Veterans With Prior Suicidal Thoughts Rate Emergency Department Intervention Highly

Veterans who received training in coping skills before leaving the emergency department (ED) following a suicide-related concern and follow-up calls weekly until they entered outpatient treatment reported that the program was helpful in preventing further suicidal behavior and fostering treatment engagement, according to a study published Monday in Psychiatric Services in Advance.

Patients discharged from EDs following suicide attempts often fail to connect with follow-up care or experience significant delays between ED discharge and outpatient treatment. The literature suggests that up to 50% of these individuals fail to seek recommended follow-up care, and among those who do seek treatment, approximately 40% discontinue treatment within three months.

In an effort to improve treatment engagement and reduce the risk of suicide attempts in veterans after their first contact with the ED, a team of researchers developed the SAFE VET intervention, a two-part intervention that teaches individuals who present in EDs coping strategies prior to leaving the ED and engages patients weekly by phone until their first outpatient treatment appointment. A previous study found SAFE VET enhanced treatment engagement. In the current study, Barbara Stanley, Ph.D., of Columbia University and colleagues asked a sample of 100 veterans who participated in SAFE VET to rate the acceptability, usefulness, and helpfulness of the intervention.

Most participants found the SAFE VET intervention to be useful in mitigating suicide risk (93%) and in increasing the likelihood of attending follow-up mental health appointments (77%). The overwhelming majority (99%) said they found the SAFE VET intervention very acceptable, reporting that they would recommend it to a friend in crisis. Participants also rated the program’s ability to assist them in identifying professional support (46%) and having “someone check in regularly” (75%) as being the most helpful components of the program.

“This intervention was designed to fill a crucial gap in the current system of care,” the study authors noted. The authors cautioned that “although the combined intervention was found to be both acceptable and helpful,” further studies are needed to assess whether the results would be the same in EDs outside the VA system.

For related information, see the Psychiatric News article “Study Points to Risk Factors Predictive of Suicide After Emergency Visit.”

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