Comparing Suicide Rates Across Subpopulations of Veterans Receiving Veterans Health Administration Care, 2017-2021:...

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Suicide remains a critical public health issue, particularly among veteran populations.
• The Veterans Health Administration (VHA) seeks to identify and support high-risk patient subpopulations.
• Effective suicide surveillance requires robust data and analytical tools to compare risk across diverse groups.

Purpose of the Study:

• To present suicide surveillance findings using the VHA Suicide Risk Encyclopedia.
• To identify Veteran VHA patient subpopulations with the most elevated suicide rates.
• To compare suicide rates across various demographic, diagnostic, and utilization measures.

Main Methods:

• Utilized VHA data for cohorts alive from 2016-2020 with recent VHA encounters.
• Assessed subpopulation size, suicide deaths, and suicide rates for 482 measures.
• Compared and rank-ordered subgroups by suicide rates from 2017-2021.

Main Results:

• Highest suicide rates observed in subgroups with prior suicide attempts, high-risk Veterans Crisis Line (VCL) calls, VHA suicide high-risk flags, and suicidal ideation diagnoses.
• Among measures with >=10% prevalence, elevated rates were linked to alcohol use disorder diagnoses, anxiolytic prescriptions, and certain mental health outpatient encounters.
• Identified specific high-risk VHA patient subpopulations and provided data on their size and associated suicide rates.

Conclusions:

• Findings pinpoint critical VHA patient subpopulations at higher risk for suicide.
• The VHA Suicide Risk Encyclopedia serves as a valuable population-based suicide rate comparison tool.
• Health systems can benefit from developing similar risk comparison tools for targeted suicide prevention efforts.