Suicide Among Patients in the Veterans Affairs Health System: Rural–Urban Differences in Rates, Risks, and Methods

McCarthy, John F.; Blow, Frederic C.; Ignacio, Rosalinda V.; Ilgen, Mark A.; Austin, Karen; Valenstein, Marcia

doi:10.2105/ajph.2011.300463

Cited by 128 publications

(101 citation statements)

References 30 publications

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“…Other factors associated with increased suicidality were consistent with prior findings, including active duty, and rurality (i.e., living further from the VA; Kapur et al, 2009;McCarthy et al, 2012;Zivin et al, 2007), and consequently it was not surprising that these factors applied to Iraq and Afghanistan veterans as well. Given our findings of increased risk of active duty and rural veterans, clinicians who screen and provide care to veterans with these demographic variables should be aware of the potential for increased risk and ask about these variables if not known.…”

Section: Discussionsupporting

confidence: 86%

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Maguen

Madden

Cohen

et al. 2015

Journal of Psychiatric Research

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Suicide rates among U.S. military personnel and veterans are a public health concern, and those with mental health conditions are at particular risk. We examined demographic, military, temporal, and diagnostic associations with suicidality in veterans. We conducted a population-based, retrospective cohort study of all Iraq and Afghanistan war veterans who screened positive for posttraumatic stress disorder (PTSD) and/or depression, received a suicide risk assessment, and endorsed hopelessness about the present or future after their last deployment and between January 1, 2010 and June 29, 2014 (N = 45,741). We used bivariate and multivariate logistic regression analyses to examine variables associated with having endorsed suicidal thoughts and a plan. Multiple factors were associated with suicidality outcomes, including longer time from last deployment to screening (proxy for time to seeking VA care), an alcohol use disorder diagnosis, further distance from VA (rurality), and being active duty during military service. Hispanic veterans were at decreased risk of having suicidal ideation and a plan, compared to their white counterparts. In high-risk veterans, some of the strongest associations with suicidality were with modifiable risk factors, including time to VA care and alcohol use disorder diagnoses. Promising avenues for suicide prevention efforts can include early engagement/intervention strategies with a focus on amelioration of high-risk drinking.

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Section: Discussionsupporting

confidence: 86%

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Maguen

Madden

Cohen

et al. 2015

Journal of Psychiatric Research

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“…4 The primary outcome was death by suicide as indicated by the National Death Index, considered the most sensitive population-based data source. 20 Consistent with prior work, 3,21 suicide deaths were identified using the ICD-10 22 codes X60-X84, Y87.0.…”

Section: Data Sources and Measuresmentioning

confidence: 99%

Military Sexual Trauma and Suicide Mortality

Kimerling

Makin-Byrd

Louzon

et al. 2016

American Journal of Preventive Medicine

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152

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Study results are among the first population-based investigations to document sexual trauma as a risk factor for suicide mortality. Military sexual trauma represents a clinical indicator for suicide prevention in the Veterans Health Administration. Results suggest the importance of continued assessments regarding military sexual trauma and suicide risks and of collaboration between military sexual trauma-related programs and suicide prevention efforts. Moreover, military sexual trauma should be considered in suicide prevention strategies even among individuals without documented psychiatric morbidity.

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“…This method was developed based on published approaches to defining VA patient cohorts for suicide surveillance. 39,41 Results…”

Section: Analysesmentioning

confidence: 99%

Mortality Among Veterans with Transgender-Related Diagnoses in the Veterans Health Administration, FY2000–2009

et al. 2014

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The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses.

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Suicide Among Patients in the Veterans Affairs Health System: Rural–Urban Differences in Rates, Risks, and Methods

Abstract: Rural residence is a suicide risk factor, even after controlling for mental health accessibility. Public health and health system suicide prevention should address risks in rural areas.

Cited by 128 publications

References 30 publications

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

Military Sexual Trauma and Suicide Mortality

Mortality Among Veterans with Transgender-Related Diagnoses in the Veterans Health Administration, FY2000–2009

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