inpatient
treatment heighten the importance of accurate suicide assessment. The authors recommend several strategies that VA administrators
can consider for improving the assessment and management of veterans with long-term suicide risk factors. |
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