Mortality following non‐fatal suicide attempts by Veterans in Veterans Health Administration care. Issue 2 (23rd November 2021)

• Record Type: Journal Article
• Authors: Hein, Tyler C.; Cooper, Samantha A.; McCarthy, John F.
• Is Part Of: Suicide and life-threatening behavior. Volume 52:Issue 2(2022)
• Page Start: 222
• Page End: 230
• Publication Date: 2021-11-23
• Subjects: mortality -- suicide -- Veteran -- Veterans Health Administration; Suicide -- Periodicals; Suicide -- Prevention -- Periodicals; Behavior -- Periodicals; Suicide -- Periodicals; 362.28
• DOI: 10.1111/sltb.12811
• Languages: English
• ISSNs: 0363-0234

Abstract

Abstract: Introduction: Little is known regarding long‐term mortality outcomes after non‐fatal suicide attempts among Veterans Health Administration (VHA) patients, which may inform services delivery and program evaluation. Methods: For 4, 601, 081 Veterans with 2005 VHA encounters, we assessed unadjusted and age‐adjusted all‐cause and cause‐specific mortality through 2017, overall and for Veterans with ( N = 8243) versus without ( N = 4, 592, 838) 2005 VHA suicide attempt documentation. Standardized mortality ratios compared mortality rates by suicide attempt status. Multivariable proportional hazards regression models assessed age‐ and gender‐adjusted mortality risk. Results: Among Veteran VHA users with non‐fatal suicide attempt diagnoses, 1.6% died of suicide, 4.6% of non‐suicide external causes, and 30.7% of any cause. In age‐ and gender‐adjusted analyses, Veterans who attempted suicide had increased suicide (hazard ratio [HR] = 4.52, 95% confidence interval [CI] = 3.82–5.36), non‐suicide external cause (HR = 3.75, 95% CI = 3.38–4.17), and all‐cause (separate due to non‐proportional hazards: 2006, HR = 2.05, 95% CI = 1.81–2.31; 2007–2017, HR = 1.72, 95% CI = 1.65–1.80) mortality through 2017. Conclusion: Over 12 years, Veteran VHA patients with non‐fatal suicide attempt diagnoses had increased risk of suicide, non‐suicide external cause, and all‐cause mortality. Over 98% of Veteran VHA users who had a diagnosed non‐fatal attempt did not die by suicide, highlighting additional program evaluation outcomes and opportunities to support physical and mental health.