Thursday, January 31, 2019

Suicide Risk Factors May Be Overlooked in Older Veterans, Study Suggests

General health professionals may be missing key opportunities to assess suicidal risk and prevent suicide attempts in veterans aged 50 or older. A study in the American Journal of Geriatric Psychiatry found that veterans aged 50 and older who later attempted suicide were less likely to be asked about impulsivity and firearms access during their last visit prior to the attempt than younger veterans who later attempted suicide. The older veterans were also less likely to receive mental health referrals than their younger peers.

Kelsey Simons, Ph.D., L.M.S.W., of the Veterans Administration VISN 2 Center of Excellence for Suicide Prevention in Canandaigua, N.Y., and colleagues used electronic health records to examine differences in suicide risk screening among 93 patients who attempted suicide and who had visited VA medical facilities within a year before the attempt. The researchers also looked at differences in mental health referrals made by general health professionals. All patients were veterans who had survived a suicide attempt within 48 hours before hospitalization. Thirty-seven patients were age 50 or older, and 56 were 18 to 49.

Among all patients, the last visit to a VA medical facility occurred at an average of about 27 days before a suicide attempt, and most visits occurred in an outpatient setting. Although general health professionals screened both groups of patients equally for risk factors such as depression and suicidal ideation, they were less likely to screen older patients for impulsivity or access to firearms. Furthermore, just 16.2% of older patients who saw a general health professional received a referral to a mental health professional, compared with 46.4% of the younger veterans.

The researchers noted that their study was limited by the number of patients and the number of facilities involved, and that the study may not generalize to all veterans or to non-veterans. However, they noted the need for more screening among older veterans.

“Despite these limitations, our findings are important as they emphasize primary care as a key site for suicide prevention among older veterans, informing both research and program development,” Simons and colleagues wrote. “Interventions that capitalize on primary care for reaching older patients at risk for suicide (e.g., collaborative and integrated care) have the potential to improve prevention efforts in this population.”

For related information, see the Psychiatric News article “Suicide Deaths Climb Dramatically in U.S., Nearly Double for Women.”

(Image: iStock/Ridofranz)

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