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

This study aimed to assess associations between characteristics of contacts with the Veterans Crisis Line (VCL) and subsequent Veterans Health Administration (VHA) mental health care use, suicide-related events (SREs), and suicide mortality from 2016 to 2023.

This retrospective cohort study used VCL user data and administrative records from the Veterans Affairs Corporate Data Warehouse for 365,222 unique veterans who contacted the VCL between January 2016 and December 2022. The authors examined relationships between VCL contact characteristics, including contact type (calls, texts, and transfers), responder-assessed suicide risk level, and day of contact, and outcomes within 12 months of VCL contact (VHA mental health care use, VHA emergency department use, SREs, all-cause mortality, and suicide-specific mortality).

High-risk users, those requiring emergency dispatch or welfare checks, and those contacting VCL on weekends were more likely than their counterparts to use mental health services and experience SREs. Users contacting the VCL by text had a lower likelihood of all-cause mortality than direct callers. Changes in user characteristics since VCL service expansion in 2016 were observed, indicating a broader demographic reach and altered risk profiles.

The findings underscore the critical role of the VCL in facilitating access to health care for veterans experiencing a crisis and the necessity of targeted interventions for high-risk groups. The evolution in VCL user profiles and contact characteristics suggests ongoing changes in veterans' needs and preferences, reinforcing the importance of continuous adaptation of suicide prevention strategies. Future evaluations should focus on longitudinal outcomes and qualitative user experiences to enhance the effectiveness of crisis intervention services for veterans.