Study Shows Methods of Suicide Differ Between Stably and Unstably Housed Veterans
Compared to stably housed Veterans, unstably housed Veterans (i.e., those who are currently homeless or at risk of being homeless) are more likely to experience suicidal ideation (0.8% vs.10%, respectively), suicide attempts (0.7% vs. 9%), and suicide. However, it is unknown whether methods of suicide differ between stably and unstably housed Veterans. This information is essential for understanding how suicide prevention strategies may need to be tailored to meet the needs of unstably housed Veterans. This study examined whether Veterans' methods of suicide varied by housing status. Investigators used existing data from 5,849,870 Veterans who were screened for housing instability in VA between October 1, 2012 and September 30, 2016, then determined date and cause of death during the study period. Using VA data, investigators also examined demographic (e.g., age, gender) and health factors (i.e., depression, alcohol use disorder, drug use disorders) related to risk for suicide.
- Across the study period, 169,221 (3%) Veterans were unstably housed. Among the 7,005 Veterans who died by suicide, 4% (n=297) were unstably housed.
- After accounting for demographic and health factors, unstably housed Veterans had an 86% increased hazard of suicide from self-poisoning from exposure to drugs and other biological substances, compared to stably housed Veterans. Unstably housed Veterans also were more than 3 times more likely to die by suicide from jumping from a height and more than 2.5 times more likely to die by suicide from unspecified means than stably housed Veterans.
- Among stably housed Veterans, nearly 3 of 4 suicides involved firearms; in contrast, for unstably housed Veterans, less than half of suicides involved firearms.
- Understanding methods of suicide can inform prevention and intervention efforts, allowing VA to tailor suicide prevention programs for unstably housed Veterans. In particular, lethal means safety efforts (i.e., counseling and public health approaches) to suicide prevention should consider unstably housed Veterans at greater risk for using different means of suicide.
- Misclassification of suicide may be amplified among unstably housed individuals, whose deaths may be more isolated and without witnesses – and who may have limited next-of-kin contacts.
- The timing of housing instability was limited to Veterans' responses to a clinical screen conducted upon presenting for VA care, which may not have been when Veterans were currently experiencing housing instability.
This work was supported by an HSR&D Career Development Award (CDA 14-408) to Dr. Blosnich and by an HSR&D Merit Award to Dr. Montgomery (IIR 13-334).
Dr. Blosnich is part of HSR&D’s Center for Health Equity, Research and Promotion (CHERP), Pittsburgh and Philadelphia, PA, and Dr. Montgomery is with the Birmingham VA Medical Center.
Blosnich JR, Monteith LL, Holliday R, Brenner LA, and Montgomery AE. Differences in Methods of Suicide among Veterans Experiencing Housing Instability, 2013-2016. Psychiatry Research. April 12, 2020; Epub ahead of print.