Suicidal Behaviors and Risk Taking Among Homeless Individuals: A Systematic Review and Meta-Analysis

Armoon, Bahram; Griffiths, Mark D.; Mohammadi, Rasool; Ahounbar, Elaheh

doi:10.1007/s10597-023-01111-3

Cited by 3 publications

(4 citation statements)

References 75 publications

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“…With a data-driven approach, we identified top associations of SI and SB, separately. There was a high degree of concordance between results from our model and those reported by a recent meta-analysis (Armoon et al, 2023), which is notable given that our model included over 250 clinical features representing 10,000+ diagnoses. We find that mental health diagnoses (anxiety [which includes PTSD], mood…”

Section: Using Hie Data To Study Homelessness Si and Sbssupporting

confidence: 83%

“…That our model identified almost every clinical characteristic reported in a meta-analysis of 23 studies from 1998 to 2022 demonstrates the power of HIE data as a complementary approach to clinical research. We also conducted bivariable analyses on significant associations reported by Armoon et al (2023) using our large sample and found that every characteristic analyzed was significantly associated with increased odds of SI and SB, separately.…”

Section: Using Hie Data To Study Homelessness Si and Sbsmentioning

confidence: 99%

“…In addition to validating widely reported associations of SI/SB, we contribute to the current debate on the association between psychotic disorders (including schizophrenia) and SI/SB among the unhoused population. Psychotic disorders have been described as both a risk factor (Armoon et al, 2023;Feodor Nilsson et al, 2014;Gentil et al, 2021) and a protective factor (Noël F, et al, 2016) of SI/SB among unhoused individuals. Like Gentil et al (2021), we found that schizophrenia and other psychotic disorders are associated with increased odds of SI but are not associated with SB.…”

Section: Using Hie Data To Study Homelessness Si and Sbsmentioning

confidence: 99%

“…| 2543 associated with suicide attempts only (Armoon et al, 2023). Another study using a data-driven approach to find top associations from a broad range of variables revealed interesting findings with increased odds of suicide attempt (but not SI) in participants with functional disability or previous hospitalizations, and increased odds of SI (but not suicide attempts) in those with schizophrenia and other psychotic disorders.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

Arias

Kunicki

et al. 2023

J Clin Psychol

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IntroductionUnhoused individuals have high rates of suicidal ideation (SI) and suicidal behaviors (SB), but few have studied the relative timing of homelessness and SI/SB. Our study examines the potential to use state‐wide electronic health record data from Rhode Island's health information exchange (HIE) to identify temporal relationships, service utilization, and associations of SI/SB among unhoused individuals.MethodsWe use timestamped HIE data for 5368 unhoused patients to analyze service utilization and the relative timing of homelessness versus SI/SB onset. Multivariable models identified associations of SI/SB, hospitalization, and repeat acute care utilization within 30 days from clinical features representing 10,000+ diagnoses captured within the HIE.ResultsThe onset of SI typically precedes homelessness onset, while the onset of SB typically follows. Weekly rates of suicide‐related service utilization increased over 25 times the baseline rate during the week before and after homelessness onset. Over 50% of encounters involving SI/SB result in hospitalization. Of those engaging in acute care for suicide‐related reasons, we found high rates of repeat acute care encounters.ConclusionHIEs are a particularly valuable resource for understudied populations. Our study demonstrates how longitudinal, multi‐institutional data from an HIE can be used to characterize temporal associations, service utilization, and clinical associations of SI and behaviors among a vulnerable population at scale. Increasing access to services that address co‐occurring SI/SB, mental health, and substance use is needed.

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Section: Using Hie Data To Study Homelessness Si and Sbssupporting

confidence: 83%

Section: Using Hie Data To Study Homelessness Si and Sbsmentioning

confidence: 99%

Section: Using Hie Data To Study Homelessness Si and Sbsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

Arias

Kunicki

et al. 2023

J Clin Psychol

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The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis

Armoon,

Mohammadi,

Griffiths

2024

Community Ment Health J

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Injury Pattern Analysis to Optimize Burn Injury Prevention in the Unhoused Community

Ross,

Speiser,

Donohue

et al. 2024

Journal of Burn Care &Amp; Research

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Unhoused patients are an overrepresented group in burn injury, and are a uniquely vulnerable population. Current research focuses on the consequences of homelessness on burn outcomes, with little known about the specific circumstances and behaviors leading to burn injury that may represent specific targets for injury prevention efforts. The burn registry at an urban regional burn center was queried for burn admissions in unhoused adults from 2019 to 2022. Registry data pulled included demographics, urine toxicology, mechanism of injury, and injury subjective history. Subjective injury history was reviewed to determine more specific injury circumstances and activities during which accidental burns occurred. Demographic and mechanistic trends in burn admissions were explored via descriptive statistics. Among 254 admissions for burns from the unhoused community, 58.1% of patients were positive for stimulants on admission. Among accidental injuries (69.7%), common circumstances included preparing food or beverages, cooking or using methamphetamine, smoking cannabis or tobacco, bonfires, and candles. A specific common circumstance was lighting a cigarette while handling accelerants (6.7%). Interventions for stimulant abuse, as well as outreach efforts to educate unhoused patients about situational awareness, safe handling of accelerants, safe smoking practices, and safe cooking practices, may be effective tools in reducing burn admissions in this vulnerable population.

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Suicidal Behaviors and Risk Taking Among Homeless Individuals: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 75 publications

Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis

Injury Pattern Analysis to Optimize Burn Injury Prevention in the Unhoused Community

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