Association of the Veterans Crisis Line Caring Letters Project With Health Services Utilization and Health Outcomes...

Area of Science:

• Mental Health Services Research
• Suicide Prevention Interventions
• Veterans Health Administration (VHA) Studies

Background:

• The Veterans Crisis Line (VCL) provides critical support to Veterans in crisis.
• The Caring Letters (CL) intervention is an evidence-based suicide prevention program.
• Understanding the impact of CL on service utilization among at-risk Veterans is crucial.

Purpose of the Study:

• To evaluate the impact of the VCL Caring Letters (CL) intervention on Veterans' outcomes.
• To assess if CL affects service utilization in Veterans with elevated psychiatric risk.
• To determine the association of CL with mental health service use and mortality.

Main Methods:

• Secondary analysis of a randomized clinical trial involving Veterans who contacted the VCL.
• Utilized data from the Veterans Health Administration's Corporate Data Warehouse (N=186,514).
• Employed time-to-event models stratified by psychiatric risk indicators to assess CL's association with outcomes.

Main Results:

• Receipt of CL was associated with increased outpatient mental health service utilization for all Veterans.
• Among Veterans without psychiatric risk indicators, CL increased all-cause outpatient and inpatient service use.
• The CL intervention showed no significant impact on all-cause mortality for any Veteran group.

Conclusions:

• The Caring Letters (CL) intervention is linked to greater utilization of VHA services among Veterans.
• This increased service use, regardless of psychiatric risk, may indicate appropriate engagement with high-value mental health care.
• CL appears to facilitate access to VHA mental health services for Veterans in crisis.