Suicidal Behaviors in Homeless Older Veterans

It is well-established that the elderly have the highest suicide rate of any age group; individuals age 65 and older comprise 12% of the population but account for 16% of suicides. Several factors are known to be risk markers for suicide in the elderly, including depression, substance abuse, physical illness, decline in functional capacity, and social isolation. Veterans are over-represented in suicides across all adult age groups, representing approximately 20% of the suicides in America. Current population estimates suggest that 75,000+ veterans are homeless on any given night and perhaps twice as many experience homelessness at some point during the course of a year. A sizable and growing minority (21%) of homeless veterans are age 55 and older. Although older homeless veterans might be predicted to be especially vulnerable to suicidal behaviors as a result of nutritional, traumatic, and healthcare factors, no studies have examined suicidal behaviors in this group. In this study we examine the frequency of suicidal ideation and suicide attempts in a large sample of older homeless veterans. The analyses are based on comprehensive intake, admission, and discharge data from the largest VA housing intervention program (Grant and Per Diem) during years 2003-2009. Using data collected from 435 service providers across the nation, the sample consisted of 10,141 older veterans. Analyses specifically address the frequency of suicidal behaviors, characteristics of older homeless veterans experiencing suicidical ideation or attempting suicide, determination of predictors of suicidal behavior, impact of the presence of suicidal behaviors on housing intervention outcomes.