Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115528

Katherine S. Virgo, PhD, MBA¹, Darcy R. Denner, BS¹, Nathan K. Risk, MA², Gery Ryan, PhD³, Rumi K. Price, PhD, MPE², and Jennette Piry, MEd¹. (1) Department of Surgery, Saint Louis University & Department of Veterans Affairs Medical Center, 3635 Vista at Grand Blvd, St. Louis, MO 63110-0250, (314) 289-7023, virgoks@slu.edu, (2) Department of Psychiatry, Washington University School of Medicine, 40 North Kingshighway, Suite 2, St. Louis, MO 63108, (3) RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138

Objective: Identify and compare the types of patient-based and system-based barriers and facilitators experienced by Vietnam veterans at risk for suicide when seeking care for physical,psychiatric, and substance abuse conditions. Methods: This study is based on a longitudinal sample of 494 Vietnam veterans discharged from military service in September 1971 and subsequently identified as at risk for suicide (306 low risk;188 high risk). Seventy-one percent (350) of 494 participants completed an extensive qualitative and quantitative interview covering among other topics, physical conditions, psychiatric conditions, substance use, barriers to care, facilitators of care, and quality of care. Barriers and facilitators were compared by type of condition and suicidal risk category using chi-square analysis and Fishers as appropriate. The analysis is based on 228 interviews (65 percent) with qualitative data transcribed thus far. Results: Of the 228 patients analyzed, 64 (38.1 percent) expressed self-imposed barriers to care and 35 (20.8 percent) expressed system-based barriers to care. The group at higher risk of suicide was significantly more likely (p < .05) to report patient-based barriers to care and less likely to report system-based facilitators of care-seeking. Presence of system-based barriers to care or patient-based facilitators of care-seeking did not differ significantly by suicide risk category. Conclusion: Patients at high risk of suicide are likely to have higher levels of self-perceived barriers to care that are not related to system characteristics. Targeted interventions are required to reach out to these patients and address needs for care currently unmet by the health care system.

Learning Objectives:

• Characterize and compare the types of self-perceived and system-based barriers experienced by Vietnam veterans at risk for suicide when seeking care for physical, psychiatric, and substance use conditions.

Keywords: Access to Care, Suicide

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.