Suicide Risk and Health Care Utilization Among Veterans Contacting the Veterans Crisis Line: Retrospective Cohort...

Area of Science:

• Public Health
• Mental Health Services Research
• Veterans Affairs

Background:

• The Veterans Crisis Line (VCL) is a critical resource for veterans experiencing mental health crises.
• Understanding the characteristics of VCL contacts and their association with subsequent healthcare utilization and outcomes is essential for optimizing veteran care.

Purpose of the Study:

• To examine the relationship between Veterans Crisis Line (VCL) contact characteristics and subsequent Veterans Health Administration (VHA) mental health care use, suicide-related events (SREs), and mortality.
• To analyze changes in VCL user demographics and risk profiles following service expansion.

Main Methods:

• Retrospective cohort study utilizing VCL user data and Veterans Affairs Corporate Data Warehouse records (2016-2022).
• Analysis of 365,222 unique veterans' VCL contact types, assessed suicide risk, and contact day.
• Outcomes assessed within 12 months included VHA mental health care use, emergency department visits, SREs, and mortality.

Main Results:

• High-risk VCL users and those contacting on weekends had increased likelihood of VHA mental health service use and SREs.
• Veterans using text-based VCL contact showed a lower likelihood of all-cause mortality compared to direct callers.
• Observed shifts in user demographics and risk profiles post-2016 VCL service expansion indicate broader reach and evolving needs.

Conclusions:

• The VCL plays a vital role in connecting veterans in crisis to healthcare services.
• Targeted interventions are necessary for high-risk veterans identified through VCL contacts.
• Continuous adaptation of suicide prevention strategies is crucial, informed by evolving veteran needs and VCL user characteristics.