How Veterans Health Administration Suicide Prevention Coordinators Assess Suicide Risk

Pease, James L.; Forster, Jeri E.; Davidson, Collin L.; Holliman, Brooke Dorsey; Genco, Emma K.; Brenner, Lisa A.

doi:10.1002/cpp.2011

Cited by 13 publications

(25 citation statements)

References 18 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reductions in VA homelessness services may further complicate the VA's ability to support the mental health and recovery of these high-risk high utilizers. The VA's current suicide prevention efforts are dedicated to identification, screening and monitoring, and crisis intervention and referral (8,14). In addition to using predictive analytics and high-risk models, the VA should aim to achieve a standard level of comprehensive care for all veterans.…”

Section: Practice and Policy Implicationsmentioning

confidence: 99%

Addressing Veteran Homelessness to Prevent Veteran Suicides

Tsai

Trevisan

Huang

et al. 2018

View full text Add to dashboard Cite

The U.S. Department of Veterans Affairs (VA) is shifting its focus from ending veteran homelessness to preventing veteran suicides. With supporting data, this Open Forum argues that VA homelessness services also help address veteran suicides. Analysis of a nationally representative survey of U.S. veterans in 2015 shows that veterans with a history of homelessness attempted suicide in the previous two years at a rate >5.0 times higher compared with veterans without a history of homelessness (6.9% versus 1.2%), and their rates of two-week suicidal ideation were 2.5 times higher (19.8% versus 7.4%). Because the majority of veterans who die by suicide are not engaged in VA care, VA services for the homeless that include outreach efforts to engage new veterans may be reaching some of these veterans. Thus continued federal support for VA homelessness services not only may help address homelessness but also may help prevent suicide of veterans.

show abstract

Section: Practice and Policy Implicationsmentioning

confidence: 99%

Addressing Veteran Homelessness to Prevent Veteran Suicides

Tsai

Trevisan

Huang

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Understanding the variability in current practice has several implications for clinical practice. First, tailored educational policies and practices can be developed 17 . Formal SRA training is still limited in certain disciplines, with residency training directors expressing little confidence in their resident’s abilities to recognize and treat suicidal patients 18 .…”

mentioning

confidence: 99%

Exploring Uniformity of Clinical Judgment: A Vignette Approach to Understanding Healthcare Professionals’ Suicide Risk Assessment Practices

et al. 2022

View full text Add to dashboard Cite

Objectives: Suicide risk assessment often requires health professionals to consider a complex interplay of multiple factors, with a significant reliance on judgment, which can be influenced by factors such as education and experience. Our study aimed at assessing the uniformity of decision making around suicide risk within healthcare professionals. Methods:We used a factorial survey approach to gather information on healthcare professionals' demographics, clinical experience, and their decision on 3 vignettes of patients with suicidal ideation. We used Kruskal-Wallis tests for determining if there were significant differences between groups for continuous variables and Spearman rank correlation for measuring the association between continuous variables. Content analysis was used for analyzing free-text comments.Results: Responses were gathered from 79 healthcare professionals (nurses, nurse practitioners, physicians) who worked in primary care, mental health, or emergency department settings. Median suicide risk rates across all respondents were 90%, 50%, and 53% for vignettes 1, 2, and 3, respectively. Confidence in healthcare professionals' decisions was significantly associated with the clinical designation and personal risk profile of the healthcare professional in certain vignettes, with nurses and those willing to take more risks having a higher confidence in their decisions for vignettes 1 and 3, respectively. Treatment decision was significantly associated with mental health experience (i.e., those with lengthier mental health experiences were less likely to choose "admit to psychiatry ward" for vignette 2), clinical designation (i.e., nurses were more likely to "admit to psychiatry ward" for vignette 1), and practice setting. It should be noted that these associations were not consistent across all 3 vignettes, and results for each association were only specific to 1 of the 3 vignettes.Discussion: Findings compare decision-making practices for suicide risk assessment across several types of healthcare professions over a range of practice settings, with the high-risk vignette showing the least variability. Insights from this study are relevant when building clinical decision support systems for suicide risk assessment. Designers should think about incorporating tailored messaging and alerts to health professionals' mental health experience and/or designation.Conclusions: Within our Canadian sample, there was considerable variability among healthcare professionals assessing the risk of suicide, with important implications for tailoring education and decision support.

show abstract

“…Previous research has shown that history of suicide attempt is one of the most significant risk factors for suicide [14]. Similarly, when clinicians were asked about factors which they considered "most important" in assessing suicide risk, they weighed the presence of suiciderelated behaviors (e.g., preparatory behavior) as well as a history of attempts more heavily than other factors [15]. In fact, prior history of suicide attempt is strongly recommended as one of…”

Section: Plos Onementioning

confidence: 99%

Validation of a Computerized Adaptive Test Suicide Scale (CAT-SS) among United States Military Veterans

et al. 2022

Self Cite

View full text Add to dashboard Cite

To validate the Computerized Adaptive Test Suicide Scale (CAT-SS), Veterans completed measures at baseline (n = 305), and 6- (n = 249), and 12-months (n = 185), including the CAT-SS (median items 11, duration of administration 107 seconds) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Logistic regression was used to relate CAT-SS scores (baseline) to C-SSRS assessed outcomes (active ideation with plan and intent; attempt; interrupted, aborted or self-interrupted attempt, or preparatory acts or behaviors; all outcomes combined). A mixed-effects logistic regression model was used to evaluate the relationship between the lagged CAT-SS scores and outcomes (6- and 12-months). The baseline CAT-SS demonstrated predictive accuracy for all outcomes at 6-months, and similar results were found for baseline and all outcomes at and through 12-months. Longitudinal analysis revealed for every 10-point change in the CAT-SS there was a 50–77% increase in the likelihood of suicide-related outcomes. The CAT-SS demonstrated added value when compared to current suicide risk prediction practices.

show abstract

How Veterans Health Administration Suicide Prevention Coordinators Assess Suicide Risk

Abstract: Identifies factors that practitioners consider most important in suicide risk assessment Discusses how to distinguish between chronic and acute risk for suicide Identifies factors that lead to more consistent clinical judgments.

Cited by 13 publications

References 18 publications

Addressing Veteran Homelessness to Prevent Veteran Suicides

Addressing Veteran Homelessness to Prevent Veteran Suicides

Exploring Uniformity of Clinical Judgment: A Vignette Approach to Understanding Healthcare Professionals’ Suicide Risk Assessment Practices

Validation of a Computerized Adaptive Test Suicide Scale (CAT-SS) among United States Military Veterans

Contact Info

Product

Resources

About