An emergency department based brief intervention for veterans at risk for suicide

Reducing deaths from Veteran suicide and decreasing the burden on individuals and families due to suicidal behavior in Veterans is a public health problem both for Veterans who receive their care from the Department of Veterans Affairs (VA) and for those who receive services in community settings. Emergency Departments (ED) frequently function as the primary or sole point of contact with the health care system for suicidal individuals. Therefore, EDs represent an important venue in which to identify and treat Veterans who are at high risk for suicide.

In response to a priority recommendation from a Blue Ribbon Panel on Veteran Suicide in 2008 VA leadership called for development and implementation of an ED-based intervention for suicidal Veterans. We describe the design and implementation of an innovative brief behavioral intervention for suicidal Veterans who seek care in VA EDs. This clinical demonstration project is known as the Suicide Assessment and Follow-up Engagement: Veteran Emergency Treatment Project (SAFE VET). This initiative is designed to reduce deaths from suicide as well as mitigate suicidal behaviors in Veterans through a Veteran-focused, clinical safety plan intervention conducted in the ED, and intensive outreach protocol following discharge from the ED. T he SAFE VET project was evaluated using health services data to determine engagement with care following the intervention. This brief behavioral intervention is likely to be transferable to a wide variety of VA and non-VA settings, including community Emergency Departments and urgent care centers.