Characteristics of Veterans' Last Clinical Contact Before Suicide Attempt or Death

Death by suicide remains a critical public health issue and leading preventable cause of death in the United States, particularly among Veterans. Notably, almost half of Veterans who attempt or die by suicide engage with the healthcare system in the days and months before these events, highlighting critical points for prevention and intervention.

Utilizing the Suicide Prevention Applications Network (SPAN) database at a large Department of Veterans Affairs hospital in the Southeast, this Institutional Review Board (IRB) approved quality improvement project sought to document access and clinical care characteristics of Veterans who attempted or died by suicide over the course of a 10-year period. The data included 569 events among 497 unique Veterans (82.6% male, mean age = 45.62, SD = 15.00).

Most events were suicide attempts (88.2%), whereas the remainder were suicide deaths. Almost half of the events involved an overdose, followed by firearms. Approximately two-thirds of Veterans were seen by a healthcare provider within 30 days of the event with most of these encounters occurring outside of mental health services. Over half of the Veterans had a prior attempt history, and though most had a safety plan documented, suicide was not discussed in approximately half of the last encounters.

These findings highlight opportunities for providers to screen for and utilize suicide prevention strategies, especially in non-mental health settings. The integration of brief, low-cost interventions, including consistent safety planning and follow-up communication across healthcare settings could enhance suicide prevention efforts and better support Veterans at risk.