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Age Differences in Suicide Risk Screening and Management Prior to Suicide Attempts

  • Kelsey Simons
    Correspondence
    Send correspondence and reprint requests to Kelsey Simons, Ph.D., L.M.S.W., VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Ave., Bldg. 37A, Canandaigua, NY 14424.
    Affiliations
    VISN 2 Center of Excellence for Suicide Prevention (KS, KVO), Canandaigua VA Medical Center, Canandaigua, NY

    Department of Psychiatry (KS, KVO, KRC), University of Rochester School of Medicine and Dentistry, Rochester, NY
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  • Kimberly Van Orden
    Affiliations
    VISN 2 Center of Excellence for Suicide Prevention (KS, KVO), Canandaigua VA Medical Center, Canandaigua, NY

    Department of Psychiatry (KS, KVO, KRC), University of Rochester School of Medicine and Dentistry, Rochester, NY
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  • Kenneth R. Conner
    Affiliations
    Department of Psychiatry (KS, KVO, KRC), University of Rochester School of Medicine and Dentistry, Rochester, NY

    Department of Emergency Medicine (KRC), University of Rochester Medical Center, Rochester, NY
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  • Courtney Bagge
    Affiliations
    Department of Psychiatry and Human Behavior (CB), University of Mississippi Medical Center, Jackson, MS
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Published:January 22, 2019DOI:https://doi.org/10.1016/j.jagp.2019.01.017

      ABSTRACT

      Objective

      This study examined differences by age in suicide risk screening and clinical actions to reduce suicide risk among patients with visits to Veterans Health Administration (VHA) medical facilities in the year prior to an attempt.

      Methods

      Ninety-three VHA patient records were reviewed specific to the last visit before an attempt. Information was extracted regarding documentation of individual suicide risk factors and provider actions to reduce risk.

      Results

      The authors examined differences by patient age (≥50 versus 18–49). Older patients’ medical records were less likely to have evidence of 1) screening for impulsivity and firearms access and 2) engagement in safety planning, referrals for mental health services, and consideration of psychiatric hospitalization. General medical providers were less likely to document these risk factors and action steps in comparison with mental health clinicians.

      Conclusion

      Lethal means education and collaborative care are universal strategies that may improve identification of and lower suicide risk in older veterans.

      Key Words

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