Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3041 — Predictors of a Suicide Attempt One Year after Entry into Substance Use Disorder Treatment

Ilgen MA (Center for Health Care Evaluation) , Harris AS (Center for Health Care Evaluation), Moos RH (Center for Health Care Evaluation), Tiet QQ (Center for Health Care Evaluation)

Objectives:
Despite the high prevalence of suicide attempts in patients presenting for substance use disorder (SUD) treatment, risk factors for suicidal behavior in these patients are just beginning to be understood. The vast majority of research on suicide in treatment seeking SUD patients is cross-sectional and little is known about how patient and treatment related factors relate to subsequent suicidal behaviors. The present study examined the baseline patient characteristics and treatment-related risk factors associated with a suicide attempt in the thirty days prior to a 1-year post-treatment assessment.

Methods:
A national sample of 8,807 patients presenting for treatment of substance use disorders in the VA healthcare system were assessed at treatment intake and 12-month follow-up. The MacArthur Model of risk factor assessment was used to identify patient- and treatment-related risk and protective factors for a subsequent suicide attempt.

Results:
At follow-up, 4% (314/8,807) of the patients reported a suicide attempt within the past 30 days. Baseline predictors of a suicide attempt prior to follow-up included elevated suicidal/psychiatric symptoms, greater recent problematic alcohol use, and longer duration of cocaine use. Contact with the criminal justice system was a protective factor that reduced the likelihood of a future suicide attempt. Greater engagement in SUD treatment was also associated with a reduction in suicide risk.

Implications:
Both psychiatric symptoms and substance use were associated with a suicide attempt at follow-up. After accounting for these predictors, more involvement in SUD treatment reduced the likelihood of a future suicide attempt in high risk patients.

Impacts:
Substance use disorder treatment providers interested in reducing future suicidal behavior may want to concentrate their efforts on identifying at-risk individuals and actively engaging these patients in continuing treatment.