Age Differences in Suicide Risk Screening and Management Prior to Suicide Attempts |
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| Institution: | 1. VISN 2 Center of Excellence for Suicide Prevention (KS, KVO), Canandaigua VA Medical Center, Canandaigua, NY;2. Department of Psychiatry (KS, KVO, KRC), University of Rochester School of Medicine and Dentistry, Rochester, NY;3. Department of Emergency Medicine (KRC), University of Rochester Medical Center, Rochester, NY;4. Department of Psychiatry and Human Behavior (CB), University of Mississippi Medical Center, Jackson, MS;1. Department of Epidemiology, Shandong University School of Public Health, Jinan, China;2. Shandong University Center for Suicide Prevention Research, China;3. Department of Sociology, State University of New York College at Buffalo, Buffalo, NY, USA;4. Shandong Center for Disease Prevention and Control, Jinan, China;5. Shandong Provincial Center for Mental Health, Jinan, China;6. Department of Psychology, State University of New York College at Buffalo, Buffalo, NY, USA;1. Department of Pediatrics (C Naureckas Li and MR Flaherty),;2. Medicine (CA Sacks),;3. and Pediatric Surgery (PT Masiakos), Massachusetts General Hospital, Boston;4. Department of Child and Adolescent Psychiatry, New York University Langone Health (KA McGregor);5. Harvard Medical School, Boston, Mass (C Naureckas Li, CA Sacks, PT Masiakos, and MR Flaherty);1. Department of Psychology (GK), Chung-Ang University, Seoul, South Korea;2. Department of Consumer Sciences (SHS), University of Alabama, Tuscaloosa, AL;3. Alabama Research Institute on Aging (MAS, PP), University of Alabama, Tuscaloosa, AL;4. Department of Psychology (MAS, PP), University of Alabama, Tuscaloosa, AL;1. Department of Psychology, Oklahoma State University, Stillwater, OK, USA;2. Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA;3. Substance Abuse Treatment Program, Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA;4. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA;1. VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, United States of America;2. University of Michigan Department of Psychiatry, Ann Arbor, MI, United States of America;3. Department of Health Sciences, Northeastern University Bouvé College of Health Sciences, Boston, MA, United States of America;4. University of Michigan School of Public Health, Ann Arbor, MI, United States of America;5. Injury Control Research Center, West Virginia University, Morgantown, WV, United States of America;6. Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, WV, United States of America |
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| Abstract: | ObjectiveThis study examined differences by age in suicide risk screening and clinical actions to reduce suicide risk among patients with visits to Veterans Health Administration (VHA) medical facilities in the year prior to an attempt.MethodsNinety-three VHA patient records were reviewed specific to the last visit before an attempt. Information was extracted regarding documentation of individual suicide risk factors and provider actions to reduce risk.ResultsThe authors examined differences by patient age (≥50 versus 18–49). Older patients’ medical records were less likely to have evidence of 1) screening for impulsivity and firearms access and 2) engagement in safety planning, referrals for mental health services, and consideration of psychiatric hospitalization. General medical providers were less likely to document these risk factors and action steps in comparison with mental health clinicians.ConclusionLethal means education and collaborative care are universal strategies that may improve identification of and lower suicide risk in older veterans. |
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