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Suicide Risk Significantly Higher for VHA Patients Compared to the General Population


KEY FINDINGS:

  • Suicide rates among the Veterans enrolled in the VA healthcare system during FY00 and FY01 were significantly higher than those in the general population. However, the differentials between suicide rates for VA patients and the general population were less than what might be expected given previous comparisons.
  • Overall, for men and women combined, suicide risks among Veterans were 66% higher than those observed in the general population.
  • Among male Veterans, suicide rates were highest for those aged 30-49 years and lowest among Veterans aged 18-29 and 60-69.
  • Among women Veterans, suicide rates were highest among those aged 50-59 years.
  • It is important to emphasize that this study compares a general population to users of a health care system where the prevalence of all conditions would be expected to be higher. Also, the study population precedes current conflicts in Iraq and Afghanistan.

BACKGROUND:
Understanding and reducing suicide risks among Veterans is a national concern and a major priority for VA. This study compared suicide rates among Veterans enrolled in the VA healthcare system with rates in the general population. Investigators used VA data to identify all Veterans using inpatient or outpatient services in any VA facility during FY00 or FY01, who were alive at the beginning of FY01 (total number of Veterans = 4,670,968; male Veterans = 4,200,911; women veterans = 470,057). Rates of suicide in the general population were calculated for calendar year 2001. Suicide risks for Veterans also were calculated for age and gender subgroups compared with those in the general population.

LIMITATIONS:

  • There are longstanding concerns regarding potential undercounting of suicide deaths. Research is needed to assess potential differential recording of suicide deaths by Veteran status.
  • Although investigators compared suicide rates among VA patients with those among the general population, VA patients were included in the general population.

NOTES:

  • Based on its Mental Health Strategic Plan, VHA has worked to ensure access to quality mental health services and to develop programs specifically designed to prevent suicide. For example, since 2005, VHA has added more than 3,600 mental health staff, and mental health expenditures increased from $2 billion in FY01 to $4 billion in FY08.

AUTHOR/FUNDING INFORMATION:
Authors are with VA’s Serious Mental Illness Treatment Research and Evaluation Center, which is part of HSR&D’s Center for Clinical Management Research in Ann Arbor, MI.


PubMed Logo McCarthy JF, Valenstein M, Kim HM, Ilgen M, Zivin K, Blow FC. Suicide mortality among patients receiving care in the Veterans Health Administration health system. Am J Epidemiol. 2009 Apr 15;169(8):1033-8. Epub 2009 Feb 27.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.