Prevalence & Correlates of Suicidal Ideation & Suicide Attempts among Veterans in Primary Care Referred for a Mental Health Evaluation
BACKGROUND:
The Veterans Health Administration has made concerted
efforts to increase mental health services offered in primary care. However,
few studies have evaluated correlates of suicidal ideation and suicide attempt
in veterans in primary care-mental health integration
(PCMHI). The purpose of the present study is to examine associations between
suicidal ideation and suicide attempts as dependent variables and demographic
and clinical factors as the independent variables.
METHODS:
Veterans (n=3004)
referred from primary care to PCMHI were contacted for further assessment,
which included past-year severity of suicidal thoughts (none, low, high) and
attempts using the Paykel Suicide Scale, mental health disorders, and illicit
drug use. Multinomial logistic regression models were used to identify
correlates of suicidal ideation and suicide attempts.
RESULTS:
Thoughts
of taking one's life was endorsed by 24% of participants and suicide attempts
were reported in 2%. In adjusted models, depression, psychosis, mania, PTSD and
generalized anxiety disorder were associated with high severity suicidal
ideation, but not suicide attempt. Illicit drug use was not associated with
suicidal ideation, but was the only variable associated with suicide attempt.
LIMITATIONS:
The
study was cross-sectional, focused on one clinical setting, and the suicide
attempt analyses had limited power.
CONCLUSIONS:
PCMHI
is a critical setting to assess suicidal ideation and suicide attempt and
researchers and clinicians should be aware that the differential correlates of
these suicide-related factors. Future research is needed to identify
prospective risk factors and assess the utility of follow-up care in preventing
suicide.
- 1VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA. Electronic address: Lisham.Ashrafioun@va.gov.
- 2VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Department of Psychiatry, University of Rochester, School of Medicine & Dentistry, USA.
- 3Department of Psychiatry, University of Pennsylvania, USA; VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia VA Medical Center, USA.
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