Self-Directed Violence Surveillance in the Veterans Health Administration: A National Examination of Factors Associated with Undetermined Versus Suicide Attempt Classification.

Denneson LM, Cameron DC, Hooker ER, Laliberte AZ, Chen JI. Self-Directed Violence Surveillance in the Veterans Health Administration: A National Examination of Factors Associated with Undetermined Versus Suicide Attempt Classification. Community mental health journal. 2023 Jul 1; 59(5):954-961.

Related HSR&D Project(s)

• IIR 21-218 – Serving All Who Have Served: Enhancing Suicide-Related Care Quality for Black, Indigenous, and People of Color Veterans
• IIR 17-131 – Advancing Suicide Prevention for Female Veterans

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Abstract:

This national, observational study examined factors associated with undetermined self-directed violence (SDV) classification among Veterans with a SDV event classified as either "suicide attempt" or "undetermined SDV" in in the Veterans Health Administration (VHA) between 2013 and 2018 (N? = 55,878). Generalized estimating equations were used to examine associations of patient and SDV event factors with likelihood of an undetermined SDV classification. Veterans who used poisoning or other methods had 1.52 (95%CI: 1.38, 1.66) and 2.33 (95%CI: 2.16, 2.50) increased odds of having their SDV classified as undetermined, respectively. Veterans with a prior year substance use disorder diagnosis had 1.19 (95%CI: 1.14, 1.24) increased odds of having their SDV classified as undetermined. In sex-stratified analyses, associations of poisoning and substance use disorders held only among males. Additional clinical evaluation of patients with histories of substance use disorders or who use poisoning as method of SDV may be warranted when making SDV determinations.